ParticipantsKenneth T. Wengler, MS, Stony Brook, NY (Abstract Co-Author) Nothing to Disclose
Kwan Y. Chen, MD, Nesconset, NY (Presenter) Nothing to Disclose
Christine DeLorenzo, PhD, Stony Brook, NY (Abstract Co-Author) Nothing to Disclose
Mark E. Schweitzer, MD, Stony Brook, NY (Abstract Co-Author) Consultant, MMI Medical Metrics; Consultant, MCRA; Data Safety Monitoring Board, Histogenics Corporation; Data Safety Monitoring Board, Genae Americas Inc; Data Safety Monitoring Board, Premia Spine; Data Safety Monitoring Board, NeoCart;
Turhan Canli, Stony Brook, NY (Abstract Co-Author) Nothing to Disclose
Xiang He, PhD, Stony Brook, NY (Abstract Co-Author) Consultant, Endo International plc
kenneth.wengler@stonybrook.edu
PURPOSEMajor depressive disorder (MDD) is the most prevalent and disabling form of depression. Blood-brain barrier (BBB) disruption has been implicated in the development and progression of MDD. The purpose of this study was to investigate differences in BBB integrity between patients with MDD and healthy subjects using the recently developed Intrinsic Diffusivity Encoding of Arterial Labeled Spins (IDEALS) MRI technique.
METHOD AND MATERIALS14 healthy subjects and 14 MDD patients were recruited with IRB approval and informed consent. Depression symptom severity was assessed with the Beck's Depression Index (demographics in Table 1). All studies were performed on a Siemens 3T Prisma MRI with 64-channel head/neck coil. IDEALS images were acquired according to (Wengler et al. NeuroImage, 2019) for mapping of cerebral blood flow (CBF), water extraction fraction (Ew), and water permeability (PSw). High resolution T1w images were acquired for segmentation and spatial normalization. Four regions of interest (ROIs) implicated in MDD were evaluated: anterior cingulate cortex (ACC), amygdala, dorsolateral prefrontal cortex (DLPFC), and hippocampus. ROIs were selected using WFU Pickatlas. Analysis of covariance (ANCOVA) was used to evaluate group differences between BBB water permeability parameters within the 4 ROIs while controlling for age and gender; p < 0.05 was considered significant.
RESULTSFigure 1 displays the group averaged IDEALS parameter maps. Box plots with individual data points for PSw, Ew, and CBF within ROIs are shown in Figure 2. Figure 3 displays the mean values after adjusting for age and gender. No significant differences in CBF between healthy subjects and MDD patients were. Significantly lower Ew was observed in the amygdala, ACC, DLPFC, and hippocampus of MDD patients compared to healthy subjects. Significantly lower PSw was observed in the amygdala and hippocampus of MDD patients compared to healthy subjects.
CONCLUSIONWith active trans-membrane water cycling pathways, such as NaK-ATPase, accounting for a large fraction of water exchange, the lower BBB water permeability observed in MDD patients suggests BBB disruption and cerebral metabolic deficits.
CLINICAL RELEVANCE/APPLICATIONDespite its societal impact, the mechanisms underlying major depressive disorder (MDD) are not well understood. This study uses the IDEALS MRI method to probe BBB water permeability disruption in MDD.