Abnormal Cerebellar Volume in Patients with Remitted Major Depression with Persistent Cognitive Deficits
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ORIGINAL ARTICLE
Abnormal Cerebellar Volume in Patients with Remitted Major Depression with Persistent Cognitive Deficits Malte S. Depping 1 & Mike M. Schmitgen 1 & Claudia Bach 1 & Lena Listunova 1 & Johanna Kienzle 1 & Katharina M. Kubera 1 & Daniela Roesch-Ely 1 & R. Christian Wolf 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Cerebellar involvement in major depressive disorder (MDD) has been demonstrated by a growing number of studies, but it is unknown whether cognitive functioning in depressed individuals is related to cerebellar gray matter volume (GMV) abnormalities. Impaired attention and executive dysfunction are characteristic cognitive deficits in MDD, and critically, they often persist despite remission of mood symptoms. In this study, we investigated cerebellar GMV in patients with remitted MDD (rMDD) that showed persistent cognitive impairment. We applied cerebellum-optimized voxel-based morphometry in 37 patients with rMDD and with cognitive deficits, in 12 patients with rMDD and without cognitive deficits, and in 36 healthy controls (HC). Compared with HC, rMDD patients with cognitive deficits had lower GMV in left area VIIA, crus II, and in vermal area VIIB. In patients with rMDD, regression analyses demonstrated significant associations between GMV reductions in both regions and impaired attention and executive dysfunction. Compared with HC, patients without cognitive deficits showed increased GMV in bilateral area VIIIB. This study supports cerebellar contributions to the cognitive dimension of MDD. The data also point towards cerebellar area VII as a potential target for non-invasive brain stimulation to treat cognitive deficits related to MDD. Keywords Magnetic resonance imaging . Major depressive disorder . Cerebellum . Cerebellar gray matter . Attention . Executive function
Introduction Cognitive dysfunction is a highly relevant symptom domain in major depressive disorder (MDD), affecting about twothirds of acutely depressed patients [1]. In patients with MDD, cognitive impairment independently mediates functional outcomes, e.g., workforce performance [2]. Cognitive dysfunction in depression typically includes deficits of attention and executive functions [1, 3]. Importantly, in 30–50% of patients with MDD, cognitive dysfunction persists despite remission of mood symptoms [1, 4]. If persistent in remitted Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12311-020-01157-z) contains supplementary material, which is available to authorized users. * R. Christian Wolf [email protected] 1
Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Vossstr. 4, 69115 Heidelberg, Germany
individuals with MDD, such impairments may mediate an increased risk of major depression relapse [5–7]. Cognitive dysfunction in MDD is difficult to treat with little evidence for procognitive effects of antidepressant medication [8]. Non-pharmacological interventions, such as cog
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