Citation

Hassan TA, Elkholy SF, Mahmoud BE, ElSherbiny M. Egyptian Journal of Radiology and Nuclear Medicine 2019; 50(1).

Copyright

(Copyright © 2019)

DOI

10.1186/s43055-019-0033-8

PMID

unavailable

Abstract

BACKGROUND: Multiple sclerosis is one of the commonest causes of neurological disability in middle-aged and young adults. Depression in MS patients can compromise cognitive functions, lead to suicide attempts, impair relationships and reduce compliance with disease-modifying treatments. The aim of this study was to investigate and compare the microstructural changes in the white matter tracts of the limbic system in MS patients with and those without depressive manifestations using a diffusion tensor imaging (DTI) technique.

METHODS: This study included 40 patients who were divided into three groups. Group 1 comprised of 20 patients with relapsing-remitting MS with depressive symptoms and group 2 comprised 10 MS patients without symptoms of depression. The third group is a control group that included 10 age-matched healthy individuals. All patients underwent conventional MRI examinations and DTI to compare the fractional anisotropy (FA) values in the white matter tracts of the limbic system.

RESULTS: We compared the DTI findings in MS patients with and those without depressive symptoms. It was found that patients with depression and MS exhibited a significant reduction in the FA values of the cingulum (P < 0.0111 on the right and P < 0.0142 on the left), uncinate fasciculus (P < 0.0001 on the right and P < 0.0076 on the left) and the fornix (P < 0.0001 on both sides). No significant difference was found between the FA values of the anterior thalamic radiations in both groups.

CONCLUSION: Patients with depression and MS showed more pronounced microstructural damage in the major white matter connections of the limbic pathway, namely, the uncinate fasciculus, cingulum and fornix. These changes can be detected by DTI as decreased FA values in depressed MS patients compared to those in non-depressed patients. © 2019, The Author(s).

Language: en

Keywords

adult; human; Depression; female; male; depression; white matter; Multiple sclerosis; comparative study; controlled study; clinical article; priority journal; multiple sclerosis; limbic system; Article; structure analysis; diffusion tensor imaging; Limbic system; fractional anisotropy; uncinate fasciculus; brain fornix; brain radiation; cingulum (brain); Diffusion tensor imaging; thalamus anterior nucleus