[18], 15 patients with single episode of MDD (MDDs), 22 with recurrent MDD (MDDr) and 15 with ADDM. Reduced BR echogenicity was found in 54% of the patients with Z-VAD-FMK research buy MDD and ADDM, but only in four

(8%) of the healthy subjects. BR echogenicity scores did not differ among patients with MDDs, MDDr, or ADDM, and pair-wise group comparisons failed to show differences between diagnostic groups with respect to frequency of reduced BR echogenicity. TCS findings of this study showed that reduced echogenicity of pontomesencephalic BR is frequent in depressive states, irrespective of diagnostic category. As a result of the present study, the hypothesis that BR echogenicity might distinguish patients with MDD and patients with ADDM had to be rejected. Reduced BR echogenicity is found with

similar frequency in MDDs, MDDr, and ADDM. This is in agreement with results of clinical and neurophysiological studies suggesting common pathophysiological mechanisms in MDD and ADDM [28]. Bipolar affective disorders are characterized by recurrent episodes of depression Lapatinib order as well as mania or hypomania [26]. In histological studies, subtle structural deficits in the dorsal raphe with a regional reduction in the synthesis of noradrenalin have been described in patients with bipolar disorder. The first TCS study evaluated BR alterations in patients with bipolar affective disorders, revealed normal or even increased echogenicity of BR in bipolar disorder, irrespective of the existing disease conditions. This observation led to the assumption that reduced echogenicity of BR may be specific to unipolar depression [3]. Recently, Krogias et al. found

the BR hypoechogenicity in 36.1% of the 36 patients with bipolar I disorder (14 depressed, 8 manic, 14 euthymic) and in 20% of the 35 healthy controls. Compared to the SB-3CT control group, frequency of altered BR echogenicities did not reach statistical significance. Hypoechogenicity of BR was depicted in six (42.9%) of the depressed, in three (37.5%) of the manic and in four (28.6%) of the euthymic bipolar patients, with no significant difference between the three subgroups [29]. The width of third ventricle was significantly larger in the patient group (3.8 ± 2.1 mm vs. 2.7 ± 1.2 mm). Depressed bipolar patients with reduced BR echogenicity showed significantly higher scores on the Hamilton Depression Rating Scale as well as the Montgomery-Åsberg Depression Rating Scale [29]. Relating to echogenicity of SN, a strong trend of more frequent SN hyperechogenicities in the depressed subgroup was identified. Hyperechogenic SN was seen in six patients (16.7%): five (35.7%) of the depressed, in none (0%) of the manic and in one (7.1%) of the euthymic patients, indicating cyclical dysregulation in quantitative dopaminergic transmission as one of the underlying pathologies in the pathogenesis of bipolar disorder.