Background

Persons with multiple sclerosis (PwMS) are at an elevated risk of depression. Decreased Conscientiousness may affect patient outcomes in PwMS. Low Conscientiousness has a strong correlation with depression. Previous work has also reported that white matter (WM) tract disruption in frontal–parietal networks explains reduced Conscientiousness in PwMS.

Objective

We hypothesized that Conscientiousness-associated WM tract disruption predicts new-onset depression over 5 years in PwMS and evaluated this by assessing the predictive power of mean Conscientiousness associated frontal–parietal network (CFPN) disruption in PwMS for clinically diagnosed depression over 5 years.

Methods

This longitudinal retrospective analysis included 53 PwMS who were not previously diagnosed as depressed. All participants underwent structural MRI. Medical records were reviewed to evaluate diagnosis of depression for these patients over 5 years. WM tract damage between pairs of gray matter regions in the CFPN was measured using diffusion imaging. The relationship between CFPN disruption and depression was analyzed using logistic regression.

Results

Participants with MS had a mean age of 46.0 years (SD = 11.2). 22.6% (n = 12) acquired a diagnosis of clinical depression over the 5-year period. Baseline disruption in the CFPN was a significant predictor (ROC AUC = 61.8%). of new-onset clinical depression, accounting for age, sex, lateral ventricular volume, disease modifying treatment, and lesion volume.

Conclusion

Baseline CFPN disruption is associated with progression to clinical depression over 5 years in PwMS. Development of new WM pathology within this network may be a risk factor for depression.

中文翻译：

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多发性硬化症的抑郁症的诊断可通过额顶顶白质束破坏来预测。

背景

多发性硬化症（PwMS）患者患抑郁症的风险较高。意识下降可能会影响PwMS患者的预后。责任心低与抑郁症有很强的相关性。先前的工作还报告说，额顶网络中的白质（WM）道破裂可解释PwMS的尽责程度降低。

目的

我们假设，与良心相关的WM管道破裂可预测PwMS在5年内会出现新的抑郁症，并通过评估PwMS中平均良心相关的额叶顶叶网络（CFPN）破裂对5年内临床诊断为抑郁症的预测能力来进行评估。

方法

这项纵向回顾性分析包括53例先前未被诊断为抑郁的PwMS。所有参与者均接受了结构性MRI检查。回顾了医疗记录以评估这些患者在5年内的抑郁症诊断。使用扩散成像测量CFPN中成对的灰质区域之间的WM道损伤。使用logistic回归分析CFPN中断与抑郁之间的关系。

结果

MS参与者的平均年龄为46.0岁（SD = 11.2）。 在5年中，有22.6％（n = 12）获得了临床抑郁症的诊断。CFPN的基线破坏是一个重要的预测指标（ROC AUC = 61.8％）。新发临床抑郁症的病因，包括年龄，性别，侧脑室容积，疾病治疗方法和病变体积。

结论

基线CFPN中断与PwMS中超过5年的临床抑郁进展有关。在该网络内发展新的WM病理可能是抑郁的危险因素。