Substantia nigra hyperechogenicity in depressive subjects relates to motor asymmetry and impaired word fluency

• Published in: European archives of psychiatry and clinical neuroscience 2009-02, Vol.259 (2), p.92-97
• Main Authors: Hoeppner, Jacqueline, Prudente-Morrissey, Lara, Herpertz, Sabine Christiane, Benecke, Reiner, Walter, Uwe
• Format: Article
• Language: English
• Subjects: Adjustment Disorders - complications; Adjustment Disorders - diagnostic imaging; Adjustment Disorders - psychology; Adult; Age Factors; Aged; Cognition; Depressive Disorder, Major - complications; Depressive Disorder, Major - diagnostic imaging; Depressive Disorder, Major - psychology; Female; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Motor Skills; Neurosciences; Original Paper; Parkinson Disease - diagnostic imaging; Parkinson Disease - psychology; Psychiatry; Risk Factors; Speech Disorders - complications; Speech Disorders - diagnostic imaging; Speech Disorders - psychology; Substantia Nigra - ultrastructure; Ultrasonography, Doppler, Transcranial; Young Adult
• ISSN: 0940-1334; 1433-8491
• DOI: 10.1007/s00406-008-0840-9

Background Substantia nigra hyperechogenicity (SNH) is a characteristic transcranial sonography (TCS) finding in Parkinson’s disease (PD). SNH, found also in about 10% of healthy adults, was related to a subclinical malfunction of the nigrostriatal dopaminergic system on positron emission tomography studies. Both, liability for developing PD and frequency of SNH were found to be increased in depressed subjects. Here, we investigated whether SNH in depression is related to motor or cognitive abnormalities resembling early PD. Methods Fourty-one patients with major depressive disorder and 15 with adjustment disorder with depressed mood were studied clinically and with TCS. Results Frequency of SNH was similar in both groups (39, 33%; Chi-square test, P  = 0.70). Larger SN echogenic size correlated with larger right-to-left asymmetry of finger tapping (Spearman test, r  = 0.37, P  = 0.009) and lower verbal fluency ( r  = −0.35, P  = 0.038). These correlations were stronger in patients at ages ≥ 50 years ( r  = 0.52, P  = 0.007; r  = −0.50, P  = 0.020), and, independently from age, in patients with reduced echogenicity of brainstem raphe suggested to reflect alteration of the serotonergic system ( r  = 0.40, P  = 0.045; r  = −0.51, P  = 0.044). Whereas bilateral sum score of finger tapping was negatively correlated with severity of depression on the beck depression inventory ( r  = −0.50, P  = 0.001) and the Hamilton depression rating scale ( r  = −0.34, P  = 0.019), no correlation was found between depression severity and tapping asymmetry, or between depression severity and verbal fluency. Conclusion Data suggest that TCS detects a subgroup of patients with depression characterized by symptoms of early parkinsonism who are possibly at an elevated risk of later developing definite PD.