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Marawi T, Ainsworth NJ, Zhukovsky P, Rashidi-Ranjbar N, Rajji TK, Tartaglia MC, Voineskos AN, Mulsant BH. Brain-cognition relationships in late-life depression: a systematic review of structural magnetic resonance imaging studies. Transl Psychiatry 2023; 13:284. [PMID: 37598228 PMCID: PMC10439902 DOI: 10.1038/s41398-023-02584-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 08/06/2023] [Accepted: 08/08/2023] [Indexed: 08/21/2023] Open
Abstract
BACKGROUND Most patients with late-life depression (LLD) have cognitive impairment, and at least one-third meet diagnostic criteria for mild cognitive impairment (MCI), a prodrome to Alzheimer's dementia (AD) and other neurodegenerative diseases. However, the mechanisms linking LLD and MCI, and brain alterations underlying impaired cognition in LLD and LLD + MCI remain poorly understood. METHODS To address this knowledge gap, we conducted a systematic review of studies of brain-cognition relationships in LLD or LLD + MCI to identify circuits underlying impaired cognition in LLD or LLD + MCI. We searched MEDLINE, PsycINFO, EMBASE, and Web of Science databases from inception through February 13, 2023. We included studies that assessed cognition in patients with LLD or LLD + MCI and acquired: (1) T1-weighted imaging (T1) measuring gray matter volumes or thickness; or (2) diffusion-weighted imaging (DWI) assessing white matter integrity. Due to the heterogeneity in studies, we only conducted a descriptive synthesis. RESULTS Our search identified 51 articles, resulting in 33 T1 studies, 17 DWI studies, and 1 study analyzing both T1 and DWI. Despite limitations, reviewed studies suggest that lower thickness or volume in the frontal and temporal regions and widespread lower white matter integrity are associated with impaired cognition in LLD. Lower white matter integrity in the posterior cingulate region (precuneus and corpus callosum sub-regions) was more associated with impairment executive function and processing speed than with memory. CONCLUSION Future studies should analyze larger samples of participants with various degrees of cognitive impairment and go beyond univariate statistical models to assess reliable brain-cognition relationships in LLD.
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Affiliation(s)
- Tulip Marawi
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Nicholas J Ainsworth
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Peter Zhukovsky
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Neda Rashidi-Ranjbar
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, Toronto, ON, Canada
| | - Tarek K Rajji
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Toronto Dementia Research Alliance, University of Toronto, Toronto, ON, Canada
| | - Maria Carmela Tartaglia
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Neurology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
| | - Aristotle N Voineskos
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Benoit H Mulsant
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- Toronto Dementia Research Alliance, University of Toronto, Toronto, ON, Canada.
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Cao P, Chen C, Si Q, Li Y, Ren F, Han C, Zhao J, Wang X, Xu G, Sui Y. Volumes of hippocampal subfields suggest a continuum between schizophrenia, major depressive disorder and bipolar disorder. Front Psychiatry 2023; 14:1191170. [PMID: 37547217 PMCID: PMC10400724 DOI: 10.3389/fpsyt.2023.1191170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/03/2023] [Indexed: 08/08/2023] Open
Abstract
Objective There is considerable debate as to whether the continuum of major psychiatric disorders exists and to what extent the boundaries extend. Converging evidence suggests that alterations in hippocampal volume are a common sign in psychiatric disorders; however, there is still no consensus on the nature and extent of hippocampal atrophy in schizophrenia (SZ), major depressive disorder (MDD) and bipolar disorder (BD). The aim of this study was to verify the continuum of SZ - BD - MDD at the level of hippocampal subfield volume and to compare the volume differences in hippocampal subfields in the continuum. Methods A total of 412 participants (204 SZ, 98 MDD, and 110 BD) underwent 3 T MRI scans, structured clinical interviews, and clinical scales. We segmented the hippocampal subfields with FreeSurfer 7.1.1 and compared subfields volumes across the three diagnostic groups by controlling for age, gender, education, and intracranial volumes. Results The results showed a gradual increase in hippocampal subfield volumes from SZ to MDD to BD. Significant volume differences in the total hippocampus and 13 of 26 hippocampal subfields, including CA1, CA3, CA4, GC-ML-DG, molecular layer and the whole hippocampus, bilaterally, and parasubiculum in the right hemisphere, were observed among diagnostic groups. Medication treatment had the most effect on subfields of MDD compared to SZ and BD. Subfield volumes were negatively correlated with illness duration of MDD. Positive correlations were found between subfield volumes and drug dose in SZ and MDD. There was no significant difference in laterality between diagnostic groups. Conclusion The pattern of hippocampal volume reduction in SZ, MDD and BD suggests that there may be a continuum of the three disorders at the hippocampal level. The hippocampus represents a phenotype that is distinct from traditional diagnostic strategies. Combined with illness duration and drug intervention, it may better reflect shared pathophysiology and mechanisms across psychiatric disorders.
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Affiliation(s)
- Peiyu Cao
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
| | - Congxin Chen
- Women’s Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Qi Si
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
- Huai’an No. 3 People’s Hospital, Huai’an, China
| | - Yuting Li
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
| | - Fangfang Ren
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
| | - Chongyang Han
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
| | - Jingjing Zhao
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
| | - Xiying Wang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
| | - Guoxin Xu
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
| | - Yuxiu Sui
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
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Comparing cardiovascular risk factors in older persons with mild cognitive impairment and lifetime history of major depressive disorder. Int Psychogeriatr 2022; 34:563-569. [PMID: 33775259 DOI: 10.1017/s1041610221000259] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To compare the prevalence of select cardiovascular risk factors (CVRFs) in patients with mild cognitive impairment (MCI) versus lifetime history of major depression disorder (MDD) and a normal comparison group using baseline data from the Prevention of Alzheimer's Dementia with Cognitive Remediation plus Transcranial Direct Current Stimulation (PACt-MD) study. DESIGN Baseline data from a multi-centered intervention study of older adults with MCI, history of MDD, or combined MCI and history of MDD (PACt-MD) were analyzed. SETTING Community-based multi-centered study based in Toronto across 5 academic sites. PARTICIPANTS Older adults with MCI, history of MDD, or combined MCI and history of MDD and healthy controls. MEASUREMENTS We examined the baseline distribution of smoking, hypertension and diabetes in three groups of participants aged 60+ years in the PACt-MD cohort study: MCI (n = 278), MDD (n = 95), and healthy older controls (n = 81). Generalized linear models were fitted to study the effect of CVRFs on MCI and MDD as well as neuropsychological composite scores. RESULTS A higher odds of hypertension among the MCI cohort compared to healthy controls (p < .05) was noted in unadjusted analysis. Statistical significance level was lost on adjusting for age, sex and education (p > .05). A history of hypertension was associated with lower performance in composite executive function (p < .05) and overall composite neuropsychological test score (p < .05) among a pooled cohort with MCI or MDD. CONCLUSIONS This study reinforces the importance of treating modifiable CVRFs, specifically hypertension, as a means of mitigating cognitive decline in patients with at-risk cognitive conditions.
