Parental Report of Child s Depressive Symptoms and Cerebral Cortical Volume: Racial Differences

Research Article

J Pediatr & Child Health Care. 2022; 7(1): 1051.

Parental Report of Child’s Depressive Symptoms and Cerebral Cortical Volume: Racial Differences

Assari S1,2,3*, Najand B1 and Saqib M4

1Marginalization-Related Diminished Returns (MDRs) Research Center, Charles Drew University, Los Angeles, CA 90059, USA

2Department of Family Medicine, Charles Drew University, Los Angeles, CA 90059, USA

3Department of Urban Public Health, Charles Drew University, Los Angeles, CA 90059, USA

4University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA

*Corresponding author: Shervin Assari, Marginalization-Related Diminished Returns (MDRs) Research Center, Charles Drew University, Los Angeles, CA 90059, USA; Email: assari@umich.edu

Received: December 06, 2021; Accepted: January 06, 2022; Published: January 13, 2022

Abstract

Background: Although the association between self-reported depression and altered properties of the prefrontal cortex are well described, less is known about the link between parental reports or child depressive symptoms and volume for various cortical structures. It is also unknown whether these associations differ by race/ethnicity.

Aim: This study tested the associations between parental reports of the child’s depressive symptoms, and volume of various cortical structures in 9/10-year-old U.S. children. We also explored racial/ethnic differences in these associations.

Methods: We used the Adolescent Brain Cognitive Development (ABCD) study’s baseline data for this cross-sectional study. Our analytical sample included 10,855 non-Latino Black and non- Latino White U.S. children between the ages of 9 and 10. The independent variable was the parental report or child’s depressive symptoms, measured using Parent Adult Self Report Scores Aseba (ASR). Structural Magnetic Resonance Imaging (sMRI) was used to measure the volume of various cortical structures based on the Desikan cortical atlas. Race/ethnicity was the moderator. Age, sex, parental education, household income, and family structure were the covariates. Mixed-effects regression models were used for data analysis.

Results: In the overall sample, parental report of child’s depressive symptoms was associated with the volume of cortical structures. The direction of the association between parental report or child’s depressive symptoms (PRCDS) and cerebral cortex regions differed across cortical areas. These associations also differed between non-Latino Black and non-Latino White children. Opposite associations were found for various cortical structures and regions including the right caudal middle frontal, Isthmus cingulate, lateral orbitofrontal, medial orbitofrontal, middle temporal, paracentral, pericalcarine, supramarginal, temporal pole, superior temporal, postcentral, and the Transverse temporal region as well as left bankssts, cuneus, entorhinal, fusiform, inferior temporal, insula, isthmus cingulate, lateral orbitofrontal, medial orbitofrontal, middle temporal, parahippocampal, pericalcarine, rostral middle frontal, superior temporal, supramarginal, Transverse temporal. For almost all of these cortical structures, the association between depressive symptoms and cortical volume was negative in non-Latino White but positive for non-Latino Black children.

Conclusion: Racial differences in the association between parental reports or child depressive symptoms and child cerebral cortical morphometry, in non- Latino Black and non-Latino White children, invite researchers to explore how repeated stress, trauma, and adversity contribute to such differences. Differential access to depression treatment and chronicity of depression may also alter how depression correlates with cortical structures across racial groups.

Keywords: Cerebral cortex; Depression depressive symptoms; Ethnic groups; Population groups; MRI

Introduction

Depression is one of the most common in the U.S. With more than a 16% lifetime prevalence [1], depression imposes a 200 billion dollar burden on the U.S. economy annually [2]. According to the WHO, depression is the leading cause of years lived with disability worldwide [3]. Not only is depression one of the most prevalent non-fatal health problems [3], it is also linked to multiple health and social consequences, including suicide and addiction [4]. Additionally, only 50% of patients with depression respond to standard-of-care treatments [5], and up to 70% do not get full remission [6]. Over half of all depression cases are from individuals younger than 25 years old, meaning that a heavy burden of depression is on youth and young adults. Youth depression is also a predictor of undesired outcomes later in life, including chronic illnesses, suicide, addiction, and unemployment [7]. While depression is linked to brain structure impairments [8-11], most of what we know is about the association to an individual’s own self-reported depression. Less is known about the association between parental report or child’s depressive symptoms (PRCDS) and imaging characteristics of the individual. In addition, due to the lack of diversity in imaging studies of adolescent samples, we know very little about the heterogeneity in the imaging characteristics linked to parental depression.

During the last few decades, structural imaging techniques such as magnetic resonance imaging (MRI) have provided more knowledge on the link between brain structures and depression [12,13]. MRI provides useful information on brain structure with a broad range of techniques for analysis, measurement, and visualization of brain structure’s morphology [14]. Various structural magnetic resonance imaging (sMRI) studies in patients with depression have documented morphological changes, mainly regarding changes in thickness and volume of cortical structures [15-17].

Further, the development of voxel-based morphometry (VBM) has allowed for an exploration of the analysis of whole-brain anatomical structures [18]. The VBM method has helped with the detection of some alterations of changes in the volume of gray matter structures in patients with depression [19]. For example, some studies have provided evidence of a decline in the volume of the anterior cingulate cortex (ACC) in depression patients [20,21], which may play a role in various affective and cognitive presentations of depression [22]. In addition, a study indicated a negative association between the cortical thickness of the rostral middle frontal cortex (MFC), and depression severity in untreated patients with first-episode mid-life depression [23]. Other research has documented early morphological alterations in first-episode untreated depression [24,25].

