In 2016, nearly 16.2 million adult population of the United States had at least one episode of major depression. The scientists across the globe are putting efforts to reduce the mortality and morbidity associated with the disorder. A recent study, published in JAMA Psychiatry, has linked some neural mechanisms to depression relapse suggesting that paying attention to certain neural regions could help understand the disease prognosis.
As per author Mary L. Phillips, despite being prevalent, major depressive disorder (MDD) has a high rate of relapse and a low remission rate. Unfortunately, there is a dearth of research on understanding neural mechanisms that increase the propensity of an individual towards MDD. She added that understanding certain pathophysiological pathways that make people susceptible to MDD can be helpful in discovering neural markers which might be used to institute personalized intervention strategies. In addition, the knowledge of these neural mechanisms could prevent or halt a relapse in high-risk patients. Phillips gave reference of a German study that attempted to bridge this gap.
Relapse occurs when gray matter regulating emotions reduce
Dario Zaremba and his colleagues had conducted a small-scale research in which they investigated the entire brain region and regions with changes in the gray matter volume and cortical thickness for a period of two years. The study population comprised 60 patients with MDD and 54 healthy individuals.
The researchers used whole-brain voxel-based morphometry to investigate the volume of gray matter in patients and regions that exhibited changes in cortical thickness. In the follow-up, the participants were categorized into two groups – those who didn’t experience any relapse and those who had an episode of at least one relapse. Out of the pool, 37 individuals were put in the latter group.
Phillips interpreted the results and stated that an occurrence of relapse was associated with gray matter reduction in the neuronal regions that were tied to emotional regulation, salience processing and executive function. Most likely, it happened because of the glial cell density or neuronal size changes. She also noted that there was an absence of correlation between symptom severity at the baseline, at follow-up and medication load on gray matter volume. She added that this was first-of-a-kind trial in identifying objective neural markers to trace future course of MDD specifically in middle-age population.
Philips emphasized that the study by Zaremba was unique as it focused on high relapse rate and challenges in assessing the disease progression. She further wrote that this study might help in identifying neuroimaging techniques as potential tools for establishing long-term treatment plans with better outcomes for people struggling with MDD.
Recovery from depression is possible
Depression can be treated through medications and psychotherapies, like cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT). In addition, individual and group therapies also play a pivotal role in alleviating the symptoms. Patients are also encouraged to maintain a healthy balance between physical and mental health by focusing on diet, physical exercise, mind relaxation techniques and pursuit of interests.