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Ballester PL, Romano MT, de Azevedo Cardoso T, Hassel S, Strother SC, Kennedy SH, Frey BN. Brain age in mood and psychotic disorders: a systematic review and meta-analysis. Acta Psychiatr Scand 2022; 145:42-55. [PMID: 34510423 DOI: 10.1111/acps.13371] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 09/05/2021] [Accepted: 09/07/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To evaluate whether accelerated brain aging occurs in individuals with mood or psychotic disorders. METHODS A systematic review following PRISMA guidelines was conducted. A meta-analysis was then performed to assess neuroimaging-derived brain age gap in three independent groups: (1) schizophrenia and first-episode psychosis, (2) major depressive disorder, and (3) bipolar disorder. RESULTS A total of 18 papers were included. The random-effects model meta-analysis showed a significantly increased neuroimaging-derived brain age gap relative to age-matched controls for the three major psychiatric disorders, with schizophrenia (3.08; 95%CI [2.32; 3.85]; p < 0.01) presenting the largest effect, followed by bipolar disorder (1.93; [0.53; 3.34]; p < 0.01) and major depressive disorder (1.12; [0.41; 1.83]; p < 0.01). The brain age gap was larger in older compared to younger individuals. CONCLUSION Individuals with mood and psychotic disorders may undergo a process of accelerated brain aging reflected in patterns captured by neuroimaging data. The brain age gap tends to be more pronounced in older individuals, indicating a possible cumulative biological effect of illness burden.
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Affiliation(s)
- Pedro L Ballester
- Neuroscience Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Maria T Romano
- Integrated Science Undergraduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Taiane de Azevedo Cardoso
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Stefanie Hassel
- Mathison Centre for Mental Health Research and Education, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Stephen C Strother
- Rotman Research Institute, Baycrest, Toronto, Ontario, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Sidney H Kennedy
- Centre for Depression and Suicide Studies, and Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Benicio N Frey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Mood Disorders Treatment and Research Centre, and Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, Ontario, Canada
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Wang Z, Yuan Y, Jiang Y, You J, Zhang Z. Identification of specific neural circuit underlying the key cognitive deficit of remitted late-onset depression: A multi-modal MRI and machine learning study. Prog Neuropsychopharmacol Biol Psychiatry 2021; 108:110192. [PMID: 33285264 DOI: 10.1016/j.pnpbp.2020.110192] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/23/2020] [Accepted: 11/30/2020] [Indexed: 01/21/2023]
Abstract
Neuropsychological impairment is a key feature of late-onset depression (LOD), with deficits observed across multiple cognitive domains. And this neuropsychological impairment can persist even after the remission of depressive symptoms. However, none of previous studies have explored the pattern of cognitive deficit in remitted LOD (rLOD), and investigated the specific neural circuit underlying the key cognitive deficit of LOD. 40 rLOD patients and 36 controls underwent comprehensive neuropsychological assessments and magnetic resonance imaging (MRI) scans. The influence of executive function or information processing speed deficit on other cognitive domains was first investigated. We then applied a multivariate machine learning technique known as relevance vector regression to evaluate the potential of multiple-modal MRI (i.e., integrating whole-brain grey-matter [GM] volume and white-matter [WM] tract features) for making accurate predictions about the key cognitive deficit for individual rLOD patient. We revealed that the information processing speed appears to represent a key cognitive deficit in rLOD. Further the machine learning model identified a wide range of GM regions and WM tracts that significantly contributed to the prediction of individual performance on information processing speed (r = 0.50, P < 0.001). The GM regions mainly located in the frontal-subcortical and limbic systems; and the WM tracts mainly located in the frontal-limbic pathway, including the anterior corona radiata, fornix, posterior cingulate bundle, and uncinate fasciculus. This present study provide strongly evidence supporting the concept of rLOD that the core aspect of the cognitive deficits (i.e., information processing speed) is associated with disruption of the frontal-subcortical-limbic pathway.
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Affiliation(s)
- Zan Wang
- School of Medicine, Southeast University, Nanjing 210009, China; Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Nanjing 210009, China.
| | - Yonggui Yuan
- School of Medicine, Southeast University, Nanjing 210009, China; Department of Psychosomatics and Psychiatry, Affiliated ZhongDa Hospital of Southeast University, Nanjing 210009, China
| | - Ying Jiang
- Department of Neurology, the 962nd Hospital of the PLA Joint Logistic Support Force, Harbin 150080, China
| | - Jiayong You
- Department of Psychiatry, Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China
| | - Zhijun Zhang
- School of Medicine, Southeast University, Nanjing 210009, China; Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Nanjing 210009, China.
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Kim YK, Han KM. Neural substrates for late-life depression: A selective review of structural neuroimaging studies. Prog Neuropsychopharmacol Biol Psychiatry 2021; 104:110010. [PMID: 32544600 DOI: 10.1016/j.pnpbp.2020.110010] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 06/05/2020] [Accepted: 06/09/2020] [Indexed: 12/15/2022]
Abstract
Recent neuroimaging studies have characterized the pathophysiology of late-life depression (LLD) as a dysfunction of the brain networks involved in the regulation of emotion, motivational behavior, cognitive control, executive function, and self-referential thinking. In this article, we reviewed LLD-associated structural neuroimaging markers such as white matter hyperintensity (WMH), white matter integrity measured by diffusion tensor imaging, cortical and subcortical volumes, and cortical thickness, which may provide a structural basis for brain network dysfunction in LLD. LLD was associated with greater severity or volumes of deep, periventricular, or overall WMH and with decreased white matter integrity in the brain regions belonging to the fronto-striatal-limbic circuits and reduced white matter tract integrity which connects these circuits, such as the cingulum, corpus callosum, or uncinate fasciculus. Decreased volumes or cortical thickness in the prefrontal cortex, orbitofrontal cortex, anterior and posterior cingulate cortex, several temporal and parietal regions, hippocampus, amygdala, striatum, thalamus, and the insula were associated with LLD. These structural neuroimaging findings were also associated with cognitive dysfunction, which is a prominent clinical feature in LLD. Several structural neuroimaging markers including the WMH burden, white matter integrity, and cortical and subcortical volumes predicted antidepressant response in LLD. These structural neuroimaging findings support the hypothesis that disruption of the brain networks involved in emotion regulation and cognitive processing by impaired structural connectivity is strongly associated with the pathophysiology of LLD.
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Affiliation(s)
- Yong-Ku Kim
- Department of Psychiatry, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Kyu-Man Han
- Department of Psychiatry, College of Medicine, Korea University, Seoul, Republic of Korea.
