Voxel Based Morphometry In Patients With Psychotic Versus Non Psychotic Depression

Study Overview
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Brief Summary
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To examine structural brain changes in patients with depression measured using voxel based morphometry(VBM) in comparison with healthy subjects. Relation between grey mater volume (GMV) and other structural changes, and the severity of clinical symptoms. To study if there is structural brain difference between psychotic and non-psychotic depression

Detailed Description
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Depression is a major psychiatric disorder and a leading cause of disability worldwide. The clinical representation encompasses affective, cognitive and somatic complains such as low mood, anxiety, lack of pleasure and interest, disturbances of sleep and appetite, decreased self-esteem, thoughts of guilt, hopelessness, and even suicide. Major depressive disorder (MDD) with psychotic features (psychotic depression) is a severe disorder with a lifetime prevalence of 0.35-1% . Over the last decades, increasing evidence from post-mortem studies and in vivo studies emerged that mood disorder can induce structural and morphometric changes of the brain The development of magnetic resonance imaging (MRI) has allowed for more advanced structural imaging Several structural magnetic resonance imaging (s MRI) studies have identified key brain areas involved in MDD. In particular, voxel-based morphometry (VBM), it is helpful in quantitatively identifying unexpected anatomic changes studies have found that MDD is associated with widespread local brain abnormalities, mainly affecting the frontal gyrus, insula, temporal lobes and anterior cingulate gyrus . Structural white matter alterations have also been reported within the inferior parietal lobule and frontal gyrus . Many studies are positive about grey matter (GM) volume reductions in various cortical regions in depressed patients compared to healthy controls . The most consistent findings appear to be related to GM loss in medial frontal cortex (MFC), anterior cingulate cortex (ACC) and orbitofrontal cortex (OFC) with less evidence about subcortical structures such as the amygdala and the hippocampus .

Official Title
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Voxel Based Morphometry In Patients With Psychotic Versus Non Psychotic Depression

Conditions
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Psychotic Depression, Non Psychotic Depression

Intervention / Treatment
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* Radiation: MRI Voxel based morphometry


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 18-60 years old. Based on DSM5 Criteria: MDD with or without psychotic features. Exclusion Criteria: 1 • Patients under 18 years old or above 60 2• Pregnant or lactating women. 3• Other current or past major psychiatric disorders 4• History or concurrent neurological disease(seizures) or prior head trauma with evidence of consequent cognitive impairment. 5• First degree family history of schizophrenia if the participant is less than 33 years old (mean age of onset of schizophrenia plus two standard deviations) to exclude possible prodromal phase of schizophrenia. 6• Unstable medical condition (i.e., any active illness that may affect the brain as blood dyscrasis, lymphomas, endocrinopathies, renal failure, chronic obstructive lung disease, systemic autoimmune disorders or Malignancy). 7• Patients being treated with steroids or hormonal therapy . 8• Current substances or alcohol use disorders (past diagnosis allowed if in remission for more than 6 months 9• Contraindications for MRI as: Metal implants or paramagnetic objects contained within the body (including heart pacemaker or surgical prosthesis) Claustrophobia significant enough to interfere with MRI 10• Refusal of informed consent

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Radiation: MRI Voxel based morphometry|Voxel based morphometry through analysis of 3D T1 weighted sequence to assess total intracranial volume. All participants were scanned on the 1.5Tesla MR scanner (Achieva, Philips Medical Systems, Best, NL) with a 16-channel head coil at the diagnostic radiology department.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Study the structural brain changes in different areas in patients with psychotic depression and non-psychotic depression. | Investigators will use MRI the voxel based morphometry to measure the volume of different areas in grey and white matter in depressed patients and compare them to structure of brain in healthy group. | one year | 
| Examine different variables related to major depressive disorder and their specific relation to structural changes in different areas in brain | Investigators will measure the changes occur in volume of different areas in brain with different types of depression. Investigators will measure the changes in volume of different areas in brain which occur by the effect of psychotic features. Investigators will measure the effect of suicide on changes of volume of different areas of brain. | one year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Depression, Psychotic depression, Voxel based morphometry