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Szymkowicz SM, Gerlach AR, Homiack D, Taylor WD. Biological factors influencing depression in later life: role of aging processes and treatment implications. Transl Psychiatry 2023; 13:160. [PMID: 37160884 PMCID: PMC10169845 DOI: 10.1038/s41398-023-02464-9] [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: 11/24/2022] [Revised: 04/23/2023] [Accepted: 04/27/2023] [Indexed: 05/11/2023] Open
Abstract
Late-life depression occurring in older adults is common, recurrent, and malignant. It is characterized by affective symptoms, but also cognitive decline, medical comorbidity, and physical disability. This behavioral and cognitive presentation results from altered function of discrete functional brain networks and circuits. A wide range of factors across the lifespan contributes to fragility and vulnerability of those networks to dysfunction. In many cases, these factors occur earlier in life and contribute to adolescent or earlier adulthood depressive episodes, where the onset was related to adverse childhood events, maladaptive personality traits, reproductive events, or other factors. Other individuals exhibit a later-life onset characterized by medical comorbidity, pro-inflammatory processes, cerebrovascular disease, or developing neurodegenerative processes. These later-life processes may not only lead to vulnerability to the affective symptoms, but also contribute to the comorbid cognitive and physical symptoms. Importantly, repeated depressive episodes themselves may accelerate the aging process by shifting allostatic processes to dysfunctional states and increasing allostatic load through the hypothalamic-pituitary-adrenal axis and inflammatory processes. Over time, this may accelerate the path of biological aging, leading to greater brain atrophy, cognitive decline, and the development of physical decline and frailty. It is unclear whether successful treatment of depression and avoidance of recurrent episodes would shift biological aging processes back towards a more normative trajectory. However, current antidepressant treatments exhibit good efficacy for older adults, including pharmacotherapy, neuromodulation, and psychotherapy, with recent work in these areas providing new guidance on optimal treatment approaches. Moreover, there is a host of nonpharmacological treatment approaches being examined that take advantage of resiliency factors and decrease vulnerability to depression. Thus, while late-life depression is a recurrent yet highly heterogeneous disorder, better phenotypic characterization provides opportunities to better utilize a range of nonspecific and targeted interventions that can promote recovery, resilience, and maintenance of remission.
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Affiliation(s)
- Sarah M Szymkowicz
- Center for Cognitive Medicine, Department of Psychiatry and Behavioral Science, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Andrew R Gerlach
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Damek Homiack
- Department of Psychiatry, University of Illinois-Chicago, Chicago, IL, USA
| | - Warren D Taylor
- Center for Cognitive Medicine, Department of Psychiatry and Behavioral Science, Vanderbilt University Medical Center, Nashville, TN, USA.
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Tennessee Valley Health System, Nashville, TN, USA.
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Fleischman DA, Arfanakis K, Leurgans SE, Zhang S, Lamar M, Han SD, Poole VN, Kim N, Bennett DA, Barnes LL. Late-life depressive symptoms and white matter structural integrity within older Black adults. Front Aging Neurosci 2023; 15:1138568. [PMID: 37205056 PMCID: PMC10186351 DOI: 10.3389/fnagi.2023.1138568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 04/12/2023] [Indexed: 05/21/2023] Open
Abstract
Introduction Older Black adults experience a high burden of depressive symptoms and cerebrovascular disease but the specific neurobiological substrates underlying the association between late-life depressive symptoms and brain integrity are understudied, particularly in within-group designs. Methods Using the Center for Epidemiologic Studies Depression Scale and diffusion-tensor imaging, within-Black variation in the association between late-life depressive symptoms and white matter structural integrity was examined in 297 older Black participants without dementia that were enrolled across three epidemiological studies of aging and dementia. Linear regression models were used to test associations with DTI metrics (fractional anisotropy, trace of the diffusion tensor) as the outcomes and depressive symptoms as the predictor, while adjusting for age, sex, education, scanner, serotonin-reuptake inhibitor use, total volume of white-matter hyperintensities normalized by intracranial volume, and presence of white-matter hyperintensities at the voxel level. Results Higher level of self-reported late-life depressive symptoms was associated with greater diffusion-tensor trace (reduced white matter integrity) in connections between commissural pathways and contralateral prefrontal regions (superior and middle frontal/dorsolateral prefrontal cortex), association pathways connecting dorsolateral prefrontal cortex with insular, striatal and thalamic regions, and association pathways connecting the parietal, temporal and occipital lobes and the thalamus. Discussion This study demonstrated a discernable pattern of compromised white matter structural integrity underlying late-life depressive symptoms within older Black adults.