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Liu X, Song D, Yin Y, Xie C, Zhang H, Zhang H, Zhang Z, Wang Z, Yuan Y. Altered Brain Entropy as a predictor of antidepressant response in major depressive disorder. J Affect Disord 2020; 260:716-721. [PMID: 31563070 DOI: 10.1016/j.jad.2019.09.067] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 09/17/2019] [Accepted: 09/18/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To explore the alterations and value of brain entropy (BEN) in major depressive disorder (MDD). METHODS 85 MDD patients and 45 matched normal controls were recruited. MDD was diagnosed based on Diagnostic and Statistical Manual of Mental Disorders, 4th ed (DSM-IV). Symptoms of depression were assessed using the Hamilton depression scale-24 (HAMD-24) at baseline and follow-up (after 8-week treatment). All subjects underwent functional magnetic resonance imaging (fMRI) scans at baseline, and 30 MDD patients completed scans at 8th week. Whole brain BEN maps at each session was calculated using the BEN mapping toolbox. RESULTS The 8-week antidepressant treatment improved symptoms for all MDD patients. As compared to normal controls, MDD showed reduced BEN in medial orbitofrontal cortex (MOFC)/subgenual cingulate cortex (sgACC), but increased BEN in motor cortex (MC). In MDD patients, higher baseline BEN in MOFC/sgACC and lower baseline BEN in temporal cortex (TC) were associated with higher baseline HAMD scores; higher baseline BEN in MOFC/sgACC and hippocampus were associated with greater reduction of HAMD scores after 8-week medication; greater reduction of HAMD scores after 8-week medication was correlated with greater BEN reduction in MOFC/sgACC but were correlated with less BEN reduction in MC, TC, fusiform gyrus (FG) and visual cortex (VC). CONCLUSION The results highlighted MOFC/sgACC BEN as a potential marker for the prediction of MDD diagnosis and treatment effect. MDD might have increased MOFC/sgACC BEN but reduced BEN in visual and sensory-motor circuits corresponding to the imbalanced emotional and sensory-motor information processing. Reversing this unbalanced BEN would improve disease conditions in MDD.
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Affiliation(s)
- Xiaoyun Liu
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Donghui Song
- Center for Cognition and Brain Disorders, Department of Psychology, Hangzhou Normal University, Hangzhou, China
| | - Yingying Yin
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Chunming Xie
- Department of Neurology, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Haisan Zhang
- Departments of Clinical Magnetic Resonance Imaging, the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China
| | - Hongxing Zhang
- Departments of Psychiatry, the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China
| | - Zhijun Zhang
- Department of Neurology, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Ze Wang
- Department of Radiology, University of Maryland School of Medicine, USA.
| | - Yonggui Yuan
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
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Jamieson A, Goodwill AM, Termine M, Campbell S, Szoeke C. Depression related cerebral pathology and its relationship with cognitive functioning: A systematic review. J Affect Disord 2019; 250:410-418. [PMID: 30878653 DOI: 10.1016/j.jad.2019.03.042] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 02/26/2019] [Accepted: 03/04/2019] [Indexed: 01/29/2023]
Abstract
BACKGROUND Depression's relationship with cerebral abnormalities and cognitive decline is temporally dynamic. Despite clear clinical utility, understanding depression's effect on cerebral structures, cognitive impairment and the interaction between these symptoms has had limited consideration. METHODS This review summarised studies examining a clinical depression diagnosis or validated scales measuring depressive symptoms, data concerning amyloid-beta (Aβ) levels, brain structure and function focusing on hippocampal alterations, or white matter hyperintensities (WMH), and at least one validated neuropsychological test. Online database searches of: PsycINFO, EMBASE, MEDLINE, and Scopus were conducted to identify potential articles. RESULTS While depression was consistently associated with cross-sectionally cognitive decline across multiple domains, the neuropathological basis of this dysfunction remained unclear. Hippocampal, frontal, and limbic dysfunction as well as cortical thinning, WMH, and Aβ burden all provide inconsistent findings, likely due to depression subtypes. The consistency of these findings additionally decreases when examining this relationship longitudinally, as these results are further confounded by pre-dementia states. The therapeutic interventions examined were more efficacious in the younger compared with the older samples, who were characterised by greater WMH and Aβ burden. LIMITATIONS The limited number of longitudinal and interventional studies in addition to the heterogeneity of the samples restricts their generalisability. CONCLUSIONS Symptomatological differences between early-onset and late-onset depression (EOD and LOD) appear crucial in understanding whether late-life depression is the primary or secondary source of cerebral pathology. Though severe cognitive impairments and clearer neuropathological underpinnings are more characteristic of LOD than EOD, the inconsistency of valid biomarkers remains problematic.
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Affiliation(s)
- Alec Jamieson
- Centre for Medical Research, Royal Melbourne Hospital, Faculty of Medicine Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Alicia M Goodwill
- Centre for Medical Research, Royal Melbourne Hospital, Faculty of Medicine Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia; Healthy Brain Initiative, Faculty of Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - Mario Termine
- Centre for Medical Research, Royal Melbourne Hospital, Faculty of Medicine Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Stephen Campbell
- Australian Healthy Ageing Organisation (AHAO), Parkville, Victoria, Australia
| | - Cassandra Szoeke
- Centre for Medical Research, Royal Melbourne Hospital, Faculty of Medicine Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia; Healthy Brain Initiative, Faculty of Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia; Australian Healthy Ageing Organisation (AHAO), Parkville, Victoria, Australia.
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Liu X, Jiang W, Yuan Y. Aberrant Default Mode Network Underlying the Cognitive Deficits in the Patients With Late-Onset Depression. Front Aging Neurosci 2018; 10:310. [PMID: 30337869 PMCID: PMC6178980 DOI: 10.3389/fnagi.2018.00310] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 09/14/2018] [Indexed: 12/15/2022] Open
Abstract
Late-onset depression (LOD) is regarded as a risk factor or a prodrome of Alzheimer’s disease (AD). Moreover, LOD patients with cognitive deficits have the higher risk of subsequent AD. Thus, it is necessary to understand the neural underpinnings of cognitive deficits and its pathological implications in LOD. Consistent findings show that the default mode network (DMN) is an important and potentially useful brain network for the cognitive deficits in LOD patients. In recent years, genetics has been actively researched as a possible risk factor in the pathogenesis of LOD. So, in this review, we discuss the current research progress on the cognitive deficits and DMN in LOD through a combined view of brain network and genetics. We find that different structural and functional impairments of the DMN might be involved in the etiological mechanisms of different cognitive impairments in LOD patients.
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Affiliation(s)
- Xiaoyun Liu
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, Institute of Psychosomatics, Medical School, Southeast University, Nanjing, China
| | - Wenhao Jiang
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, Institute of Psychosomatics, Medical School, Southeast University, Nanjing, China
| | - Yonggui Yuan
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, Institute of Psychosomatics, Medical School, Southeast University, Nanjing, China
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Zaremba D, Enneking V, Meinert S, Förster K, Bürger C, Dohm K, Grotegerd D, Redlich R, Dietsche B, Krug A, Kircher T, Kugel H, Heindel W, Baune BT, Arolt V, Dannlowski U. Effects of cumulative illness severity on hippocampal gray matter volume in major depression: a voxel-based morphometry study. Psychol Med 2018; 48:2391-2398. [PMID: 29415775 DOI: 10.1017/s0033291718000016] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Patients with major depression show reduced hippocampal volume compared to healthy controls. However, the contribution of patients' cumulative illness severity to hippocampal volume has rarely been investigated. It was the aim of our study to find a composite score of cumulative illness severity that is associated with hippocampal volume in depression. METHODS We estimated hippocampal gray matter volume using 3-tesla brain magnetic resonance imaging in 213 inpatients with acute major depression according to DSM-IV criteria (employing the SCID interview) and 213 healthy controls. Patients' cumulative illness severity was ascertained by six clinical variables via structured clinical interviews. A principal component analysis was conducted to identify components reflecting cumulative illness severity. Regression analyses and a voxel-based morphometry approach were used to investigate the influence of patients' individual component scores on hippocampal volume. RESULTS Principal component analysis yielded two main components of cumulative illness severity: Hospitalization and Duration of Illness. While the component Hospitalization incorporated information from the intensity of inpatient treatment, the component Duration of Illness was based on the duration and frequency of illness episodes. We could demonstrate a significant inverse association of patients' Hospitalization component scores with bilateral hippocampal gray matter volume. This relationship was not found for Duration of Illness component scores. CONCLUSIONS Variables associated with patients' history of psychiatric hospitalization seem to be accurate predictors of hippocampal volume in major depression and reliable estimators of patients' cumulative illness severity. Future studies should pay attention to these measures when investigating hippocampal volume changes in major depression.
