Elsevier

Biological Psychiatry

Volume 59, Issue 8, 15 April 2006, Pages 702-706
Biological Psychiatry

Original article
Smaller Cingulate Volumes in Unipolar Depressed Patients

https://doi.org/10.1016/j.biopsych.2005.10.011Get rights and content

Background

The anterior cingulate cortex is a key structure in brain networks involved in mood regulation. Abnormalities in this brain region are possibly implicated in the pathophysiology of depression. This anatomical magnetic resonance imaging (MRI) study compared cingulate cortex volumes in unipolar depressed patients and age- and gender-matched healthy control subjects.

Methods

Thirty-one unmedicated DSM-IV unipolar patients (24 female, aged 39.2 ± 11.9 years [mean ± SD]) and 31 healthy control subjects (24 female, aged 36.7 ± 10.7 years) were studied in a 1.5-T GE Signa magnet (General Electric Medical Systems, Milwaukee, Wisconsin). Cingulate volumes were compared by analysis of covariance with intracranial volume as the covariate.

Results

The unipolar patients had significantly smaller anterior and posterior cingulate volumes bilaterally compared with healthy control subjects. When patients were divided into currently depressed (n = 21) and remitted (n = 10) subgroups, currently depressed patients had significantly smaller anterior and posterior cingulate volumes bilaterally compared with healthy control subjects, whereas remitted patients had significantly smaller left anterior cingulate volumes compared with healthy individuals.

Conclusions

Gray matter abnormalities in the cingulate cortex are implicated in the pathophysiology of unipolar depression. Smaller cingulate volumes in currently depressed patients support the hypothesis that cingulate cortex abnormalities are state dependent, whereas changes in left anterior cingulate might be trait related.

Section snippets

Subjects

Thirty-one unipolar patients (24 female, 7 male, aged 18–58 years [mean ± SD, 39.2 ± 11.9 years]) were recruited from the outpatient clinics of the Department of Psychiatry, University of Pittsburgh Medical Center, or through advertisements in the local community. All patients met DSM-IV diagnostic criteria for current or past major depressive disorder, as determined by the Structured Clinical Interview for DSM-IV (SCID; Spitzer et al 1994). Exclusion criteria were other Axis I psychiatric

Results

The unipolar patients did not differ significantly from the healthy control subjects in terms of age, gender, race, and education (Table 1).

The unipolar patient group had significantly smaller mean cingulate cortex volumes for both anterior and posterior regions, bilaterally, compared with the healthy control group (Table 2).

There were no significant relationships between cingulate volumes and clinical variables (age at onset, length of illness, and HDRS scores) after Bonferroni adjustment.

Discussion

Our findings showed significantly smaller cingulate cortex volumes in unipolar patients compared with healthy control subjects. This is in agreement with previous MRI studies (Ballmaier et al 2004, Botteron et al 2002, Drevets et al 1997). Moreover, postmortem studies in unipolar patients demonstrated neuronal soma size reduction and neuronal density increase in the anterior cingulate (Chana et al 2003, Cotter et al 2001, Ongur et al 1998, Rajkowska et al 1999).

These MRI findings are in line

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      All β coefficients reflect standardized regression weights. Although previous studies that reported reductions in ACC volume in depression compared to controls have generally utilized a diagnosis of MDD (Ballmaier et al., 2004; Botteron et al., 2002; Caetano et al., 2006; Coryell et al., 2005; Drevets et al., 1997; Hastings et al., 2004; Lavretsky et al., 2007) or, in the case of the ENIGMA studies, the Beck Depression Inventory or Hamilton Depression Rating Scale (Han et al., 2020), our study indicates that there is a significant relationship between severity of self-reported depressive symptoms and right ACC size in a large sample that includes individuals with a broad range of depressive symptomatology. Thus, by using a different design and larger sample size, the current study complements the findings of prior reports and suggests that a negative association between ACC volume and depressive symptoms can be observed even in individuals who are not formally diagnosed with MDD but who, nevertheless, report depressive symptoms.

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