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Affiliation(s)
- Debra A. Fleischman
- Rush Alzheimer’s Disease Center, Chicago, IL, United States
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Konstantinos Arfanakis
- Rush Alzheimer’s Disease Center, Chicago, IL, United States
- Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, IL, United States
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, United States
| | - Sue E. Leurgans
- Rush Alzheimer’s Disease Center, Chicago, IL, United States
- Department of Preventive Medicine, Rush University Medical Center, Chicago IL, United States
| | - Shengwei Zhang
- Rush Alzheimer’s Disease Center, Chicago, IL, United States
| | - Melissa Lamar
- Rush Alzheimer’s Disease Center, Chicago, IL, United States
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - S. Duke Han
- Rush Alzheimer’s Disease Center, Chicago, IL, United States
- Department of Family Medicine and Neurology, Keck School of Medicine, Los Angeles, CA, United States
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
- School of Gerontology, University of Southern California, Los Angeles, CA, United States
| | - Victoria N. Poole
- Rush Alzheimer’s Disease Center, Chicago, IL, United States
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, United States
| | - Namhee Kim
- Rush Alzheimer’s Disease Center, Chicago, IL, United States
| | | | - Lisa L. Barnes
- Rush Alzheimer’s Disease Center, Chicago, IL, United States
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
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Safri AA, Nassir CMNCM, Iman IN, Mohd Taib NH, Achuthan A, Mustapha M. Diffusion tensor imaging pipeline measures of cerebral white matter integrity: An overview of recent advances and prospects. World J Clin Cases 2022; 10:8450-8462. [PMID: 36157806 PMCID: PMC9453345 DOI: 10.12998/wjcc.v10.i24.8450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/20/2022] [Accepted: 07/17/2022] [Indexed: 02/05/2023] Open
Abstract
Cerebral small vessel disease (CSVD) is a leading cause of age-related microvascular cognitive decline, resulting in significant morbidity and decreased quality of life. Despite a progress on its key pathophysiological bases and general acceptance of key terms from neuroimaging findings as observed on the magnetic resonance imaging (MRI), key questions on CSVD remain elusive. Enhanced relationships and reliable lesion studies, such as white matter tractography using diffusion-based MRI (dMRI) are necessary in order to improve the assessment of white matter architecture and connectivity in CSVD. Diffusion tensor imaging (DTI) and tractography is an application of dMRI that provides data that can be used to non-invasively appraise the brain white matter connections via fiber tracking and enable visualization of individual patient-specific white matter fiber tracts to reflect the extent of CSVD-associated white matter damage. However, due to a lack of standardization on various sets of software or image pipeline processing utilized in this technique that driven mostly from research setting, interpreting the findings remain contentious, especially to inform an improved diagnosis and/or prognosis of CSVD for routine clinical use. In this minireview, we highlight the advances in DTI pipeline processing and the prospect of this DTI metrics as potential imaging biomarker for CSVD, even for subclinical CSVD in at-risk individuals.
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Affiliation(s)
- Amanina Ahmad Safri
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
| | - Che Mohd Nasril Che Mohd Nassir
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
| | - Ismail Nurul Iman
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
| | - Nur Hartini Mohd Taib
- Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
| | - Anusha Achuthan
- School of Computer Sciences, Universiti Sains Malaysia, 11800 USM, Penang, Malaysia
| | - Muzaimi Mustapha
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
- Department of Neurosciences, Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
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Blöchl M, Schaare HL, Kunzmann U, Nestler S. The Age-Dependent Association Between Vascular Risk Factors and Depressed Mood. J Gerontol B Psychol Sci Soc Sci 2021; 77:284-294. [PMID: 34080633 DOI: 10.1093/geronb/gbab063] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Cumulative burden of vascular risk factors (VRFs) has been linked to an increased risk of depressed mood. However, the role of age in this association is still unclear. Here, we investigated whether VRF burden is associated with levels and changes in depressed mood and whether these associations become stronger or weaker from mid- to later life. METHOD We used longitudinal data from 5,689 participants (52-89 years) of the English Longitudinal Study of Ageing. A composite score incorporated the presence of 5 VRFs: hypertension, diabetes, smoking, obesity, and hypercholesterolemia. Second-order latent growth models were used to test whether levels and changes of depressed mood differed as a function of baseline VRF burden, and whether these associations were moderated by age. RESULTS Baseline VRF burden showed a small association with higher levels of depressed mood (estimate = 0.081; 95% CI: 0.024, 0.138, p = .005). This association varied with age, such that it was stronger in midlife compared to later life (estimate = -0.007; 95% CI: -0.013, -0.002, p = .017). There was no evidence that VRF burden was associated with changes in depressed mood. DISCUSSION Our findings suggest that VRF burden in midlife, but less so in later life, predicts individual differences in depressed mood. These findings are consistent with reports on the importance of midlife VRFs and support the idea that promotion of vascular health in this age group or earlier in life may be critical to maintain mental health across adulthood.
