White matter correlates of impaired attention control in major depressive disorder and healthy volunteers

Mina M. Rizk, Harry Rubin-Falcone, John Keilp, Jeffrey M. Miller, M. Elizabeth Sublette, Ainsley Burke, Maria A. Oquendo, Ahmed M. Kamal, Mohamed A. Abdelhameed, J. John Mann

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Background Major depressive disorder (MDD) is associated with impaired attention control and alterations in frontal-subcortical connectivity. We hypothesized that attention control as assessed by Stroop task interference depends on white matter integrity in fronto-cingulate regions and assessed this relationship using diffusion tensor imaging (DTI) in MDD and healthy volunteers (HV). Methods DTI images and Stroop task were acquired in 29 unmedicated MDD patients and 16 HVs, aged 18–65 years. The relationship between Stroop interference and fractional anisotropy (FA) was examined using region-of-interest (ROI) and tract-based spatial statistics (TBSS) analyses. Results ROI analysis revealed that Stroop interference correlated positively with FA in left caudal anterior cingulate cortex (cACC) in HVs (r = 0.62, p = 0.01), but not in MDD (r = −0.05, p= 0.79) even after controlling for depression severity. The left cACC was among 4 ROIs in fronto-cingulate network where FA was lower in MDD relative to HVs (F(1,41) = 8.87, p = 0.005). Additionally, TBSS showed the same group interaction of differences and correlations, although only at a statistical trend level. Limitations The modest sample size limits the generalizability of the findings. Conclusions Structural connectivity of white matter network of cACC correlated with magnitude of Stroop interference in HVs, but not MDD. The cACC-frontal network, sub-serving attention control, may be disrupted in MDD. Less cognitive control may include enhanced effects of salience in HVs, or less effective response inhibition in MDD. Further studies of salience and inhibition components of executive function may better elucidate the relationship between brain white matter changes and executive dysfunction in MDD.

Original languageEnglish
Pages (from-to)103-111
Number of pages9
JournalJournal of Affective Disorders
StatePublished - Nov 2017
Externally publishedYes


  • Attention control
  • Caudal anterior cingulate cortex
  • Diffusion tensor imaging
  • Major depressive disorder
  • Stroop interference
  • Tract-based spatial statistics


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