Mapping the Relationship of White Matter Lesions to Depression in Multiple Sclerosis.

Autor: Baller EB; Penn Lifespan Informatics and Neuroimaging Center, Philadelphia, Pennsylvania; Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania., Sweeney EM; Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania., Cieslak M; Penn Lifespan Informatics and Neuroimaging Center, Philadelphia, Pennsylvania; Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania., Robert-Fitzgerald T; Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania., Covitz SC; Penn Lifespan Informatics and Neuroimaging Center, Philadelphia, Pennsylvania; Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania., Martin ML; Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania., Schindler MK; Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania; Center for Neuroinflammation and Neurotherapeutics, University of Pennsylvania, Philadelphia, Pennsylvania., Bar-Or A; Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania; Center for Neuroinflammation and Neurotherapeutics, University of Pennsylvania, Philadelphia, Pennsylvania., Elahi A; Department of Information Services, University of Pennsylvania, Philadelphia, Pennsylvania., Larsen BS; Penn Lifespan Informatics and Neuroimaging Center, Philadelphia, Pennsylvania; Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania., Manning AR; Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania., Markowitz CE; Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania; Center for Neuroinflammation and Neurotherapeutics, University of Pennsylvania, Philadelphia, Pennsylvania., Perrone CM; Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania; Center for Neuroinflammation and Neurotherapeutics, University of Pennsylvania, Philadelphia, Pennsylvania., Rautman V; Department of Information Services, University of Pennsylvania, Philadelphia, Pennsylvania., Seitz MM; Penn Lifespan Informatics and Neuroimaging Center, Philadelphia, Pennsylvania; Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania; Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania., Detre JA; Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania., Fox MD; Center for Brain Circuit Therapeutics, Department of Neurology, Psychiatry, and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Shinohara RT; Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania; Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, Pennsylvania., Satterthwaite TD; Penn Lifespan Informatics and Neuroimaging Center, Philadelphia, Pennsylvania; Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania; Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: sattertt@pennmedicine.upenn.edu.
Jazyk: angličtina
Zdroj: Biological psychiatry [Biol Psychiatry] 2024 Jun 15; Vol. 95 (12), pp. 1072-1080. Date of Electronic Publication: 2023 Nov 18.
DOI: 10.1016/j.biopsych.2023.11.010
Abstrakt: Background: Multiple sclerosis (MS) is an immune-mediated neurological disorder, and up to 50% of patients experience depression. We investigated how white matter network disruption is related to depression in MS.
Methods: Using electronic health records, 380 participants with MS were identified. Depressed individuals (MS+Depression group; n = 232) included persons who had an ICD-10 depression diagnosis, had a prescription for antidepressant medication, or screened positive via Patient Health Questionnaire (PHQ)-2 or PHQ-9. Age- and sex-matched nondepressed individuals with MS (MS-Depression group; n = 148) included persons who had no prior depression diagnosis, had no psychiatric medication prescriptions, and were asymptomatic on PHQ-2 or PHQ-9. Research-quality 3T structural magnetic resonance imaging was obtained as part of routine care. We first evaluated whether lesions were preferentially located within the depression network compared with other brain regions. Next, we examined if MS+Depression patients had greater lesion burden and if this was driven by lesions in the depression network. Primary outcome measures were the burden of lesions (e.g., impacted fascicles) within a network and across the brain.
Results: MS lesions preferentially affected fascicles within versus outside the depression network (β = 0.09, 95% CI = 0.08 to 0.10, p < .001). MS+Depression patients had more lesion burden (β = 0.06, 95% CI = 0.01 to 0.10, p = .015); this was driven by lesions within the depression network (β = 0.02, 95% CI = 0.003 to 0.040, p = .020).
Conclusions: We demonstrated that lesion location and burden may contribute to depression comorbidity in MS. MS lesions disproportionately impacted fascicles in the depression network. MS+Depression patients had more disease than MS-Depression patients, which was driven by disease within the depression network. Future studies relating lesion location to personalized depression interventions are warranted.
(Copyright © 2023 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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