Associations between depression subtypes, depression severity and diet quality: cross-sectional findings from the BiDirect study

Depression is supposed to be associated with an unhealthy lifestyle including poor diet. The objective of this study was to investigate differences in diet quality between patients with a clinical diagnosis of depression and population-based controls. Additionally, we aimed to examine effects of specific depression characteristics on diet by analyzing if diet quality varies between patients with distinct depression subtypes, and if depression severity is associated with diet quality.The study included 1660 participants from the BiDirect Study (n = 840 patients with depression, n = 820 population-based controls). The psychiatric assessment was based on clinical interviews and a combination of depression scales in order to provide the classification of depression subtypes and severity. Diet quality scores, reflecting the adherence to a healthy dietary pattern, were calculated on the basis of an 18-item food frequency questionnaire. Using analysis of covariance, we calculated adjusted means of diet quality scores and tested differences between groups (adjusted for socio-demographic, lifestyle-, and health-related factors).We found no differences in diet quality between controls and patients with depression if depression was considered as one entity. However, we did find differences between patients with distinct subtypes of depression. Patients with melancholic depression reported the highest diet quality scores, whereas patients with atypical depression reported the lowest scores. Depression severity was not associated with diet quality.Previous literature has commonly treated depression as a homogeneous entity. However, subtypes of depression may be associated with diet quality in different ways. Further studies are needed to enlighten the diet-depression relationship and the role of distinct depression subtypes.Corinna Rahe, Bernhard T Baune, Michael Unrath, Volker Arolt, Jürgen Wellmann, Heike Wersching and Klaus Berge

Comprehensive Evaluation of Corticospinal Tract Metabolites in Amyotrophic Lateral Sclerosis Using Whole-Brain 1H MR Spectroscopy

Changes in the distribution of the proton magnetic resonance spectroscopy (MRS) observed metabolites N-acetyl aspartate (NAA), total-choline (Cho), and total-creatine (Cre) in the entire intracranial corticospinal tract (CST) including the primary motor cortex were evaluated in patients with amyotrophic lateral sclerosis (ALS). The study included 38 sporadic definite-ALS subjects and 70 age-matched control subjects. All received whole-brain MR imaging and spectroscopic imaging scans at 3T and clinical neurological assessments including percentage maximum forced vital capacity (FVC) and upper motor neuron (UMN) function. Differences in each individual metabolite and its ratio distributions were evaluated in the entire intracranial CST and in five segments along the length of the CST (at the levels of precentral gyrus (PCG), centrum semiovale (CS), corona radiata (CR), posterior limb of internal capsule (PLIC) and cerebral peduncle (CP)). Major findings included significantly decreased NAA and increased Cho and Cho/NAA in the entire intracranial CST, with the largest differences for Cho/NAA in all the groups. Significant correlations between Cho/NAA in the entire intracranial CST and the right finger tap rate were noted. Of the ten bilateral CST segments, significantly decreased NAA in 4 segments, increased Cho in 5 segments and increased Cho/NAA in all the segments were found. Significant left versus right CST asymmetries were found only in ALS for Cho/NAA in the CS. Among the significant correlations found between Cho/NAA and the clinical assessments included the left-PCG versus FVC and right finger tap rate, left -CR versus FVC and right finger tap rate, and left PLIC versus FVC and right foot tap rate. These results demonstrate that a significant and bilaterally asymmetric alteration of metabolites occurs along the length of the entire intracranial CST in ALS, and the MRS metrics in the segments correlate with measures of disease severity and UMN function

Veränderungen des vestibulo-okulären Reflexes (VOR) bei verschiedenen Formen cerebellärer Degeneration

Bei den in Deutschland häufigsten spinocerebellärer Ataxien, der SCA1, SCA2 und SCA3, liegt in aller Regel eine olivopontocerebellären Atrophie vor. Letztere wird auch bei der sporadisch auftretenden Multisystematrophie vom cerebellären Typ (MSA-C) beobachtet. Anatomische Strukturen, die die Generierung von Augenbewegungen beeinflussen, sind sowohl bei SCA als auch bei MSA-C in besonderem Maß betroffen. Ziel des Projektes war es, die Störungen vestibulärer Funktionen bei MSA-C und SCA1, SCA2 und SCA3 vergleichend zu untersuchen. 19 SCA-Patienten (SCA1: N=7, SCA2: N=8, SCA3: N=4), 8 MSA-C-Patienten und 13 gesunde Kontrollpersonen wurden mittels der Search-Coil-Technik im Vestibulären Stimulationsgerät untersucht. Getestet wurden folgende Paradigmen: (a) 3-dimensionale Antwort auf sinusförmige Rotation um eine vertikale Achse im Dunkeln mit 0,2Hz/15° (A), 0,1Hz/30° (B) und 0,1Hz/60° (C), sowie um eine horizontale Achse mit 0,2Hz/15° (D) und 0,1Hz/30° (E). (b) Konstante Rotation mit 100°/s für die Dauer von 60s in Dunkelheit. Die positive sowie negative Beschleunigung lag bei 400°/s2. Die Drehung erfolgte um die Erdvertikale. Der Gain war definiert als Quotient aus Augengeschwindigkeit durch Kopfgeschwindigkeit. Die Antwort auf sinusförmige Drehung war bei SCA1 und SCA3 reduziert, bei MSA-C im Vergleich zu Gesunden jedoch signifikant gesteigert. Auch für die konstante Rotation ergaben sich reduzierte Gains für SCA1 und 3, während SCA2 und MSA-C keine signifikanten Auffälligkeiten zeigten. Die diskrepanten Untersuchungsbefunde des vestibulären Systems weisen auf Unterschiede im Degenerationsmuster bei SCA und MSA-C hin. Pathophysiologisch geht der gesteigerte VOR bei MSA-C wahrscheinlich auf den Verlust der inhibitorischen Wirkung des Flocculus zurück. Dieser ist auch bei SCA betroffen, so dass die Reduktion des VOR bei SCA auf eine zusätzliche Degeneration des VIII-Kerngebietes oder auch der vestibulären Afferenz hindeutet. Vergleichende pathologisch-anatomische Untersuchungen sollen diese Frage weiter klären