Alterations in white matter fractional anisotropy in subsyndromal perimenopausal depression

Xianglan Wang, Jiong Tao, Lingjiang Li, Zhiyong Zhong, Sha Liu, Tianzi Jiang, Jinbei Zhang

BackgroundSubsyndromal depression (SSD) is considered as a predictor for future depressive disorders, however whether white matter abnormalities are involved in the high-susceptibility of women to depressive disorders during perimenopause is unknown. The purpose of this study was to investigate fractional anisotropy (FA) in the white matter of the whole brain in perimenopausal women with SSD using diffusion tensor imaging (DTI).MethodsIn a cross-sectional study, 24 perimenopausal women with SSD and 24 other age-, education-, and body mass index-matched healthy women underwent DTI. A voxel-based analysis was used to elucidate regional FA changes at a voxel threshold of p¿<¿0.001 with an extent threshold of k¿>¿127 voxels (p¿<¿0.05, AlphaSim correction). Subsequently, correlation analyses were performed between mean FA values in significant brain regions and plasma estradiol level.ResultsCompared to healthy controls, women with SSD exhibited significantly lower FA values in the left insula, while higher FA values were observed in the left ventral lateral thalamus and left and right brainstem in the midbrain. In subjects with SSD, the mean FA value in the left insula was positively correlated to plasma estradiol levels (r¿=¿0.453, p¿=¿0.026) (uncorrected).LimitationsThe study had a relatively small size sample and did not include perimenopausal women with clinically diagnosed depressive disorders or premenopausal women with depressive disorders for comparison.ConclusionsOur findings indicate altered microstructures in white matter of the insula and subcortical regions may be associated with the high susceptibility of perimenopausal women to depressive disorders. Estrogen may modulate the white matter microstructure of the insula.