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Transcranial Sonography Findings in Depression in Association With Psychiatric and Neurologic Diseases: A Review
Author(s) -
Krogias Christos,
Walter Uwe
Publication year - 2016
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon.12328
Subject(s) - depression (economics) , medicine , echogenicity , disease , suicidal ideation , psychiatry , poison control , radiology , injury prevention , ultrasound , macroeconomics , environmental health , economics
ABSTRACT The transcranial sonography (TCS) finding of reduced echogenicity of brainstem raphe (hypoechogenic BR) has been associated with depressive states. Here, we review the TCS studies in subjects with depressive disorders and with depression related to degenerative brain diseases, and compare the frequency and clinical correlates of hypoechogenic BR in these reports. Summarizing the data published so far, hypoechogenic BR is present in 67% (range, 37‐95%) of depressed but only in 15% (5‐36%) of nondepressed subjects without history of neurodegenerative disease. The finding of hypoechogenic BR in these subjects is associated with a relative risk of 3.03 (95% CI, 2.44‐3.75; P < .001) of being diagnosed with depression. In patients with Parkinson's disease, hypoechogenic BR is present in 63% (35‐92%) of depressed but only in 27% (10‐62%) of nondepressed patients, resulting in a relative risk of 2.18 (95% CI, 1.80‐2.66; P < .001) of being diagnosed with depression. Hypoechogenic BR is associated with depression in a number of neurological disorders such Huntington's disease, idiopathic Rapid Eye Movement (REM) sleep behavior disorder, myotonic dystrophies, and cerebral small vessel disease. Although some studies did not show any relationship between BR echogenicity and severity of depression, others suggest an association with higher severity of depression, or even with suicidal ideation. In one study BR hypoechogenicity was found to be associated with better responsivity to serotonin reuptake inhibitors. Further studies are warranted to compare the TCS findings of BR alteration with post‐mortem histopathological findings, and with genetic variants related to cerebral serotonin metabolism.