engleski

Brainstem raphe lesion recorded on transcranial sonography (TCS)

Introduction: Numerous evidences from neuroimaging, biochemical and animal studies implicate basal limbic system involvement in the pathogenesis of mood disorders. Recent TCS studies showed that disruption of echogenic midbrain line corresponding to nuclei raphe might represent a functional marker for the development of depression. We initiated this study to replicate these findings in a group of unipolar depressed patients, suicidal patients and controls. Patients and methods: 31 patients with unipolar depression (DSMIV) of whom 11 were suicidal and 30 controls were studied using TCS. Severity of the disease was measured according to Hamilton Depression Rating Scale. Examination was performed by standardized semiquantative protocol by two independent physicians. Results: Reduced raphe echogenicity was found in 19 of 31 (63%) of the patients with unipolar depression but only in 3 (10%) controls. Furthermore, 9 of 11 (82%) suicidal patients exhibit the same reduced echogenicity, what was also in negative correlation with the severity of the illness assessed by HDRS cc=– 0.569, p=0.003. No correlation was found between raphe echogenicity and the number of depressive episodes, age, gender or duration of the disease. (p>0.05). We also found significant interobserver reliability for this method. Discussion: Our result showed that altered echogenicity of the mesencephalic midline, what corresponds to the nuclei raphe is frequent in patients with unipolar depression. Such finding is rare in healthy subjects ; however, in suicidal patients that finding was even more pronounced. These data suggest that TCS might be a novel method for the detection of depressive disorders and differentiating suicidal patients.

TCS; transcranial sonography; brainstem; nuclei raphe

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