The topography of infratentorial lesions in depression and anxiety in multiple sclerosis.

IF 4.8 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Neurology Pub Date : 2025-05-26 DOI:10.1007/s00415-025-13167-0

Federica Giofrè, Alessandra Lugaresi, Flavia Baccari, Elaine Lui, Stefanie Roberts, Charles Malpas, Tomas Kalincik

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Abstract

Background: Depression and anxiety are highly prevalent in multiple sclerosis and significantly impact patient outcomes. However, their link to specific areas of demyelination remains unclear.

Objectives: This study examines the association between infratentorial lesions and depression or anxiety, focusing on three regions of interest: raphe nuclei, locus coeruleus, and cerebellar lobule VIIA.

Methods: Patients were recruited from the cognitive neuroimmunology clinic at the Royal Melbourne Hospital. Participants were categorised as belonging to the groups 'depression'/'no depression' and 'anxiety'/'no anxiety' based on SPECTRA Indices of Psychopathology. MRI scans were examined for lesion presence in regions of interest. Association analyses were performed using multivariable logistic regression, adjusting for demographics, clinical parameters, and therapy.

Results: Of 73 patients, 21 (29%) had clinically relevant depressive symptoms, and 18 (25%) had anxiety. Depression was significantly associated with lesions in the raphe nuclei (47.6% vs. 17.3%, OR 10.5, 95%CI 1.9-57.5, p=0.007) and locus coeruleus (38.1% vs. 15.4%, OR 20.5, 95%CI 2.3-184, p=0.007). Anxiety showed a potential association with locus coeruleus lesions (38.9% vs. 16.4%, OR 8.62, 95%CI 0.9-79.2, p=0.057).

Conclusions: Depression in multiple sclerosis is associated with lesions within serotoninergic and noradrenergic brainstem nuclei. No definitive anatomical substrate for anxiety was identified. These findings suggest that inflammatory structural changes may underlie mood disorders in multiple sclerosis, potentially serving as early imaging markers of susceptibility to depression.

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多发性硬化症伴抑郁和焦虑的幕下病变的地形图。

背景：抑郁和焦虑在多发性硬化症中非常普遍，并显著影响患者的预后。然而，它们与特定脱髓鞘区域的联系尚不清楚。目的：本研究探讨了幕下病变与抑郁或焦虑之间的关系，重点关注三个感兴趣的区域：中缝核、蓝斑和小脑小叶。方法：从皇家墨尔本医院的认知神经免疫学诊所招募患者。根据精神病理学光谱指数，将参与者分为“抑郁”/“无抑郁”组和“焦虑”/“无焦虑”组。MRI扫描检查感兴趣区域的病变存在。使用多变量逻辑回归进行关联分析，调整人口统计学、临床参数和治疗。结果：73例患者中，21例（29%）有临床相关抑郁症状，18例（25%）有焦虑。抑郁与中缝核病变（47.6%比17.3%,OR 10.5, 95%CI 1.9-57.5, p=0.007）和蓝斑区病变（38.1%比15.4%,OR 20.5, 95%CI 2.3-184, p=0.007）显著相关。焦虑表现出与蓝斑病变的潜在关联（38.9%比16.4%,OR 8.62, 95%CI 0.9-79.2, p=0.057）。结论：多发性硬化症患者的抑郁与血清素能和去甲肾上腺素能脑干核内的病变有关。没有确定焦虑的确切解剖学基础。这些发现表明，炎症结构改变可能是多发性硬化症情绪障碍的基础，有可能作为抑郁症易感性的早期影像学标记。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neurology 医学-临床神经学

CiteScore

10.00

自引率

5.00%

发文量

558

审稿时长

1 months

期刊介绍： The Journal of Neurology is an international peer-reviewed journal which provides a source for publishing original communications and reviews on clinical neurology covering the whole field. In addition, Letters to the Editors serve as a forum for clinical cases and the exchange of ideas which highlight important new findings. A section on Neurological progress serves to summarise the major findings in certain fields of neurology. Commentaries on new developments in clinical neuroscience, which may be commissioned or submitted, are published as editorials. Every neurologist interested in the current diagnosis and treatment of neurological disorders needs access to the information contained in this valuable journal.