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Affiliation(s)
- Dario Zaremba
- Department of Psychiatry and Psychotherapy,University of Muenster,Muenster,Germany
| | - Verena Enneking
- Department of Psychiatry and Psychotherapy,University of Muenster,Muenster,Germany
| | - Susanne Meinert
- Department of Psychiatry and Psychotherapy,University of Muenster,Muenster,Germany
| | - Katharina Förster
- Department of Psychiatry and Psychotherapy,University of Muenster,Muenster,Germany
| | - Christian Bürger
- Department of Psychiatry and Psychotherapy,University of Muenster,Muenster,Germany
| | - Katharina Dohm
- Department of Psychiatry and Psychotherapy,University of Muenster,Muenster,Germany
| | - Dominik Grotegerd
- Department of Psychiatry and Psychotherapy,University of Muenster,Muenster,Germany
| | - Ronny Redlich
- Department of Psychiatry and Psychotherapy,University of Muenster,Muenster,Germany
| | - Bruno Dietsche
- Department of Psychiatry and Psychotherapy,University of Marburg,Marburg,Germany
| | - Axel Krug
- Department of Psychiatry and Psychotherapy,University of Marburg,Marburg,Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy,University of Marburg,Marburg,Germany
| | - Harald Kugel
- Department of Clinical Radiology,University of Muenster,Muenster,Germany
| | - Walter Heindel
- Department of Clinical Radiology,University of Muenster,Muenster,Germany
| | - Bernhard T Baune
- Discipline of Psychiatry,University of Adelaide,Adelaide,Australia
| | - Volker Arolt
- Department of Psychiatry and Psychotherapy,University of Muenster,Muenster,Germany
| | - Udo Dannlowski
- Department of Psychiatry and Psychotherapy,University of Muenster,Muenster,Germany
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Yüksel D, Engelen J, Schuster V, Dietsche B, Konrad C, Jansen A, Dannlowski U, Kircher T, Krug A. Longitudinal brain volume changes in major depressive disorder. J Neural Transm (Vienna) 2018; 125:1433-1447. [PMID: 30167933 DOI: 10.1007/s00702-018-1919-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 08/20/2018] [Indexed: 12/31/2022]
Abstract
Patients with major depressive disorder (MDD) exhibit gray matter volume (GMV) reductions in limbic regions. Clinical variables-such as the number of depressive episodes-seem to affect volume alterations. It is unclear whether the observed cross-sectional GMV abnormalities in MDD change over time, and whether there is a longitudinal relationship between GMV changes and the course of disorder. We investigated T1 structural MRI images of 54 healthy control (HC) and 37 MDD patients in a 3-Tesla-MRI with a follow-up interval of 3 years. The Cat12 toolbox was used to analyze longitudinal data (p < 0.05, FWE-corrected, whole-brain analysis; flexible factorial design). Interaction effects indicated increasing GMV in MDD in the bilateral amygdala, and decreasing GMV in the right thalamus between T1 and T2. Further analyses comparing patients with a mild course of disorder (MCD; 0-1 depressive episode during the follow-up) to patients with a severe course of disorder (SCD; > 1 depressive episode during the follow-up) revealed increasing amygdalar volume in MCD. Our study confirms structural alterations in limbic regions in MDD patients and an association between these impairments and the course of disorder. Thus, we assume that the reported volumetric alterations in the left amygdala (i.e. volumetric normalization) are reversible and apparently driven by the clinical phenotype. Hence, these results support the assumption that the severity and progression of disease influences amygdalar GMV changes in MDD or vice versa.
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Affiliation(s)
- Dilara Yüksel
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany.
| | - Jennifer Engelen
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany
| | - Verena Schuster
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany
| | - Bruno Dietsche
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany
| | - Carsten Konrad
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany
- Agaplesion Diakonieklinikum Rotenburg, Centre for Psychosocial Medicine, Elise-Averdieck-Straße 17, 27356, Rotenburg (Wümme), Germany
| | - Andreas Jansen
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany
| | - Udo Dannlowski
- Department of Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany
| | - Axel Krug
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany
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12
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Lebedeva A, Sundström A, Lindgren L, Stomby A, Aarsland D, Westman E, Winblad B, Olsson T, Nyberg L. Longitudinal relationships among depressive symptoms, cortisol, and brain atrophy in the neocortex and the hippocampus. Acta Psychiatr Scand 2018; 137:491-502. [PMID: 29457245 DOI: 10.1111/acps.12860] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/23/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Depression is associated with accelerated aging and age-related diseases. However, mechanisms underlying this relationship remain unclear. The aim of this study was to longitudinally assess the link between depressive symptoms, brain atrophy, and cortisol levels. METHOD Participants from the Betula prospective cohort study (mean age = 59 years, SD = 13.4 years) underwent clinical, neuropsychological and brain 3T MRI assessments at baseline and a 4-year follow-up. Cortisol levels were measured at baseline in four saliva samples. Cortical and hippocampal atrophy rates were estimated and compared between participants with and without depressive symptoms (n = 81) and correlated with cortisol levels (n = 49). RESULTS Atrophy in the left superior frontal gyrus and right lingual gyrus developed in parallel with depressive symptoms, and in the left temporal pole, superior temporal cortex, and supramarginal cortex after the onset of depressive symptom. Depression-related atrophy was significantly associated with elevated cortisol levels. Elevated cortisol levels were also associated with widespread prefrontal, parietal, lateral, and medial temporal atrophy. CONCLUSION Depressive symptoms and elevated cortisol levels are associated with atrophy of the prefrontal and limbic areas of the brain.
