Sex Differences Of White Matter Integrity In Major Depressive Disorder

Objective: Major depressive disorder(MDD)is a common emotional disorder.Domestic and foreign studies have found sex differences in both epidemiological and clinical symptoms of MDD,and the prevalence of MDD in women is about twice that in men.In terms of symptom presentation,women seem to be more prone to atypical depression,but the pathophysiological mechanism related to the disease is still unclear.In this study,we intend to use diffusion tensor imaging(DTI)technology to detect the relationship between white matter integrity and gender in MDD patients,in order to find out the gender differences of white matter integrity in MDD.Methods: A total of 186 subjects were enrolled in this study,including 91 MDD subjects(43males,48 females)and 95 healthy controls(HC)(48mals,47females).All the subjects were between 18 and 45 years old.The above subjects were scanned by DTI with 3.0T MRI in quiet state,and the imaging data were post-processed by SPM and PANDA based on MATLAB software.Using SPSS 22.0 to analyze demographic information of four groups of participants.Two-way ANOVA was performed in SPM8 with groups sex(males/females)and diagnose(BD/HC)as between-subject factors to analyze white matter integrity differences in major depressive disorder.Then using two-sample t-test to compared MDD male with MDD female,HC male with HC female,MDD male with HC male,and MDD female with HC female.Results:(1)There was no significant difference in general demographic data such as age and education among the four groups,(2)When sex was the main effect,there were significant differences between male and female subjects in the left external capsule,the splenium of the corpus callosum,the right anterior corona radiata and the right superior longitudinal fasciculus(P< 0.05,corrected).When diagnosis was the main effect,we found that there was no significant difference in white matter integrity between MDD and HC.(3)When diagnosis and gender interaction were the main effects,there were significant differences in the body of corpus callosum among the four groups(P<0.05,corrected).(4)The t-test results of the two samples showed that there were significant differences in the splenium of the corpus callosum between MDD females and HC females.However,there was no significant difference in brain regions between MDD males and HC males.There were significant differences between MDD males and MDD females in the left anterior limb of the internal capsule,the left external capsule and the splenium of the corpus callosum(P<0.05,corrected).There were significant differences between HC males and HC females in left external capsule and the splenium of the corpus callosum(P<0.05,corrected).Conclusion:(1)There were differences in the integrity of white matter between male and female patients with MDD.Abnormal white matter integrity of corpus callosum was found in female MDD,but not in male MDD.Compared with male MDD,the white matter integrity of left external capsule and corpus callosum in female MDD was abnormal.(2)The white matter integrity of MDD and HC corpus callosum,left external capsule and left anterior limb of internal capsule in females were lower than in males.This suggests that there are differences in the integrity of white matter between different genders.