Major depressive disorder (MDD) causes great decrements in health and quality of life with increments in healthcare costs, but the causes and pathogenesis of depression remain largely unknown, which greatly prevent its early detection and effective treatment. With the advancement of neuroimaging approaches, numerous functional and structural alterations in the brain have been detected in MDD and more recently attempts have been made to apply these findings to clinical practice. In this review, we provide an updated summary of the progress in translational application of psychoradiological findings in MDD with a specified focus on potential clinical usage. The foreseeable clinical applications for different MRI modalities were introduced according to their role in disorder classification, subtyping, and prediction. While evidence of cerebral structural and functional changes associated with MDD classification and subtyping was heterogeneous and/or sparse, the ACC and hippocampus have been consistently suggested to be important biomarkers in predicting treatment selection and treatment response. These findings underlined the potential utility of brain biomarkers for clinical practice.
Brain/diagnostic imaging* ; Depressive Disorder, Major/diagnostic imaging* ; Humans ; Magnetic Resonance Imaging ; Neuroimaging ; Quality of Life

A 59-year-old man with a history of major depression was found by his wife to be unconscious and foaming at the mouth. On arrival at the emergency department, the patient was noted to be unresponsive. Computed tomography of the brain showed symmetrical ill-defined areas of hypoattenuation involving the medial aspects of both lentiform nuclei, while magnetic resonance images of the brain showed symmetrical increased signal in the bilateral globi pallidi on diffusion weighted, T2-weighted and fluid attenuated inversion recovery sequences. These findings were those of acute carbon monoxide poisoning. Despite aggressive treatment, the patient's condition continued to deteriorate and he eventually passed away. The various imaging findings of carbon monoxide poisoning in the brain and the differential diagnoses are discussed.
Brain ; diagnostic imaging ; Carbon Monoxide Poisoning ; diagnosis ; diagnostic imaging ; Depressive Disorder, Major ; complications ; Diagnostic Imaging ; Fatal Outcome ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pulmonary Edema ; pathology ; Radiography, Thoracic ; Suicide, Attempted ; Tomography, X-Ray Computed

OBJECTIVES: Many recent studies of relationship between geriatric depression and changes in brain have examined the structural abnormalities in hippocampus. Using MRI, the hippocampal volumes of patients with major depression were measured and compared with control subjects for research of above relationship. METHOD: Fourteen patients (early-onset five, late-onset nine) with major depressive disorder based on DSM-IV and fourteen age-matched normal controls are included. Applying semiautomated computer program to MRI, we measured and compared the hippocampal volumes in two groups. Moreover we identified the laterality and the correlation of the volumes with age of onset, duration of education, numbers of psychiatric admission, duration of illness, MMSE scores at admission, and severity of depression. RESULT: No significant difference was observed between the hippocampal volumes of patients with major depressive disorder and those of control subjects. A significant correlation in patients was observed between duration of illness and left hippocampal volume to cerebral volume ratio. In early-onset depressed patients, left hippocampal volume was larger than in late-onset depressed patients and the positive correlation was observed between MMSE scores at admission and left hippocampal volume to cerebral volume ratio. In late-onset depressed patients, there was the negative correlation between numbers of psychiatric admission and MMSE scores at admission as well as and between cerebral volume and age of onset. CONCLUSION: Our study indicated no change in the volume of hippocampus among geriatric major depressive patients. So we suggest that more extensive and systematic studies for structural abnormality of hippocampus will be required.
Age of Onset ; Aged* ; Brain ; Depression ; Depressive Disorder, Major* ; Diagnostic and Statistical Manual of Mental Disorders ; Education ; Hippocampus ; Humans ; Magnetic Resonance Imaging