Poster No:
405
Submission Type:
Abstract Submission
Authors:
Tiana Borgers1, Kira Flinkenflügel1, Melissa Klug1, Udo Dannlowski1, Verena Enneking1, Ronny Redlich1
Institutions:
1Institute for Translational Psychiatry, Münster, North Rhine-Westphalia
First Author:
Tiana Borgers
Institute for Translational Psychiatry
Münster, North Rhine-Westphalia
Co-Author(s):
Melissa Klug
Institute for Translational Psychiatry
Münster, North Rhine-Westphalia
Udo Dannlowski
Institute for Translational Psychiatry
Münster, North Rhine-Westphalia
Verena Enneking
Institute for Translational Psychiatry
Münster, North Rhine-Westphalia
Ronny Redlich
Institute for Translational Psychiatry
Münster, North Rhine-Westphalia
Introduction:
To date, only few longitudinal diffusion-tensor-imaging (DTI) studies have been conducted in patients with depression (e.g., Repple et al., 2019), yielding a rather inconsistent pattern of results. However, recent evidence suggests that patients with depression show reductions in fractional anisotropy (FA) compared to healthy controls (HC) over a 2-year follow-up interval (Flinkenflügel et al., 2024). Despite the high clinical relevance of cognitive-behavioral therapy (CBT) in treating depression, no DTI study has yet investigated the microstructural underpinnings of CBT and their associations with treatment response in depression. Furthermore, early life adversities, such as parental neglect and overprotection, have been associated not only with increased depressive symptoms (e.g., Grotmol et al., 2010) and severe disease courses (e.g., Saffer et al., 2015), but also with lower remission rates following treatment (Asano et al., 2013; Klein et al., 2009). Thus, understanding the interactions between parenting style, disease progression, and microstructural changes is critical for improving treatment outcomes in depression. This longitudinal study, therefore, investigated the interplay of white matter (WM) integrity changes over time, treatment response, and parenting style in patients with depression.
Methods:
DTI and clinical data were assessed in n=65 patients with depression before and after 20 CBT sessions in a naturalistic design. Data from n=65 HC was acquired in an equivalent time interval. Linear-mixed-effect models were performed to compare changes in FA between patients and HC and to test associations between FA changes and symptom changes after CBT in patients. It was investigated whether parenting style predicts depressive symptoms at follow-up and whether this association is mediated by FA changes.
Results:
Patients showed differential changes in FA compared to HC over time (ptfce-FWE=.008). Increases in FA were associated with symptom improvement after CBT in patients (ptfce-FWE=.026). High parental care (pFDR=.010) and low maternal overprotection (pFDR=.001) predicted fewer depressive symptoms at follow-up. The association between maternal overprotection and depressive symptoms at follow-up was mediated by FA changes (pFDR=.044).
Conclusions:
The results revealed that patients exhibited reductions in FA in the corpus callosum and corona radiata, primarily driven by non-responders, while CBT responders showed FA increases associated with symptom improvement. These FA increases, observed in tracts essential for emotion and cognitive processing (e.g., Ochsner et al., 2009), may reflect enhanced fiber coherence and organization (Lyden et al., 2014), potentially supporting enhanced top-down emotion and cognitive regulation and underscoring their relevance to antidepressant mechanisms. Furthermore, high parental care and low maternal overprotection were associated with fewer depressive symptoms post-CBT, likely through fostering secure attachments, better emotion regulation, and stronger coping skills (e.g., Tani et al., 2018). These parenting styles may also improve therapy outcomes by supporting positive therapeutic relationships (Asano et al., 2013). Notably, the link between low maternal overprotection and reduced depressive symptoms post-CBT was mediated by FA changes, suggesting that maternal overprotection may impair WM integrity and stress-regulation pathways (Mayes et al., 2005), thereby influencing CBT efficacy. These findings underscore the interplay between parenting, WM microstructural changes, and therapeutic outcomes, highlighting the importance of considering early-life factors to optimize treatments for depression.
Disorders of the Nervous System:
Psychiatric (eg. Depression, Anxiety, Schizophrenia) 1
Modeling and Analysis Methods:
Connectivity (eg. functional, effective, structural)
Diffusion MRI Modeling and Analysis 2
Novel Imaging Acquisition Methods:
Diffusion MRI
Keywords:
Affective Disorders
Therapy
White Matter
WHITE MATTER IMAGING - DTI, HARDI, DSI, ETC
1|2Indicates the priority used for review
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Please indicate below if your study was a "resting state" or "task-activation” study.
Other
Healthy subjects only or patients (note that patient studies may also involve healthy subjects):
Patients
Was this research conducted in the United States?
No
Were any human subjects research approved by the relevant Institutional Review Board or ethics panel?
NOTE: Any human subjects studies without IRB approval will be automatically rejected.
Yes
Were any animal research approved by the relevant IACUC or other animal research panel?
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Not applicable
Please indicate which methods were used in your research:
Diffusion MRI
For human MRI, what field strength scanner do you use?
3.0T
Which processing packages did you use for your study?
FSL
Provide references using APA citation style.
1. Asano, M. (2013). Maternal overprotection score of the Parental Bonding Instrument predicts the outcome of cognitive behavior therapy by trainees for depression. Psychiatry and Clinical Neurosciences, 67(5), 340–344.
2. Flinkenflügel, K. (2024). Associations between white matter microstructure and cognitive decline in major depressive disorder versus controls in Germany: A prospective case-control cohort study. The Lancet Psychiatry, 11(11), 899–909.
3. Grotmol, K. S. (2010). Parental bonding and self-esteem as predictors of severe depressive symptoms: A 10-year follow-up study of Norwegian physicians. The Journal of Nervous and Mental Disease, 198(1), 22–27.
4. Klein, D. N. (2009). Early adversity in chronic depression: Clinical correlates and response to pharmacotherapy. Depression and Anxiety, 26, 701–710.
5. Lyden, H. (2014). Electroconvulsive therapy mediates neuroplasticity of white matter microstructure in major depression. Translational Psychiatry, 4(4), e380–e380.
6. Mayes, L. C. (2005). Parental attachment systems: Neural circuits, genes, and experiential contributions to parental engagement. Clinical Neuroscience Research, 4(5), 301–313.
7. Ochsner, K. N. (2009). Bottom-Up and Top-Down Processes in Emotion Generation: Common and Distinct Neural Mechanisms. Psychological Science, 20(11), 1322–1331.
8. Repple, J. (2019). Time heals all wounds? A 2-year longitudinal diffusion tensor imaging study in major depressive disorder. Journal of Psychiatry and Neuroscience, 44(6), 407–413.
9. Saffer, B. Y. (2015). Clarifying the Relationship of Parental Bonding to Suicide Ideation and Attempts. Suicide and Life-Threatening Behavior, 45(4), 518–528.
10. Tani, F. (2018). The Relationship Between Perceived Parenting Style and Emotion Regulation Abilities in Adulthood. Journal of Adult Development, 25(1), 1–12.
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