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Affiliation(s)
- Maria Blöchl
- Department of Psychology, University of Münster, Germany
- Department for Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - H Lina Schaare
- Otto Hahn Group Cognitive Neurogenetics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, Germany
| | - Ute Kunzmann
- Department of Psychology, Leipzig University, Germany
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Diniz BS, Vieira EM, Mendes‐Silva AP, Bowie CR, Butters MA, Fischer CE, Flint A, Herrmann N, Kennedy J, Lanctôt KL, Mah L, Pollock BG, Mulsant BH, Rajji TK. Mild cognitive impairment and major depressive disorder are associated with molecular senescence abnormalities in older adults. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2021; 7:e12129. [PMID: 33816758 PMCID: PMC8012242 DOI: 10.1002/trc2.12129] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/10/2020] [Accepted: 11/25/2020] [Indexed: 11/08/2022]
Abstract
INTRODUCTION The biological mechanisms linking mild cognitive impairment (MCI) and major depressive disorder are not well understood. We investigated whether molecular senescence changes in older adults are associated with a history of major depressive disorder (MDD) or MCI. METHODS We included 371 participants: 167 with MCI; 62 cognitively normal with a history of MDD; 97 with MDD+MCI; and 45 cognitively unimpaired (CU) without a history of MDD. The candidate Senescence-Associated Secretory Phenotype (SASP) biomarkers were measured in the plasma using a customized LUMINEX assay. RESULTS The MDD+MCI group had a higher SASP index than the other groups (P < .001). A higher SASP index was significantly associated with worse global cognitive performance, executive dysfunction, slower processing speed, and episodic memory deficits. DISCUSSION Our study suggests that increased molecular changes are associated with cognitive impairment in older adults with MDD and indicate that accelerated biological aging is an underlying feature of MDD.
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Affiliation(s)
- Breno S. Diniz
- Platform for Peripheral Biomarkers DiscoveryCentre for Addiction and Mental Health (CAMH)Campbell Family Mental Health Research InstituteTorontoOntarioCanada
- Adult Neurodevelopment and Geriatric Psychiatry DivisionCentre for Addiction and Mental Health (CAMH)TorontoOntarioCanada
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
| | - Erica M. Vieira
- Platform for Peripheral Biomarkers DiscoveryCentre for Addiction and Mental Health (CAMH)Campbell Family Mental Health Research InstituteTorontoOntarioCanada
| | - Ana Paula Mendes‐Silva
- Platform for Peripheral Biomarkers DiscoveryCentre for Addiction and Mental Health (CAMH)Campbell Family Mental Health Research InstituteTorontoOntarioCanada
| | - Christopher R. Bowie
- Adult Neurodevelopment and Geriatric Psychiatry DivisionCentre for Addiction and Mental Health (CAMH)TorontoOntarioCanada
- Department of PsychologyQueen's UniversityKingstonOntarioCanada
| | - Meryl A. Butters
- Department of PsychiatryUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Corinne E. Fischer
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
- Keenan Research Centre for Biomedical ResearchSt. Michael's HospitalLi Ka Shing Knowledge InstituteTorontoOntarioCanada
| | - Alastair Flint
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
- Centre for Mental HealthUniversity Health NetworkTorontoOntarioCanada
| | - Nathan Herrmann
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
- Sunnybrook Health Sciences CentreTorontoOntarioCanada
| | - James Kennedy
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
- Centre for Addiction and Mental Health (CAMH)TorontoOntarioCanada
| | - Krista L. Lanctôt
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
- Sunnybrook Health Sciences CentreTorontoOntarioCanada
| | - Linda Mah
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
- Baycrest Health Sciences CentreRotman Research InstituteTorontoOntarioCanada
| | - Bruce G. Pollock
- Adult Neurodevelopment and Geriatric Psychiatry DivisionCentre for Addiction and Mental Health (CAMH)TorontoOntarioCanada
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
| | - Benoit H. Mulsant
- Adult Neurodevelopment and Geriatric Psychiatry DivisionCentre for Addiction and Mental Health (CAMH)TorontoOntarioCanada
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
| | - Tarek K. Rajji
- Adult Neurodevelopment and Geriatric Psychiatry DivisionCentre for Addiction and Mental Health (CAMH)TorontoOntarioCanada
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
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Turana Y, Tengkawan J, Chia YC, Shin J, Chen C, Park S, Tsoi K, Buranakitjaroen P, Soenarta AA, Siddique S, Cheng H, Tay JC, Teo BW, Wang T, Kario K. Mental health problems and hypertension in the elderly: Review from the HOPE Asia Network. J Clin Hypertens (Greenwich) 2021; 23:504-512. [PMID: 33283971 PMCID: PMC8029564 DOI: 10.1111/jch.14121] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/19/2020] [Accepted: 11/20/2020] [Indexed: 12/20/2022]
Abstract
The "triple burden" of aging population, hypertension, and mental health problems making elderly in Asia is more vulnerable. There is evidence of a bidirectional relationship between mental health and hypertension, which results in lower quality of life, lower rate of treatment adherence, and higher mortality among elderly individuals. It is essential to overcome known barriers and care for the elderly with high-risk factors in order to address these burdens. This review revealed that elderly with hypertension were more likely to suffer from depression and anxiety. Therefore, debunking myths, creating awareness regarding mental health, and increasing access to mental health resources through holistic community-based programs would greatly reduce such problems and optimize the chances of success in controlling hypertension-related problems.