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Affiliation(s)
- A Lebedeva
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institute, Huddinge, Sweden
| | - A Sundström
- Department of Psychology, Umeå University, Umeå, Sweden.,Center for Demographic and Ageing Research, Umeå University, Umeå, Sweden
| | - L Lindgren
- Department of Nursing, Umeå University, Umeå, Sweden.,Umeå Center for Functional Brain Imaging, Umeå University, Umeå, Sweden
| | - A Stomby
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.,Jönköping County Hospital, Region Jönköping County, Jönköping, Sweden
| | - D Aarsland
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institute, Huddinge, Sweden.,Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK.,Center for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - E Westman
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institute, Huddinge, Sweden
| | - B Winblad
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institute, Huddinge, Sweden.,Geriatric Clinics, Karolinska University Hospital, Huddinge, Sweden
| | - T Olsson
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - L Nyberg
- Umeå Center for Functional Brain Imaging, Umeå University, Umeå, Sweden.,Department of Integrative Medical Biology, Physiology, Umeå University, Umeå, Sweden.,Department of Radiation Sciences, Diagnostic Radiology, Umeå University, Umeå, Sweden
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13
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Zaremba D, Dohm K, Redlich R, Grotegerd D, Strojny R, Meinert S, Bürger C, Enneking V, Förster K, Repple J, Opel N, Baune BT, Zwitserlood P, Heindel W, Arolt V, Kugel H, Dannlowski U. Association of Brain Cortical Changes With Relapse in Patients With Major Depressive Disorder. JAMA Psychiatry 2018; 75:484-492. [PMID: 29590315 PMCID: PMC5875383 DOI: 10.1001/jamapsychiatry.2018.0123] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
IMPORTANCE More than half of all patients with major depressive disorder (MDD) experience a relapse within 2 years after recovery. It is unclear how relapse affects brain morphologic features during the course of MDD. OBJECTIVE To use structural magnetic resonance imaging to identify morphologic brain changes associated with relapse in MDD. DESIGN, SETTING, AND PARTICIPANTS In this longitudinal case-control study, patients with acute MDD at baseline and healthy controls were recruited from the University of Münster Department of Psychiatry from March 21, 2010, to November 14, 2014, and were reassessed from November 11, 2012, to October 28, 2016. Depending on patients' course of illness during follow-up, they were subdivided into groups of patients with and without relapse. Whole-brain gray matter volume and cortical thickness of the anterior cingulate cortex, orbitofrontal cortex, middle frontal gyrus, and insula were assessed via 3-T magnetic resonance imaging at baseline and 2 years later. MAIN OUTCOMES AND MEASURES Gray matter was analyzed via group (no relapse, relapse, and healthy controls) by time (baseline and follow-up) analysis of covariance, controlling for age and total intracranial volume. Confounding factors of medication and depression severity were assessed. RESULTS This study included 37 patients with MDD and a relapse (19 women and 18 men; mean [SD] age, 37.0 [12.7] years), 23 patients with MDD and without relapse (13 women and 10 men; mean [SD] age, 32.5 [10.5] years), and 54 age- and sex-matched healthy controls (24 women and 30 men; mean [SD] age, 37.5 [8.7] years). A significant group-by-time interaction controlling for age and total intracranial volume revealed that patients with relapse showed a significant decline of insular volume (difference, -0.032; 95% CI, -0.063 to -0.002; P = .04) and dorsolateral prefrontal volume (difference, -0.079; 95% CI, -0.113 to -0.045; P < .001) from baseline to follow-up. In patients without relapse, gray matter volume in these regions did not change significantly (insula: difference, 0.027; 95% CI, -0.012 to 0.066; P = .17; and dorsolateral prefrontal volume: difference, 0.023; 95% CI, -0.020 to 0.066; P = .30). Volume changes were not correlated with psychiatric medication or with severity of depression at follow-up. Additional analysis of cortical thickness showed an increase in the anterior cingulate cortex (difference, 0.073 mm; 95% CI, 0.023-0.123 mm; P = .005) and orbitofrontal cortex (difference, 0.089 mm; 95% CI, 0.032-0.147 mm; P = .003) from baseline to follow-up in patients without relapse. CONCLUSION AND RELEVANCE A distinct association of relapse in MDD with brain morphologic features was revealed using a longitudinal design. Relapse is associated with brain structures that are crucial for regulation of emotions and thus needs to be prevented. This study might be a step to guide future prognosis and maintenance treatment in patients with recurrent MDD.
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Affiliation(s)
- Dario Zaremba
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Katharina Dohm
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Ronny Redlich
- Department of Psychiatry, University of Münster, Münster, Germany
| | | | - Robert Strojny
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Susanne Meinert
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Christian Bürger
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Verena Enneking
- Department of Psychiatry, University of Münster, Münster, Germany
| | | | - Jonathan Repple
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Nils Opel
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Bernhard T. Baune
- Discipline of Psychiatry, University of Adelaide, Adelaide, South Australia
| | | | - Walter Heindel
- Department of Clinical Radiology, University of Münster, Münster, Germany
| | - Volker Arolt
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Harald Kugel
- Department of Clinical Radiology, University of Münster, Münster, Germany
| | - Udo Dannlowski
- Department of Psychiatry, University of Münster, Münster, Germany
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14
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Ye Q, Su F, Gong L, Shu H, Liao W, Xie C, Zhou H, Zhang Z, Bai F. Divergent Roles of Vascular Burden and Neurodegeneration in the Cognitive Decline of Geriatric Depression Patients and Mild Cognitive Impairment Patients. Front Aging Neurosci 2017; 9:288. [PMID: 28919857 PMCID: PMC5585743 DOI: 10.3389/fnagi.2017.00288] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 08/17/2017] [Indexed: 12/28/2022] Open
Abstract
Both geriatric depression and mild cognitive impairment (MCI) confer an increased risk for the development of dementia. The mechanisms underlying the development of cognitive impairment in geriatric depression patients remain controversial. The present study aimed to explore the association of cognitive decline with vascular risk, white matter hyperintensity (WMH) burden and hippocampal volume in both remitted geriatric depression (RGD) subjects and amnestic mild cognitive impairment (aMCI) subjects. Forty-one RGD subjects, 51 aMCI subjects, and 64 healthy elderly subjects underwent multimodal MRI scans and neuropsychological tests at both baseline and a 35-month follow-up. According to the changing patterns (declining or stable) of global cognitive function during the follow-up period, each group was further divided into a declining subgroup and a stable subgroup. The Framingham 10-year cardiovascular risk, WMH volume and hippocampal volume were measured to assess vascular pathology and neurodegeneration, respectively. The RGD declining group displayed a higher vascular risk and greater WMH volume than the RGD stable group, whereas no such difference was found in the aMCI subjects. In contrast, the aMCI declining group displayed a smaller left hippocampal volume than the aMCI stable group, whereas no such difference was found in the RGD subjects. Furthermore, greater increases in the WHM volume correlated with greater decreases in global cognitive function in the RGD declining group, and greater decreases in the left hippocampal volume correlated with greater decreases in global cognitive function in the aMCI declining group. In conclusion, the cognitive decline in RGD patients is associated with vascular burden, whereas the cognitive decline in aMCI patients is associated with neurodegeneration. These findings could contribute to a better understanding of the specific mechanisms of the development of dementia in each condition.
