Association of disease course and brain structural alterations in major depressive disorder

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung


  • Hannah Lemke - , Westfälische Wilhelms-Universität Münster (Autor:in)
  • Lina Romankiewicz - , Westfälische Wilhelms-Universität Münster (Autor:in)
  • Katharina Förster - , Westfälische Wilhelms-Universität Münster (Autor:in)
  • Susanne Meinert - , Westfälische Wilhelms-Universität Münster (Autor:in)
  • Lena Waltemate - , Westfälische Wilhelms-Universität Münster (Autor:in)
  • Stella M. Fingas - , Westfälische Wilhelms-Universität Münster (Autor:in)
  • Dominik Grotegerd - , Westfälische Wilhelms-Universität Münster (Autor:in)
  • Ronny Redlich - , Westfälische Wilhelms-Universität Münster, Martin-Luther-Universität Halle-Wittenberg (Autor:in)
  • Katharina Dohm - , Westfälische Wilhelms-Universität Münster (Autor:in)
  • Elisabeth J. Leehr - , Westfälische Wilhelms-Universität Münster (Autor:in)
  • Katharina Thiel - , Westfälische Wilhelms-Universität Münster (Autor:in)
  • Verena Enneking - , Westfälische Wilhelms-Universität Münster (Autor:in)
  • Katharina Brosch - , Philipps-Universität Marburg (Autor:in)
  • Tina Meller - , Philipps-Universität Marburg (Autor:in)
  • Kai Ringwald - , Philipps-Universität Marburg (Autor:in)
  • Simon Schmitt - , Philipps-Universität Marburg (Autor:in)
  • Frederike  Stein - , Philipps-Universität Marburg (Autor:in)
  • Olaf Steinsträter - , Philipps-Universität Marburg (Autor:in)
  • Jochen Bauer - (Autor:in)
  • Walter Heindel - , Westfälische Wilhelms-Universität Münster (Autor:in)
  • Andreas Jansen - , Philipps-Universität Marburg (Autor:in)
  • Axel Krug - , Philipps-Universität Marburg, Universität Bonn (Autor:in)
  • Igor Nenadic - , Philipps-Universität Marburg (Autor:in)
  • Tilo Kircher - , Philipps-Universität Marburg (Autor:in)
  • Udo Dannlowski - , Westfälische Wilhelms-Universität Münster (Autor:in)


Introduction: The investigation of disease course-associated brain structural alterations in Major Depressive Disorder (MDD) have resulted in heterogeneous findings, possibly due to low reliability of single clinical variables used for defining disease course. The present study employed a principal component analysis (PCA) on multiple clinical variables to investigate effects of cumulative lifetime illness burden on brain structure in a large and heterogeneous sample of MDD patients. 

Methods: Gray matter volumes (GMV) was estimated in n = 681 MDD patients (mean age: 35.87 years; SD = 12.89; 66.6% female) using voxel-based-morphometry. Five clinical variables were included in a PCA to obtain components reflecting disease course to associate resulting components with GMVs. 

Results: The PCA yielded two main components: Hospitalization reflected by patients' frequency and duration of inpatient treatment and Duration of Illness reflected by the frequency and duration of depressive episodes. Hospitalization revealed negative associations with bilateral dorsolateral prefrontal cortex (DLPFC) and left insula volumes. Duration of Illness showed significant negative associations with left hippocampus and right DLPFC volumes. Results in the DLPFC and hippocampus remained significant after additional control for depressive symptom severity, psychopharmacotherapy, psychiatric comorbidities, and remission status. 

Conclusion: This study shows that a more severe and chronic lifetime disease course in MDD is associated with reduced volume in brain regions relevant for executive and cognitive functions and emotion regulation in a large sample of patients representing the broad heterogeneity of MDD disease course. These findings were only partly influenced by other clinical characteristics (e.g., remission status, psychopharmacological treatment).


Seiten (von - bis)441-451
FachzeitschriftDepression and Anxiety
Frühes Online-Datum29 Apr. 2022
PublikationsstatusVeröffentlicht - Mai 2022
Extern publiziertJa

Externe IDs

PubMed 35485921


Ziele für nachhaltige Entwicklung


  • disease course, dorsolateral prefrontal cortex, hippocampus, insula, major depressive disorder, structural neuroimaging, Reproducibility of Results, Gray Matter, Humans, Magnetic Resonance Imaging/methods, Male, Disease Progression, Depressive Disorder, Major/diagnostic imaging, Brain/diagnostic imaging, Adult, Female