ArticleNeuroImage. Clinical2021
Cerebral perfusion in depression: Relationship to sex, dehydroepiandrosterone sulfate and depression severity.
Article in NeuroImage. Clinical, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- Brain-based Sex Differences in Depression: A Systematic Review of Neuroimaging Studies.Brain imaging and behavior · 2023Pooled it
- Association between Cortical Gyrification and Major Depression: Clinical Correlates.Psychopathology · 2026Article
- Cerebral Blood Flow and Blood-Brain Barrier Water Exchange in Major Depressive Disorder: Evidence from Diffusion-Prepared Arterial Spin Labelling MRI.Brain sciences · 2025Article
- Neurovascular coupling abnormalities in first-episode drug-naïve major depressive disorder patients.BMC psychiatry · 2025Article
- Sex differences in gray matter, white matter, and regional brain perfusion in young, healthy adults.American journal of physiology. Heart and circulatory physiology · 2024Article
- Effects of hemodynamic alterations and oxygen saturation on cerebral perfusion in congenital heart disease.Pediatric research · 2024Article
- Higher levels of plasma Adrenocorticotropic hormone (ACTH) are associated with lower suicidal ideation in depressed patients compared to controls and suicide attempters, independently from depression severity.Comprehensive psychoneuroendocrinology · 2024Article
- Association of grey matter cerebral blood flow with white matter integrity in relation to youth bipolar disorder.Journal of psychiatry & neuroscience : JPNArticle
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMajor depressive disorder (MDD) is a leading cause of disease burden and shows a marked sexual dimorphism. Previous studies reported changes in cerebral perfusion in MDD, an association between perfusion and dehydroepiandrosterone sulfate (DHEAS) levels, and large sex differences in perfusion. This study examines whether perfusion and DHEAS might mediate the link between sex and depressive symptoms in a large, unmedicated community sample.
methodsThe sample included 203 healthy volunteers and 79 individuals with past or current MDD. Depression severity was assessed with the Hamilton Depression Scale (HAM-D) and Montgomery-Asberg Depression Rating Scale (MADRS). 3 T MRI perfusion data were collected with a pseudocontinuous arterial spin labelling sequence and DHEAS was measured in serum by LC-MS/MS.
resultsLarge sex differences in perfusion were observed (p < 0.001). Perfusion was negatively correlated with DHEAS (r = -0.23, p < 0.01, n = 250) and with depression severity (HAM-D: r = -0.17, p = 0.01, n = 242; partial Spearman correlation, controlling for age and sex), but not with anxiety. A significant sex*perfusion interaction on depression severity was observed. In women, perfusion showed more pronounced negative correlations with depressive symptoms, with absent or, in the case of the MADRS, opposite effects observed in men. A mediation analysis identified DHEAS and perfusion as mediating variables influencing the link between sex and the HAM-D score.
conclusionPerfusion was linked to depression severity, with the strongest effects observed in women. Perfusion and the neurosteroid DHEAS appear to mediate the link between sex and HAM-D scores, suggesting that inter-individual differences in perfusion and DHEAS levels may contribute to the sexual dimorphism in depression.
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