title: Voxel-based morphometry study of the insular cortex in female patients with current and remitted depression.
abstract: OBJECTIVE
  Women are more prone to major depressive disorders (MDDs) and the incidence of MDD in women is almost twice that of men. Insular cortex abnormalities are a common finding in neuroanatomical studies of patients with MDD. However, it remains largely unclear whether female MDD patients at different clinical stages show morphologic changes in a specific subregion of the insular cortex. Additionally, it is not understood if any subregion changes can be used as a state or trait marker of MDD, and whether the diagnostic performance of any marker is sufficient to identify MDD.
  
  
  METHODS
  Nineteen right-handed current MDD (cMDD) female patients and 19 remitted MDD (rMDD) patients, as well as 19 healthy controls matched for age and educational level, were recruited into the study. By means of voxel-based morphometry (VBM), we investigated gray matter volume abnormalities in insular subregions among the three groups and further conducted region-of-interest (ROI)-based receiver operating characteristic (ROC) analyses. The data from these investigations were correlated with clinical data to confirm the effectiveness of the identified changes in the subregions in differentiating the three groups.
  
  
  RESULTS
  Both the cMDD and rMDD groups showed significantly decreased gray matter volumes in the left dorsal anterior insula compared to the healthy controls. The cMDD groups also showed decreased gray matter volumes in the right dorsal anterior insula relative to healthy controls. Further ROC comparisons demonstrated that the left dorsal anterior insula can effectively differentiate cMDD and rMDD groups from healthy controls.
  
  
  CONCLUSIONS
  Our findings suggest that the volume changes in the left dorsal anterior insular cortex may be a trait-related marker of vulnerability to MDD and that the right dorsal anterior insular cortex may involve pathological changes of MDD.
authors.affiliation: Department of Radiology, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Beijing Key Laboratory of Mental Disorders, Department of Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China.
authors.forename: C-H
authors.initials: CH
authors.lastname: Liu
authors.affiliation: Department of Radiology, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China.
authors.forename: B
authors.initials: B
authors.lastname: Jing
authors.affiliation: Beijing Key Laboratory of Mental Disorders, Department of Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Center of the Treatment in Depressive Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Center of Schizophrenia, Beijing Institute for Brain Disorders, Laboratory of Brain Disorders, Capital Medical University, Ministry of Science and Technology, Beijing 100069, China. Electronic address: maxinanding@vip.163.com.
authors.forename: X
authors.initials: X
authors.lastname: Ma
authors.affiliation: State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China.
authors.forename: P-F
authors.initials: PF
authors.lastname: Xu
authors.affiliation: Department of Radiology, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Beijing Key Laboratory of Mental Disorders, Department of Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China.
authors.forename: F
authors.initials: F
authors.lastname: Li
authors.affiliation: Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China; Beijing Key Laboratory of Neuromodulation, Capital Medical University, Beijing 100053, China.
authors.forename: Y-P
authors.initials: YP
authors.lastname: Wang
authors.affiliation: Beijing Key Laboratory of Mental Disorders, Department of Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Center of the Treatment in Depressive Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China.
authors.forename: L-R
authors.initials: LR
authors.lastname: Tang
authors.affiliation: Beijing Key Laboratory of Mental Disorders, Department of Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China.
authors.forename: Y-J
authors.initials: YJ
authors.lastname: Wang
authors.affiliation: School of Biomedical Engineering, Capital Medical University, Beijing 100069, China. Electronic address: haiyunli@ccmu.edu.cn.
authors.forename: H-Y
authors.initials: HY
authors.lastname: Li
authors.affiliation: Beijing Key Laboratory of Mental Disorders, Department of Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Center of Schizophrenia, Beijing Institute for Brain Disorders, Laboratory of Brain Disorders, Capital Medical University, Ministry of Science and Technology, Beijing 100069, China.
authors.forename: C-Y
authors.initials: CY
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002540:Cerebral Cortex / Q000473:pathology*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D036421:Nerve Fibers, Unmyelinated / Q000473:pathology; D009929:Organ Size; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D055815:Young Adult
keywords: insular cortex; magnetic resonance imaging; major depressive disorder; voxel-based morphometry