Lesions in the left arcuate fasciculus region and depressive symptoms in multiple sclerosis

• Published in: Neurology Vol. 49; no. 4; pp. 1105 - 1110
• Main Authors: PUJOL, J, BELLO, J, DEUS, J, MARTI-VILALTA, J. L, CAPDEVILA, A
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01-10-1997
• Subjects: Adult; Arcuate Nucleus of Hypothalamus - pathology; Biological and medical sciences; Depression - etiology; Disability Evaluation; Female; Humans; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; Multiple Sclerosis - diagnosis; Multiple Sclerosis - physiopathology; Multiple Sclerosis - psychology; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Neurology; Severity of Illness Index; Human; Nervous system diseases; Multiple sclerosis; Depression; Exploration; Nuclear magnetic resonance imaging; Inflammatory disease; Demyelination; Central nervous system disease; Depression Inventory Beck; Medical imagery; Psychopathology; Comparative study
• ISSN: 0028-3878; 1526-632X
• DOI: 10.1212/WNL.49.4.1105

Depression is a common mood disturbance in multiple sclerosis (MS) patients. Epidemiologic data suggest a causative relationship between depressive symptoms and cerebral demyelination, although a specific lesion site responsible for depressed mood has not been identified. Given that depression in neurologic disease is closely related to frontal and temporal lobe damage, we focused our study on investigating the extent to which lesions in the white matter connecting both cerebral lobes may account for depressive symptoms in MS. Forty-five patients were assessed using the Beck Depression Inventory and an MRI protocol conceived to quantify lesions separately in the basal, medial, and lateral frontotemporal white matter. The presence of lesions in the left suprainsular white matter, the region that mainly includes the arcuate fasciculus, was specifically associated with depressive symptoms, accounting for a significant 17% of the depression score variance. Although a multifactorial origin is suspected for depression in MS, this finding gives support to the existence of a direct negative effect of demyelination on mood.