Negative Stressful Life Events and Social Support Are Associated With White Matter Integrity in Depressed Patients and Healthy Control Participants: A Diffusion Tensor Imaging Study

Kira Flinkenflügel; Susanne Meinert; Katharina Thiel; Alexandra Winter; Janik Goltermann; Lea Strathausen; Katharina Brosch; Frederike Stein; Florian Thomas-Odenthal; Ulrika Evermann; Adrian Wroblewski; Paula Usemann; Julia-Katharina Pfarr; Dominik Grotegerd; Tim Hahn; Elisabeth J Leehr; Katharina Dohm; Jochen Bauer; Hamidreza Jamalabadi; Benjamin Straube; Nina Alexander; Andreas Jansen; Igor Nenadić; Axel Krug; Tilo Kircher; Udo Dannlowski

doi:10.1016/j.biopsych.2023.03.022

Negative Stressful Life Events and Social Support Are Associated With White Matter Integrity in Depressed Patients and Healthy Control Participants: A Diffusion Tensor Imaging Study

Biol Psychiatry. 2023 Oct 15;94(8):650-660. doi: 10.1016/j.biopsych.2023.03.022. Epub 2023 Apr 6.

Authors

Kira Flinkenflügel¹, Susanne Meinert², Katharina Thiel¹, Alexandra Winter¹, Janik Goltermann¹, Lea Strathausen¹, Katharina Brosch³, Frederike Stein³, Florian Thomas-Odenthal³, Ulrika Evermann³, Adrian Wroblewski³, Paula Usemann³, Julia-Katharina Pfarr³, Dominik Grotegerd¹, Tim Hahn¹, Elisabeth J Leehr¹, Katharina Dohm¹, Jochen Bauer⁴, Hamidreza Jamalabadi⁵, Benjamin Straube³, Nina Alexander³, Andreas Jansen⁶, Igor Nenadić³, Axel Krug⁷, Tilo Kircher³, Udo Dannlowski⁸

Affiliations

¹ Institute for Translational Psychiatry, University of Münster, Münster, Germany.
² Institute for Translational Psychiatry, University of Münster, Münster, Germany; Institute for Translational Neuroscience, University of Münster, Münster, Germany.
³ Department of Psychiatry und Psychotherapy, University of Marburg, Marburg, Germany; Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany.
⁴ Department of Radiology, University of Münster, Münster, Germany.
⁵ Department of Psychiatry und Psychotherapy, University of Marburg, Marburg, Germany.
⁶ Department of Psychiatry und Psychotherapy, University of Marburg, Marburg, Germany; Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany; Core-Facility Brainimaging, Faculty of Medicine, University of Marburg, Marburg, Germany.
⁷ Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany.
⁸ Institute for Translational Psychiatry, University of Münster, Münster, Germany. Electronic address: dannlow@uni-muenster.de.

PMID: 37028741
DOI: 10.1016/j.biopsych.2023.03.022

Abstract

Background: Negative stressful life events and deprivation of social support play critical roles in the development and maintenance of major depressive disorder (MDD). The present study aimed to investigate in a large sample of patients with MDD and healthy control participants (HCs) whether these effects are also reflected in white matter (WM) integrity.

Methods: In this diffusion tensor imaging study, 793 patients with MDD and 793 age- and sex-matched HCs were drawn from the Marburg-Münster Affective Disorders Cohort Study (MACS) and completed the Life Events Questionnaire (LEQ) and Social Support Questionnaire (SSQ). Generalized linear models were performed to test voxelwise associations between fractional anisotropy (FA) and diagnosis (analysis 1), LEQ (analysis 2), and SSQ (analysis 3). We examined whether SSQ interacts with LEQ on FA or is independently associated with improved WM integrity (analysis 4).

Results: Patients with MDD showed lower FA in several frontotemporal association fibers compared with HCs (p_TFCE-FWE = .028). Across both groups, LEQ correlated negatively with FA in widely distributed WM tracts (p_TFCE-FWE = .023), while SSQ correlated positively with FA in the corpus callosum (p_TFCE-FWE = .043). Modeling the combined association of both variables on FA revealed significant-and antagonistic-main effects of LEQ (p_TFCE-FWE = .031) and SSQ (p_TFCE-FWE = .037), but no interaction of SSQ × LEQ.

Conclusions: Our results indicate that negative stressful life events and social support are both related to WM integrity in opposing directions. The associations did not differ between patients with MDD and HCs, suggesting more general, rather than depression-specific, mechanisms. Furthermore, social support appears to contribute to improved WM integrity independent of stressful life events.

Keywords: Diffusion tensor imaging; Environmental factors; Fractional anisotropy; Major depressive disorder; Negative stressful life events; Social support.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Anisotropy
Cohort Studies
Depressive Disorder, Major* / diagnostic imaging
Diffusion Tensor Imaging
Humans
Social Support
White Matter* / diagnostic imaging