This finding was confirmed a year later on larger number of patients in the study which compared echogenicity of the BR between 40 patients with unipolar depression, 40

patients with bipolar disorder and 40 healthy controls. LBH589 datasheet Raphe echogenicity in patients with unipolar depression was found to be distinctly reduced as compared with healthy adults and patients with bipolar affective disorder. BR echogenicity, on average, was halved in the unipolar depressed group. No correlation was found between BR echogenicity and age, sex or disease severity [3]. Reduced brainstem midline echogenicity of depressed patients was interpreted as a structural alteration of the dorsal raphe nucleus or fiber tracts in this region [14]. Increased T2-relaxation time in a pontine brainstem in patients with major depression could be in line with previous

reports of brainstem pathology in these patients [14]. The observation might indicate a subtle tissue alteration, which cannot be identified by visual inspection of the images. T2-relaxation time depends on physical tissue characteristics and is influenced by hydration status or iron content. Differences in T2-relaxation time of specific brain areas between patients with major depression and healthy controls may indicate different tissue composition caused by histological learn more changes. Several further studies confirmed the finding of reduced echogenicity of the BR in unipolar depression. In the study Astemizole of Walter [17] the frequency of patients with reduced echogenicity of BR was higher in unipolar depression compared with healthy individuals and in depressed PD patients compared with non-depressed. The

frequency of reduced echogenicity of BR was the highest in patients with unipolar depression. In this study, reduced echogenicity of the BR was more frequent in depressed than in non-depressed patients, irrespective of presence of PD. TCS findings of another study [19], showed that reduced echogenicity of pontomesencephalic BR is frequent in depressive states, irrespective of diagnostic category of depression, but only rare in healthy subjects without any history of psychiatric disorder. BR echogenicity could not discriminate between major depressive disorder and adjustment disorder with depressed mood. BR echogenicity scores showed in this study were significantly lower in SSRI responders compared with SSRI non-responders. Reduced BR echogenicity indicated SSRI responsivity with a positive predictive value of 88%. Recently, reduced raphe echogenicity was found in 47% of the patients with major depressive disorder but only in 15% of healthy controls. In patients with suicidal ideations that finding was even more pronounced (86%) with the highest frequency of completely not visible TCS raphe finding (72%). Data showed that altered echogenicity of the BR is frequent in patients with suicidal ideation.