Aims

We are unaware of any previous studies on racial and ethnic differences in the association between depressive symptoms and morphometry of the cerebral cortex. Given that race is a proxy of trauma, poverty, stress, adversity, and discrimination, race -- as a social construct -- may alter the link between cerebral cortex regions and depression. In the present study, we aimed to examine racial and ethnic heterogeneity in the association between depressive symptoms and morphometry of cerebral cortex in a sample of 9/10-year-old American pre-adolescents from the Adolescent Brain Cognitive Development (ABCD) research study [26]. We expected an association between depressive symptoms and surface area, thickness, and volume of various cortical measures. We explored heterogeneity in the direction of the association between depressive symptoms and cerebral cortex regions by race/ethnicity.

Methods

This is a cross-sectional analysis of the baseline ABCD data. ABCD baseline data were collected between 2016 and 2018. The ABCD study is an unprecedented study of brain development following a large, diverse national sample of 9/10 year old children during their transition to young adulthood.

The ABCD sample is primarily selected from schools in the U.S. Sampling was performed via 21 study sites that were located in 15 states. The analytical sample that participated in this analysis was non-Latino White and non-Latino Black. Individuals who identified as Asian, Latino, mixed-race, Native American, or other races were excluded.

The study variables included age, sex, race/ethnicity, parental education, household income, family structure (confounders), parental report or child’s depressive symptoms and volume of various cortical structures measured using sMRI (outcome).

Depressive symptoms

Our main independent variable of interest was depressive symptoms reported by the parent, which is also referred to as asr_ scr_depress_t in the NDA website. This variable is a quantitative (numerical) score, where a higher score indicates more depressive symptoms, that is positively correlated with a history of depression (KSADS), as well as teacher reports of depressive symptoms.

Structural MRI (sMRI)

Structural MRI (sMRI) was performed as described in detail by Casey et al. (2018) available here [26]. In the ABCD study, participants completed a high-resolution T1-weighted sMRI scan (1mm isotropic voxels) using scanners from Philips Healthcare (Philips, Andover, Massachusetts, USA), GE Healthcare (General Electrics, Waukesha, WI, USA), or Siemens Healthcare (Siemens, Erlangen, Germany). The sMRI data were then processed using FreeSurfer version 5.3.0, available at http://surfer.nmr.mgh.harvard. edu/ [27-30], according to standard processing pipelines. Processing included removal of nonbrain tissue, segmentation of gray and white matter structures, and cortical parcellation [26]. All scan sessions underwent radiological review, whereby scans with incidental findings were identified. Quality control for the structural images comprised of visual inspections of T1 images and FreeSurfer outputs for quality [27-30]. The quality review was conducted by the ABCD team. Subjects whose scans failed inspection (due to severe artifacts or irregularities) were excluded. The Desikan-Killiany atlas was used for cortical parcellation [31,32]. Regions of interest (ROIs) included bankssts, caudal anterior cingulate, caudal middle frontal, cuneus, entorhinal, frontal pole, fusiform, inferior parietal, inferior temporal, insula, isthmus cingulate, lateral occipital, lateral orbitofrontal, lingual, medial orbitofrontal, middle temporal, paracentral, parahippocampal, pars opercularis, pars orbitalis, pars triangularis, pericalcarine, postcentral, posterior cingulate, precentral, precuneus, rostral anterior cingulate, rostral middle frontal, superior frontal, superior parietal, superior temporal, supramarginal, temporal pole, and transverse temporal for right and left hemispheres. In this analysis, we used the volumetric data of the cerebral cortex provided by the ABCD data and available for download on the NDA website (https://nda.nih.gov/abcd).

Data analysis

Data analysis was performed on ABCD’s DEAP Website. DEAP is a platform specifically designed for analysis of the ABCD data. First, we reported frequency (%) and mean (SD) of our variables overall and by race/ethnicity. Then, we compared our racial/ethnic groups for our study variables. Chi-square was used for statistical comparison of non-Latino White and non-Latino Black children. Finally, we applied mixed-effects regression models to test whether parental report of the child’s depressive symptoms was associated with the cortical volume, specifically and separately, for each cortical structure. The independent variable was the parental report of child’s depressive symptoms, measured using Parent Adult Self Report Scores Aseba (ASR). The dependent variable was each structural MRI data (volume), treated as a continuous measure. We tested the assumptions required for multivariable analysis. All our outcomes had a normal distribution. Error terms were also normally distributed, and there was no multi-collinearity between the study measures. Beta and p values were reported for the association between depressive symptoms and each cortical structure volume. These modeling’s were performed using DEAP ROI analysis.

Results

Overall, 10,855 participants entered our analysis. Participants included 8,833 (81.4%) non-Latino White and 2,022 (18.6%) non-Latino Black children. Table 1 describes their demographic, socioeconomic, and depressive symptoms overall and by race. As shown in the table, non-Latino Black children were younger and had less depressive symptoms, reported by parents, than non-Latino White children. Compared to non-Latino White children, non- Latino Black children were from families with lower education, lower-income, and unmarried families.