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Affiliation(s)
- Qing Ye
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast UniversityNanjing, China
| | - Fan Su
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast UniversityNanjing, China
| | - Liang Gong
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast UniversityNanjing, China
| | - Hao Shu
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast UniversityNanjing, China
| | - Wenxiang Liao
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast UniversityNanjing, China
| | - Chunming Xie
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast UniversityNanjing, China
| | - Hong Zhou
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast UniversityNanjing, China
| | - Zhijun Zhang
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast UniversityNanjing, China
| | - Feng Bai
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast UniversityNanjing, China
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15
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Frequency-dependent amplitude alterations of resting-state spontaneous fluctuations in late-onset depression. BIOMED RESEARCH INTERNATIONAL 2015; 2015:505479. [PMID: 25705666 PMCID: PMC4331395 DOI: 10.1155/2015/505479] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Revised: 11/02/2014] [Accepted: 11/05/2014] [Indexed: 02/07/2023]
Abstract
There is limited amplitude of low-frequency fluctuation (ALFF) of resting-state functional magnetic resonance imaging (fMRI) studies in late-onset depression (LOD) but reported different results. This may be due to the impact of different frequency bands. In this study, we examined the ALFF in five different frequency bands (slow-6: 0-0.01 Hz; slow-5: 0.01-0.027 Hz; slow-4: 0.027-0.073 Hz; slow-3: 0.073-0.167 Hz, and slow-2: 0.167-0.25 Hz) within the whole brain during resting-state fMRI in 16 LOD patients and 16 normal control (NC) subjects. The ALFF of primary effect of disease was widely distributed over left cerebellum anterior lobe, left cerebellum posterior lobe, left middle orbitofrontal gyrus, left superior occipital, and right superior parietal, while the interaction effect of disease and frequency was distributed over right superior frontal gyrus. Further relationship analysis findings suggest these abnormal ALFF may relate to cognitive dysfunction of LOD. Therefore, our data show that LOD patients have widespread abnormalities in intrinsic brain activity, which is dependent on the frequency band, and suggest that future studies should take the frequency bands into account when measuring intrinsic brain activity.
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16
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Wang Z, Yuan Y, Bai F, Shu H, You J, Li L, Zhang Z. Altered functional connectivity networks of hippocampal subregions in remitted late-onset depression: a longitudinal resting-state study. Neurosci Bull 2015; 31:13-21. [PMID: 25564192 DOI: 10.1007/s12264-014-1489-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2014] [Accepted: 11/06/2014] [Indexed: 02/06/2023] Open
Abstract
The regional specificity of hippocampal abnormalities in late-life depression (LLD) has been demonstrated in previous studies. In this study, we sought to examine the functional connectivity (FC) patterns of hippocampal subregions in remitted late-onset depression (rLOD), a special subtype of LLD. Fourteen rLOD patients and 18 healthy controls underwent clinical and cognitive evaluations as well as resting-state functional magnetic resonance imaging scans at baseline and at ∼21 months of follow-up. Each hippocampus was divided into three parts, the cornu ammonis (CA), the dentate gyrus, and the subicular complex, and then six seed-based hippocampal subregional networks were established. Longitudinal changes of the six networks over time were directly compared between the rLOD and control groups. From baseline to follow-up, the rLOD group showed a greater decline in connectivity of the left CA to the bilateral posterior cingulate cortex/precuneus (PCC/PCUN), but showed increased connectivity of the right hippocampal subregional networks with the frontal cortex (bilateral medial prefrontal cortex/anterior cingulate cortex and supplementary motor area). Further correlative analyses revealed that the longitudinal changes in FC between the left CA and PCC/PCUN were positively correlated with longitudinal changes in the Symbol Digit Modalities Test (r = 0.624, P = 0.017) and the Digit Span Test (r = 0.545, P = 0.044) scores in the rLOD group. These results may provide insights into the neurobiological mechanism underlying the cognitive dysfunction in rLOD patients.
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Affiliation(s)
- Zan Wang
- Neurology Department, Affiliated ZhongDa Hospital, Neuropsychiatric Institute and Medical School of Southeast University, Nanjing, 210009, China
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17
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Zannas AS, McQuoid DR, Payne ME, MacFall JR, Ashley-Koch A, Steffens DC, Potter GG, Taylor WD. Association of gene variants of the renin-angiotensin system with accelerated hippocampal volume loss and cognitive decline in old age. Am J Psychiatry 2014; 171:1214-21. [PMID: 25124854 PMCID: PMC4329281 DOI: 10.1176/appi.ajp.2014.13111543] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Genetic factors confer risk for neuropsychiatric phenotypes, but the polygenic etiology of these phenotypes makes identification of genetic culprits challenging. An approach to this challenge is to examine the effects of genetic variation on relevant endophenotypes, such as hippocampal volume loss. A smaller hippocampus is associated with gene variants of the renin-angiotensin system (RAS), a system implicated in vascular disease. However, no studies to date have investigated longitudinally the effects of genetic variation of RAS on the hippocampus. METHOD The authors examined the effects of polymorphisms of AGTR1, the gene encoding angiotensin-II type 1 receptor of RAS, on longitudinal hippocampal volumes of older adults. In all, 138 older adults (age ≥60 years) were followed for an average of about 4 years. The participants underwent repeated structural MRI and comprehensive neurocognitive testing, and they were genotyped for four AGTR1 single-nucleotide polymorphisms (SNPs) with low pairwise linkage disequilibrium values and apolipoprotein E (APOE) genotype. RESULTS Genetic variants at three AGTR1 SNPs (rs2638363, rs1492103, and rs2675511) were independently associated with accelerated hippocampal volume loss over the 4-year follow-up period in the right but not left hemisphere. Intriguingly, these AGTR1 risk alleles also predicted worse episodic memory performance but were not related to other cognitive measures. Two risk variants (rs2638363 and rs12721331) interacted with the APOE4 allele to accelerate right hippocampal volume loss. CONCLUSIONS Risk genetic variants of the RAS may accelerate memory decline in older adults, an effect that may be conferred by accelerated hippocampal volume loss. Molecules involved in this system may hold promise as early therapeutic targets for late-life neuropsychiatric disorders.
