Altered white-matter architecture in treatment-naive adolescents with clinical depression.

BACKGROUND: Depressive disorders are highly prevalent in adolescence and confer a heightened risk of recurrence in adulthood. Insight into the developmental neurocircuitry of depression could advance our understanding of depression and aid the development of effective treatment strategies. Whereas white-matter (WM) abnormalities are strongly implicated in adult depression, we still lack a firm understanding of WM architecture in adolescent depression. Using diffusion tensor imaging (DTI), we set out to investigate WM microstructure in a sample of clinically depressed adolescents relative to matched controls. METHOD: We employed tract-based spatial statistics (TBSS) to examine WM microstructure in 25 treatment-naive adolescents with clinical depression relative to 21 matched controls. Using TBSS, we examined fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD) and mean diffusivity (MD). Threshold-free cluster enhancement (TFCE) with family-wise error (FWE) correction was used to control for multiple comparisons. RESULTS: Our analysis revealed abnormal WM microstructure in clinically depressed adolescents. More specifically, whole-brain analysis revealed that patients had lower FA values in the body of the corpus callosum (CC), coupled with elevated RD and MD, and preserved AD. Conversely, region-of-interest analysis revealed that patients had higher FA values in the uncinate fasciculus (UF), coupled with elevated AD, reduced RD and preserved MD. CONCLUSIONS: In line with neurocircuitry models of depression, our findings suggest that WM abnormalities within pathways facilitating cognitive and emotional functioning are involved in the pathophysiology of depression. Importantly, our findings show that these WM abnormalities are already present early in the course of the disorder.

[Percutaneous bone puncture biopsy with trocar. Apropos of 60 cases]. / Ponction biopsie osseuse percutanée au trocart. A propos de 60 observations.

Deep bone biopsies were performed in 58 patients over the last 2 years, in a radiology department in Tours, France, under television screen control. Data obtained included pathologic, cytologic and bacteriologic features in the 60 biopsies conducted, localization being the spine in 52 cases (12 dorsal, 36 lumbar, 4 sacroiliac) and the pelvis 8 times. Etiology was a tumoral process in 15 cases (14 metastases and 1 reticulosarcoma), 7 infectious processes including 2 cases of tuberculosis, 26 cases of decalcifying degenerative osteopathies, 1 Paget's disease, 1 ankylosing spondylitis and 1 bone infarct. Biopsy was unsuccessful in 9 cases, the success rate being an overall 85%. Complications were not observed. Conducted under local anesthesia, deep bone biopsy provides a rapid diagnosis and allows a shortened hospital stay. Surgery is generally avoided and appropriate treatment instituted more rapidly.