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Enhanced amygdala volume in first depressive episode
Changes in amygdala volume have been observed in patients with affective disorders. Increased amygdala volume has been reported in first-episode major depression patients compared with age-matched healthy control subjects. The study also compared amygdala volume in patients with recurrent major depression and in first-episode patients.
Thirty in-patients with first-episode major depression and 27 in-patients with recurrent major depression were recruited. All subjects were aged 18-65 years and had received antidepressive medication. Duration of illness ranged from 1 month to 37 years. For comparison, 57 healthy control subjects, matched for age, gender, and handedness, were also enrolled in the study. Magnetic resonance imaging was used to obtain brain images, particularly of the amygdala.
Images analysis revealed enlarged amygdala volume for patients with first-episode major depression compared with patients with recurrent major depression and healthy control subjects. No differences were found between patients suffering from recurrent depression and healthy control subjects. Amygdala volume did not correlate with age of onset, illness duration, or severity of depression.
These results might be explained by a higher neuronal activity in the amygdala coupled with higher metabolism and higher cerebral blood flow which might result in the greater amygdala volume found in first-episode patients in comparison with patients who have recurrent major depression. In addition antidepressant treatment might have an influence on amygdala volume. Finally disease progression with stress-related excitotoxic processes and reduced neurotrophic factors during recurrent depressive episodes cannot be ruled out, contributing to decreased amygdala volume.
Biol Psychiatry 53: 338-344, 2003

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