Ventricular volume, white matter alterations and outcome of major depression and their relationship to endocrine parameters – A pilot study

Abstract

Objectives

Brain morphology and its relation to endocrine parameters were examined, in order to determine the link of these parameters to treatment outcome to psychopharmacological treatment in depressed patients.

Methods

We examined the potentially predictive value of Magnetic Resonance Imaging (MRI) parameters related to mineralocorticoid receptor (MR) function on the treatment outcome of depression. 16 inpatients with a major depressive episode (MDE) were studied at baseline and 14 of them approximately six weeks later. Physiological biomarkers and 3-T-structural MRI based volume measures, using FreeSurfer 6.0 software, were determined.

Results

Non-responders (<50% reduction of HAMD-21; n = 6) had a significantly smaller volume of the right anterior cingulate cortex, a significantly larger ventricle to brain ratio (VBR) and third ventricle volume, and smaller volumes of the central and central-anterior corpus callosum (CC) in comparison to responders (n = 7; all p ≤ 0.05). Correlational analysis (Spearman) demonstrated that larger ventricle volume was correlated to a worse treatment outcome, higher body mass index (BMI) and smaller CC segment volume, whereas the total CC volume was negatively correlated to the saliva aldosterone/cortisol concentration ratio (AC-ratio).

Conclusion

Large ventricular volume may be a predictive marker for worse treatment response to standard antidepressant treatment, potentially via compression of white matter structures. A mediating role of the previously identified markers BMI and the AC-ratio, is suggested.

Keywords:

• Depression
• brain imaging
• ventricular volume
• choroid plexus
• corpus callosum

Acknowledgements

The hormone analyses were supported by Slovak grant agency [APVV-15-0388].

Disclosure statement

Harald Murck worked in the past for several pharmaceutical companies, including Acorda Therapeutics, Ardsley, New York and Axovant, New York City, NY, USA. He is currently the owner of the consulting company Murck-Neuroscience and holds a patent in the area of depression treatment. Carsten Konrad received fees for an educational programme from Aristo Pharma, Janssen-Cilag, Lilly, MagVenture, Servier, and Trommsdorff as well as travel support and speakers honoraria from Aristo Pharma, Janssen-Cilag, Lundbeck, Neuraxpharm and Servier. Tilo Kircher received unrestricted educational grants from Servier, Janssen, Recordati, Aristo, Otsuka, Neuraxpharm. For the remaining authors, there are no conflicts of interest.

Additional information

Funding

The hormone analyses were supported by Slovak grant agency [APVV-15-0388].