Hospital.Help

Berlin – In patients with depression, cognitive symptoms are significantly associated with loss of white matter microstructure. It could be a target for new therapies that are specifically aimed at cognitive deficits, researchers suggested today at the annual congress of the German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology (DGPPN).

Cognitive symptoms are a major cause of impairment in depression and worsen as the disease progresses. Susanne Meinert from the Institute for Translational Psychiatry at the University Hospital of Münster reported that the treatment of these symptoms is made more difficult, among other things, by the fact that the mechanisms underlying the cognitive deficits have not yet been sufficiently understood.

But “cross-sectional studies suggest that changes in white matter microstructure may contribute to cognitive symptoms,” she added. At the DGPPN Congress, the scientist from Münster presented what she said was the most comprehensive longitudinal data set to date on the complex relationship between white matter, cognitive symptoms and disease progression in depression.

Analysis of data from Marburg and Münster

Meinert’s research group analyzed data from the Marburg-Münster Affective Disorder Cohort Study (MACS). For 881 people, 418 with depression and 463 healthy controls, images from diffusion-weighted magnetic resonance imaging (MRI), a neuropsychological test battery and detailed clinical data with 2-year follow-up measurements were available.

When comparing cognitive symptoms between participants with and without depression, they found that patients with depression had more cognitive deficits than healthy controls regardless of time point (p<0.001; sr²=0.032). The diffusion-weighted MRI images also showed a greater decrease in the microstructure of the white matter over time in the patients with depression than in the controls (ptfce-FWE=0.026; sr²=0.002).

In both groups, an increase in cognitive symptoms was significantly associated with loss of white matter microstructure over time (ptfce-FWE <0.001; sr²=0.003). Changes in white matter microstructure and adverse depressive illness outcome independently predicted more cognitive deficits at follow-up in the MACS study.

“Our results highlight the critical role of white matter microstructure and disease progression in depression-related cognitive symptoms, making both priority targets for future therapeutic development,” Meinert concluded. © nec/aerzteblatt.de