title: Brainstem raphe lesion in patients with major depressive disorder and in patients with suicidal ideation recorded on transcranial sonography.
abstract: Recent transcranial sonography (TCS) studies showed that disruption of echogenic midbrain line, corresponding to basal limbic system and raphe nuclei (RN) within, might represent functional marker for the development of depression. Major depressive disorder (MDD) is one of the most common psychiatric disorders associated with suicidal ideation. We initiated this study to assess the usefulness of TCS recording in a group of MDD patients and in MDD patients who also reported suicidal ideation, on the assumption that TCS might serve as a screening method for differentiating patients at risk of suicide. Altogether 71 subjects: 17 patients with MDD, 14 patients with MDD who also reported suicidal ideation and 40 healthy controls, were studied using TCS by two independent physicians. Reduced raphe echogenicity was found in 8 of 17 (47%) of the patients with MDD but only in 6 of 40 (15%) controls. In patients with suicidal ideations that finding was even more pronounced (12 of 14, 86%) with the highest frequency of completely not visible TCS RN finding (10 of 14, 72%). Data showed that altered echogenicity of the RN is frequent in patients with suicidal ideation. Normal RN echogenicity in MDD patients was associated with less severe depressive symptoms and rarely with the presence of suicidal ideations. As far as we know, these are the first ever obtained results which show that TCS might help differentiating MDD patients with suicidal risk or eventually predict good disease recovery based on the findings of RN hypo- or normoechogenicity.
authors.affiliation: Department of Neurology, University Hospital Sestre Milosrdnice, Vinogradska Cesta 29, Zagreb, Croatia. mislavbudisic@yahoo.co.uk
authors.forename: Mislav
authors.initials: M
authors.lastname: Budisic
authors.forename: Budisic
authors.initials: B
authors.lastname: Mislav
authors.forename: Dalibor
authors.initials: D
authors.lastname: Karlovic
authors.forename: Karlovic
authors.initials: K
authors.lastname: Dalibor
authors.forename: Zlatko
authors.initials: Z
authors.lastname: Trkanjec
authors.forename: Trkanjec
authors.initials: T
authors.lastname: Zlatko
authors.forename: Arijana
authors.initials: A
authors.lastname: Lovrencic-Huzjan
authors.forename: Lovrencic-Huzjan
authors.initials: LH
authors.lastname: Arijana
authors.forename: Vlasta
authors.initials: V
authors.lastname: Vukovic
authors.forename: Vukovic
authors.initials: V
authors.lastname: Vlasta
authors.forename: Jelena
authors.initials: J
authors.lastname: Bosnjak
authors.forename: Bosnjak
authors.initials: B
authors.lastname: Jelena
authors.forename: Vida
authors.initials: V
authors.lastname: Demarin
authors.forename: Demarin
authors.initials: D
authors.lastname: Vida
mesh_terms: D000328:Adult; D003865:Major Depressive Disorder / Q000150:complications / Q000000981:diagnostic imaging / Q000523:psychology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011903:Raphe Nuclei / Q000000981:diagnostic imaging* / Q000473:pathology*; D018709:Statistics, Nonparametric; D013405:Suicide / Q000523:psychology*; D014057:Tomography, X-Ray Computed / Q000379:methods; D017585:Ultrasonography, Doppler, Transcranial