# Depression as a disease of network disruption:  learning from multiple sclerosis

> **NIH NIH K23** · UNIVERSITY OF PENNSYLVANIA · 2024 · $194,940

## Abstract

PROJECT ABSTRACT/SUMMARY
Multiplesclerosis (MS) is an immune-mediatedneurological disorder that affects one million people in
the United States. Up to 50% of patients with MS experience depression, yet the mechanisms of depression in
MS remain under-investigated. MS is characterized by white matter lesions, suggesting that brain network
disruption may underly depression symptoms. Studies of medically healthy participants with depression have
described associations between white matter variability and depressive symptoms, but frequently exclude
participants with medical comorbidities and thus cannot be extrapolated to people with intracranial diseases.
Previous research using lesion network mapping, a technique for mapping heterogeneous gray matter lesions
to neuropsychiatric symptoms, has demonstrated that strokes in gray matter associated with depression disrupt
a reproducible depression network. However, such techniques have never been applied to white matter disease
or MS. Studying white matter lesions associated with depression in MS may provide a way to understand both
the pathophysiology of depression in MS and general network mechanisms of depression more broadly. The
purpose of this current study is to investigate how brain network disruption underlies depression by learning from
the example of multiple sclerosis. In Aim 1, I will delineate how depression in adults with MS is associated with
white matter lesion location and burden in a retrospective sample of 1,554 MS patients with research-grade 3T
MRIs acquired as part of clinical care. Depression and MS diagnoses will be obtained from the electronic medical
record. While this sample provides an ideal dataset for developing a model, the electronic medical record does
not contain granular depression measures. In Aim 2, I will obtain structured clinical and cognitive assessments
for MS patients and prospectively evaluate white matter integrity as a predictor of dimensional depressive
symptoms. However, it is possible that symptoms of depression may reflect heterogenous brain network
disruption patterns. Therefore, in Aim 3, I will use advanced semi-supervised machine learning methods to parse
heterogeneity in MS white matter lesion burden in the retrospective sample and test whether this model predicts
phenotypic heterogeneity in our deeply-phenotyped prospective sample. The support of the K23 award will
provide the applicant with the training necessary to achieve these aims. The training objectives will be
accomplished with the support of an outstanding mentorship team, Drs. Satterthwaite, Shinohara, Bassett, Bar-
Or, Fox, McCoy, and the world class resources of the University of Pennsylvania. Together, the proposed
scientific aims and training objectives will form the foundation for an independent research program that will use
techniques from computational psychiatry to understand depression in patients with medical comorbidities.

## Key facts

- **NIH application ID:** 10832068
- **Project number:** 5K23MH133118-02
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Erica Berlin Baller
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $194,940
- **Award type:** 5
- **Project period:** 2023-07-01 → 2028-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10832068

## Citation

> US National Institutes of Health, RePORTER application 10832068, Depression as a disease of network disruption:  learning from multiple sclerosis (5K23MH133118-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10832068. Licensed CC0.

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