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Affiliation(s)
- Anthony S. Zannas
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, 27710,Max Planck Institute of Psychiatry, Munich, 80804, Germany,Correspondence: Anthony S. Zannas, MD, MSc, Max Planck Institute of Psychiatry, Kraepelinstrasse 2-10, 80804, Munich, Germany, , Telephone: 00498930622323
| | - Douglas R. McQuoid
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, 27710
| | - Martha E Payne
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, 27710,Neuropsychiatric Imaging Research Laboratory, Duke University Medical Center, Durham, NC 27705
| | - James R. MacFall
- Department of Radiology, Duke University Medical Center, Durham, NC, 27710, USA
| | - Allison Ashley-Koch
- Center for Human Genetics, Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA
| | - David C. Steffens
- Department of Psychiatry, University of Connecticut Health Sciences Center, Farmington, CT, 06030
| | - Guy G. Potter
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, 27710
| | - Warren D. Taylor
- Department of Psychiatry, Vanderbilt University Medical Center, Nashville, TN, 37212
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18
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Peng GP, Feng Z, He FP, Chen ZQ, Liu XY, Liu P, Luo BY. Correlation of hippocampal volume and cognitive performances in patients with either mild cognitive impairment or Alzheimer's disease. CNS Neurosci Ther 2014; 21:15-22. [PMID: 25146658 DOI: 10.1111/cns.12317] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 07/25/2014] [Accepted: 07/28/2014] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To evaluate hippocampal volume changes and neuropsychological performances in patients with either amnestic mild cognitive impairment (aMCI) or Alzheimer's disease (AD). METHODS Thirty-eight AD dementia, 22 aMCI patients, and 20 healthy controls were enrolled. Bilateral hippocampal volume was measured concurrently with mini-mental state examination (MMSE), auditory verbal learning test (AVLT), Boston naming test (BNT), and activities of daily living (ADL) test. Baseline and two additional follow-up examinations were conducted. RESULTS Baseline hippocampal volumes were significantly smaller in AD group than that in aMCI and control groups. MMSE, AVLT, ADL, and BNT scores for the AD group were significantly different from that of both aMCI and control groups. Baseline hippocampal volumes were positively correlated with MMSE and AVLT scores in AD and aMCI patients. At follow-up, left hippocampal volume loss was positively correlated with decreased MMSE and AVLT scores both in AD and aMCI groups, while right hippocampal volume loss was positively associated with decreased AVLT performance only in AD group. Increased ADL and decreased BNT scores were positively associated with left hippocampal volume reduction only in the AD group. CONCLUSIONS Current findings provide evidence of a close relationship between hippocampal volume and cognitive performances in patients with AD and aMCI, both at baseline and over follow-up.
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Affiliation(s)
- Guo-Ping Peng
- Department of Neurology, First Affiliated Hospital, Zhejiang University, Hangzhou, China; Laboratory of Brain Medical Center, First Affiliated Hospital, Zhejiang University, Hangzhou, China
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19
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Insular and hippocampal gray matter volume reductions in patients with major depressive disorder. PLoS One 2014; 9:e102692. [PMID: 25051163 PMCID: PMC4106847 DOI: 10.1371/journal.pone.0102692] [Citation(s) in RCA: 119] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 06/20/2014] [Indexed: 01/17/2023] Open
Abstract
Background Major depressive disorder is a serious psychiatric illness with a highly variable and heterogeneous clinical course. Due to the lack of consistent data from previous studies, the study of morphometric changes in major depressive disorder is still a major point of research requiring additional studies. The aim of the study presented here was to characterize and quantify regional gray matter abnormalities in a large sample of clinically well-characterized patients with major depressive disorder. Methods For this study one-hundred thirty two patients with major depressive disorder and 132 age- and gender-matched healthy control participants were included, 35 with their first episode and 97 with recurrent depression. To analyse gray matter abnormalities, voxel-based morphometry (VBM8) was employed on T1 weighted MRI data. We performed whole-brain analyses as well as a region-of-interest approach on the hippocampal formation, anterior cingulate cortex and amygdala, correlating the number of depressive episodes. Results Compared to healthy control persons, patients showed a strong gray-matter reduction in the right anterior insula. In addition, region-of-interest analyses revealed significant gray-matter reductions in the hippocampal formation. The observed alterations were more severe in patients with recurrent depressive episodes than in patients with a first episode. The number of depressive episodes was negatively correlated with gray-matter volume in the right hippocampus and right amygdala. Conclusions The anterior insula gray matter structure appears to be strongly affected in major depressive disorder and might play an important role in the neurobiology of depression. The hippocampal and amygdala volume loss cumulating with the number of episodes might be explained either by repeated neurotoxic stress or alternatively by higher relapse rates in patients showing hippocampal atrophy.
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20
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Carmasin JS, Mast BT, Allaire JC, Whitfield KE. Vascular risk factors, depression, and cognitive change among African American older adults. Int J Geriatr Psychiatry 2014; 29:291-8. [PMID: 23877973 PMCID: PMC3900598 DOI: 10.1002/gps.4007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Accepted: 06/20/2013] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Vascular burden has been linked to future depression and cognitive change in predominately European American samples. This study investigated these relationships in older African Americans. METHODS To examine the connection between vascular risk factors, depression, and cognitive change, this study utilized data from 435 older African Americans. Specifically, the study examined the link between vascular risk at baseline with depression and cognitive functioning at a 2.5-year follow-up visit. RESULTS High baseline vascular risk was associated with increased odds of future depression while controlling for age and current depression. A series of path analyses demonstrated links between baseline vascular risk, increases in depression, and decreases in processing speed. CONCLUSIONS These findings suggest that African Americans with greater vascular burden are at greater risk for depression and cognitive change.
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Affiliation(s)
- Jeremy S Carmasin
- Psychological and Brain Sciences, University of Louisville, Louisville, KY, 40292, USA
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21
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Bora E, Harrison BJ, Yücel M, Pantelis C. Cognitive impairment in euthymic major depressive disorder: a meta-analysis. Psychol Med 2013; 43:2017-2026. [PMID: 23098294 DOI: 10.1017/s0033291712002085] [Citation(s) in RCA: 352] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND There is evidence to suggest that cognitive deficits might persist beyond the acute stages of illness in major depressive disorder (MDD). However, the findings are somewhat inconsistent across the individual studies conducted to date. Our aim was to conduct a systematic review and meta-analysis of existing studies that have examined cognition in euthymic MDD patients. METHOD Following a systematic search across several publication databases, meta-analyses were conducted for 27 empirical studies that compared euthymic adult MDD patients (895 participants) and healthy controls (997 participants) across a range of cognitive domains. The influence of demographic variables and confounding factors, including age of onset and recurrent episodes, was examined. RESULTS Compared with healthy controls, euthymic MDD patients were characterized by significantly poorer cognitive functions. However, the magnitude of observed deficits, with the exception of inhibitory control, were generally modest when late-onset cases were excuded. Late-onset cases demonstrated significantly more pronounced deficits in verbal memory, speed of information processing and some executive functions. CONCLUSIONS Cognitive deficits, especially poor response inhibition, are likely to be persistent features, at least of some forms, of adult-onset MDD. More studies are necessary to examine cognitive dysfunction in remitted psychotic, melancholic and bipolar spectrum MDD. Cognitive deficits overall appear to be more common among patients with late-onset depression, supporting the theories suggesting that possible vascular and neurodegenerative factors play a role in a substantial number of these patients.
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Affiliation(s)
- E Bora
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, VIC, Australia.
