Brainstem raphe lesion in patients with major depressive disorder and in patients with suicidal ideation recorded on transcranial sonography.
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.
Budisic
Mislav
M
Department of Neurology, University Hospital Sestre Milosrdnice, Vinogradska Cesta 29, Zagreb, Croatia. mislavbudisic@yahoo.co.uk
Mislav
Budisic
B
Karlovic
Dalibor
D
Dalibor
Karlovic
K
Trkanjec
Zlatko
Z
Zlatko
Trkanjec
T
Lovrencic-Huzjan
Arijana
A
Arijana
Lovrencic-Huzjan
LH
Vukovic
Vlasta
V
Vlasta
Vukovic
V
Bosnjak
Jelena
J
Jelena
Bosnjak
B
Demarin
Vida
V
Vida
Demarin
D
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