Cerebral and cervical hemodynamic differences in adolescents with first-episode depressive disorder: a TCCD and cervical artery ultrasound study.

OBJECTIVE: To investigate cerebral and cervical hemodynamic differences assessed by transcranial color-coded duplex sonography (TCCD) combined with cervical artery ultrasound in adolescents with first-episode depressive disorder. METHODS: This study included 169 adolescents with first-episode depressive disorder and 61 healthy controls. TCCD combined with cervical artery ultrasound was used to assess hemodynamic parameters of the main cerebral and cervical arteries, including peak systolic velocity, end-diastolic velocity, mean velocity, pulsatility index, and resistance index. Differences between the depressive disorder group and the healthy control group were compared. Associations between hemodynamic parameters and clinical characteristics, including Self-Rating Depression Scale (SDS) standard score, sex, age, and disease duration, were also analyzed. RESULTS: The depressive disorder and healthy control groups were comparable in age [16 (13, 17) vs 16 (13.25, 17) years, P = 0.580] and sex distribution (female, 68.6% vs 62.3%, P = 0.367). Compared with healthy controls, adolescents with first-episode depressive disorder showed alterations in cerebral and cervical arterial hemodynamic parameters despite the absence of definite structural cerebrovascular lesions. The main changes were an increase in resistance-related indices in left middle cerebral artery, left anterior cerebral artery, and bilateral vertebral arteries. The velocity-related indices showed heterogeneous changes, including increased peak systolic velocity in the left anterior cerebral artery, decreased flow velocity in the intracranial segment of the right vertebral artery, and increased blood flow velocity in the cervical segment of the right internal carotid artery (all P < 0.05). Increasing age was predominantly associated with lower velocity-related parameters (all P < 0.05). Within the depressive disorder group, higher SDS standard scores were negatively associated with selected pulsatility, resistance, and velocity-related parameters after FDR correction (all FDR-adjusted q < 0.05). No consistent associations were found between hemodynamic parameters and sex or disease duration. CONCLUSION: TCCD combined with cervical artery ultrasound revealed differences in selected cerebral and cervical hemodynamic parameters in adolescents with first-episode depressive disorder, characterized by higher resistance-related indices and heterogeneous velocity-related changes. These findings suggest that combined ultrasound may provide complementary hemodynamic information and support future development of noninvasive hemodynamic characterization for adolescent depressive disorder.