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22
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Yue Y, Yuan Y, Hou Z, Jiang W, Bai F, Zhang Z. Abnormal functional connectivity of amygdala in late-onset depression was associated with cognitive deficits. PLoS One 2013; 8:e75058. [PMID: 24040385 PMCID: PMC3769296 DOI: 10.1371/journal.pone.0075058] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 08/09/2013] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is associated with decreased function of cortico-limbic circuits, which play important roles in the pathogenesis of MDD. Abnormal functional connectivity (FC) with the amygdala, which is involved in cortico-limbic circuits, has also been observed in MDD. However, little is known about connectivity alterations in late-onset depression (LOD) or whether disrupted connectivity is correlated with cognitive impairment in LOD. METHODS AND RESULTS A total of twenty-two LOD patients and twenty-two matched healthy controls (HC) underwent neuropsychological tests and resting state functional magnetic resonance imaging (rs-fMRI). Regional homogeneity (ReHo) and FC with bilateral amygdala seeds were used to analyze blood oxygen level-dependent fMRI data between two groups. Compared with HC, LOD patients showed decreased ReHo in the right middle frontal gyrus and left superior frontal gyrus. In the LOD group, the left amygdala had decreased FC with the right middle frontal gyrus and the left superior frontal gyrus in the amygdala positive network, and it had increased FC with the right post-central gyrus in the amygdala negative network. However, significantly reduced FC with the right amygdala was observed in the right middle occipital gyrus in the amygdala negative network. Further correlative analyses revealed that decreased FC between the amygdala and the right middle occipital gyrus was negatively correlated with the verbal fluency test (VFT, r = -0.485, P = 0.022) and the digit span test (DST, r = -0.561, P = 0.007). CONCLUSIONS Our findings of reduced activity of the prefrontal gyrus and abnormal FC with the bilateral amygdala may be key markers of cognitive dysfunction in LOD patients.
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Affiliation(s)
- Yingying Yue
- The Department of Neuropsychiatry, Affiliated ZhongDa Hospital and Institute of Neuropsychiatry of Southeast University, Nanjing, China
| | - Yonggui Yuan
- The Department of Neuropsychiatry, Affiliated ZhongDa Hospital and Institute of Neuropsychiatry of Southeast University, Nanjing, China
| | - Zhenghua Hou
- Department of Psychiatry, The 4th People’s Hospital of Wuhu City, Wuhu, China
| | - Wenhao Jiang
- The Department of Neuropsychiatry, Affiliated ZhongDa Hospital and Institute of Neuropsychiatry of Southeast University, Nanjing, China
| | - Feng Bai
- The Department of Neuropsychiatry, Affiliated ZhongDa Hospital and Institute of Neuropsychiatry of Southeast University, Nanjing, China
| | - Zhijun Zhang
- The Department of Neuropsychiatry, Affiliated ZhongDa Hospital and Institute of Neuropsychiatry of Southeast University, Nanjing, China
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23
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Zannas AS, McQuoid DR, Payne ME, Steffens DC, MacFall JR, Ashley-Koch A, Taylor WD. Negative life stress and longitudinal hippocampal volume changes in older adults with and without depression. J Psychiatr Res 2013; 47:829-34. [PMID: 23478048 PMCID: PMC3622849 DOI: 10.1016/j.jpsychires.2013.02.008] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Revised: 02/08/2013] [Accepted: 02/14/2013] [Indexed: 10/27/2022]
Abstract
Major depressive disorder is associated with smaller hippocampal volumes but the mechanisms underlying this relationship are unclear. To examine the effect of environmental influences, we examined the relationship between self-reported stressors and two-year change in hippocampal volume. Seventy elderly nondepressed subjects and eighty-nine elderly depressed subjects were followed for two years. The number of negative stressful life events (nSLE), perceived stress levels, and cranial MRI were obtained at baseline and at the two-year assessment. For secondary analyses, subjects provided blood for 5-HTTLPR polymorphism genotyping. After controlling for covariates including presence or absence of depression, greater numbers of baseline nSLEs were significantly associated with greater baseline hippocampal volumes bilaterally. Greater numbers of baseline nSLEs were also associated with reduction in hippocampal volume over two years in the right but not the left hemisphere. Neither perceived stress levels nor changes in stress measures were significantly associated with hippocampal volume measures. However, in secondary analyses, we found that increases in perceived stress over time was associated with volume reduction of the left hippocampus, but only in 5-HTTLPR L/L homozygotes. Our findings suggest different short- and long-term effects of negative life stressors on hippocampal volumes in older adults. These effects appear independent on the presence or absence of depression. Furthermore, these effects may be moderated by genetic polymorphisms in key neurotransmitter systems. These novel findings have important implications for understanding environmental influences on brain aging.
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Affiliation(s)
- Anthony S. Zannas
- Department of Psychiatry, Duke University Medical Center, Durham, NC, 27710
| | - Douglas R. McQuoid
- Department of Psychiatry, Duke University Medical Center, Durham, NC, 27710
| | - Martha E. Payne
- Department of Psychiatry, Duke University Medical Center, Durham, NC, 27710
| | - David C. Steffens
- Department of Psychiatry, University of Connecticut Health Sciences Center, Farmington, CT, 06030
| | - James R. MacFall
- Department of Radiology, Duke University Medical Center, Durham, NC, 27710
| | | | - Warren D. Taylor
- Department of Psychiatry, Vanderbilt University, Nashville, TN, 37212,Correspondence: Warren D. Taylor, MD, MHSc, Vanderbilt University, 1601 23rd Avenue South, Nashville, TN 37212, , Telephone: (615) 322-1073, Fax: (615) 875-0686
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24
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Isıklı S, Ugurlu O, Durmusoglu E, Kizilates G, Kitis O, Ozan E, Eker C, Coburn K, Gonul AS. Altered hippocampal formation shape in first-episode depressed patients at 5-year follow-up. J Psychiatr Res 2013; 47:50-5. [PMID: 23069650 DOI: 10.1016/j.jpsychires.2012.08.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Revised: 08/17/2012] [Accepted: 08/21/2012] [Indexed: 12/12/2022]
Abstract
It is generally accepted that patients with major depressive disorder have smaller hippocampus size compared to healthy people. However, it is still not known if this situation exists before the onset of the disease or is a result of the toxic mechanism created by the depression itself. The findings of the long-term follow-up studies of first-episode depressed patients might contribute to solve the ongoing problem. In this study, the hippocampus of 18 first-episode patients who were followed-up for 5 years, were compared with those of healthy controls. There were no volumetric differences among groups neither at the baseline nor after 5 years of follow-up. However, shape analyses, using high dimensional mapping methods, revealed regional structural changes in the head and tail of the hippocampal formation in CA1 and subiculum regions in patients at the follow-up. Furthermore, a significant negative correlation was found with the number of days in depression without antidepressant treatment in the CA1 region in the head and tail of the hippocampal formation bilaterally. The findings of this study support the hypothesis that pathophysiological processes of depression induce structural alterations in depressed patients.
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Affiliation(s)
- Serhan Isıklı
- Ege University School of Medicine, Department of Psychiatry, SoCAT Lab, Bornova, Izmir, Turkey
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25
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Abstract
Late life depression (LLD) is a heterogeneous illness with high rates of treatment resistance. Cognitive impairment is common in the context of LLD, and LLD may be a prodromal symptom and/or potentially a risk factor for dementia. This manuscript reviews the most recent research into the cognitive deficits associated with LLD and risk of conversion to dementia in the context of LLD. We discuss potential moderators and mediators of cognitive deficits in LLD, including demographic and clinical variables, in addition to brain structure and function. Potential interventions for cognitive symptoms of LLD are reviewed. We conclude with a discussion of the broader implications of what is now known about LLD, and how this might be applied toward improved prognosis and models for effective treatment.
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Affiliation(s)
- Sara L Weisenbach
- Department of Psychiatry, University of Michigan Medical School, 2101 Commonwealth Boulevard, Suite C, Ann Arbor, MI 48105, USA.
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