368. Relationship between childhood adversity and pre-operative structural MRI data in patients receiving deep brain stimulation of the subgenual cingulate cortex for treatment resistant depression

Abstract

Abstract Background Adverse childhood experiences (ACEs) predict poorer response to treatments for major depressive disorder (MDD) including medications, psychotherapy, and their combination. ACEs are known to have effects on brain structure and function. Aims & Objectives We aim to characterize the relationship between ACE score and pre-operative structural MRI metrics in patients with treatment resistant depression (TRD) receiving deep brain stimulation (DBS) at the subgenual cingulate cortex (SCC). Method The ACE-10 questionnaire was used to quantify categories of ACEs. Pre-operative T1-weighted images were acquired immediately before DBS surgery for stereotactic planning. Images were preprocessed with BPIPE and transformed into MNI152 space. Cortical thickness and surface are measurements were obtained using CIVET. Subcortical volume was estimated using the MAGeT brain segmentation algorithm. Cortical surface area, cortical thickness, and subcortical volume measurements were analyzed using a general linear model testing for association with total ACE score and covarying for age and sex. Correction for total brain volume, total cortical surface area, and total cortical thickness were performed as necessary. Post-hoc p-values were corrected for multiple comparisons using the false discovery rate. Results Among the 52 patients, the mean ACE score was 3.3 and 45% reported experiencing 4 or more ACEs. Following preprocessing and quality checks, data from 52 patients were retained for analysis of cortical thickness and surface data and data from 50 were used for subcortical volume analysis. As there were main effects of patient age and sex on cortical surface area, imaging metrics were residualized for age and male and female patients were considered separately. In female but not male patients, ACE score was associated with lower left anterior cingulate cortex surface area and bilateral angular gyrus surface area (all q < 0.05). In female but not male patients, total ACE score was associated with lower left fornix volume (r = -0.57, q < 0.05) but positively correlated with right subiculum volume (r = 0.62, q < 0.05). Discussion & Conclusions Structural analyses reveal correlations between ACE score and cortical thickness and subcortical volumes in female patients who would receive SCC-DBS for TRD. Further studies would be needed to understand whether and how brain stimulation impacts these structural differences.