Hypothalamus enlargement in mood disorders

• Published in: Acta psychiatrica Scandinavica Vol. 139; no. 1; pp. 56 - 67
• Main Authors: Schindler, S., Schmidt, L., Stroske, M., Storch, M., Anwander, A., Trampel, R., Strauß, M., Hegerl, U., Geyer, S., Schönknecht, P.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.01.2019
• Subjects: Adult; Affective disorders; Bipolar disorder; Bipolar Disorder - complications; Bipolar Disorder - pathology; Control Groups; Cross-Sectional Studies; Depressive Disorder, Major - complications; Depressive Disorder, Major - pathology; Emotional disorders; Female; human; Humans; Hypothalamus; Hypothalamus - diagnostic imaging; Hypothalamus - growth & development; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Mental depression; Middle Aged; Mood; Mood disorders; Mood Disorders - complications; Mood Disorders - pathology; Organ Size - physiology; Stress, Physiological - physiology; Structure-function relationships; volume; volume; magnetic resonance imaging; human; mood disorders; hypothalamus
• ISSN: 0001-690X; 1600-0447
• DOI: 10.1111/acps.12958

Objective The purpose of this study was to determine, in vivo, whether the hypothalamus volume is reduced in patients with mood disorders. Methods The cross‐sectional study included 20 unmedicated (MDDu) and 20 medicated patients with major depressive disorder, 21 patients with bipolar disorder, and 23 controls. Twenty of the controls were matched to the MDDu. Seven Tesla, T1‐weighted magnetic resonance images were acquired and processed using methods specifically developed for high‐precision volumetry of the hypothalamus. Results An overall group difference was observed for the left hypothalamus volume corrected for intracranial volume. Planned contrasts identified that the left hypothalamus was approximately 5% larger in each patient group compared with the control group. A paired t‐test with the 20 matched pairs of MDDu and controls and without correction for covariates confirmed the larger left hypothalamus volume in MDDu. Conclusions Contrary to our expectations, the hypothalamus volume was increased in patients with uni‐ and bipolar affective disorders. The effect was left‐sided and independent of medication status or statistical correction for covariates. Supported by emerging evidence that the stress response may be related to structural and functional asymmetry in the brain, our finding suggests a crucial role of the hypothalamus in mood disorders.