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Affiliation(s)
- Yuda Turana
- School of Medicine and Health SciencesAtma Jaya Catholic University of IndonesiaJakartaIndonesia
| | - Jeslyn Tengkawan
- School of Medicine and Health SciencesAtma Jaya Catholic University of IndonesiaJakartaIndonesia
| | - Yook C. Chia
- Department of Medical SciencesSchool of Healthcare and Medical SciencesSunway UniversityBandar SunwayMalaysia
- Department of Primary Care MedicineFaculty of MedicineUniversity of MalayaKuala, LumpurMalaysia
| | - Jinho Shin
- Faculty of Cardiology ServiceHanyang University Medical CenterSeoulKorea
| | - Chen‐Huan Chen
- Institute of Public Health and Community Medicine Research CenterNational Yang‐Ming University School of MedicineTaipeiTaiwan
| | - Sungha Park
- Division of CardiologyCardiovascular HospitalYonsei Health SystemSeoulKorea
| | - Kelvin Tsoi
- JC School of Public Health and Primary CareFaculty of MedicineThe Chinese University of Hong Kong
| | - Peera Buranakitjaroen
- Division of HypertensionDepartment of MedicineFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Arieska A. Soenarta
- Department of Cardiology and Vascular MedicineFaculty of MedicineUniversity of Indonesia‐National Cardiovascular CenterJakartaIndonesia
| | | | - Hao‐Min Cheng
- Faculty of MedicineSchool of MedicineNational Yang‐Ming UniversityTaipeiTaiwan
- Center for Evidence‐Based MedicineTaipei Veterans General HospitalTaipeiTaiwan
- Institute of Public HealthNational Yang‐Ming University School of MedicineTaipeiTaiwan
| | - Jam C. Tay
- Department of General MedicineTan Tock Seng HospitalSingaporeSingapore
| | - Boon W. Teo
- Division of Nephrology Department of MedicineYong Loo Lin School of MedicineSingaporeSingapore
| | - Tzung‐Dau Wang
- Department of Internal MedicineNational Taiwan University College of MedicineTaipei CityTaiwan
| | - Kazuomi Kario
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
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Roh HW, Hong CH, Lim HK, Chang KJ, Kim H, Kim NR, Choi JW, Lee KS, Cho SM, Park B, Son SJ. A 12-week multidomain intervention for late-life depression: a community-based randomized controlled trial. J Affect Disord 2020; 263:437-444. [PMID: 31969275 DOI: 10.1016/j.jad.2019.12.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 12/08/2019] [Accepted: 12/08/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Given that current unimodal strategies for treating late-life depression are insufficient, the awareness of the necessity and importance of multidomain intervention has increased. We assessed the efficacy of multidomain intervention in reducing symptoms of late-life depression. METHODS This was a 12-week community-based randomized controlled trial in 78 older adults diagnosed with major depressive disorder. Participants were randomly assigned to the multidomain intervention or supportive therapy group. We provided four home visits and 12 telephone calls over 12 weeks. Four therapeutic approaches (physical activity, healthy diet, social activity, and brief cognitive restructuring) were incorporated into the multidomain intervention. The primary outcome was the change in depressive symptoms, as measured by the Montgomery-Asberg Depression Rating Scale (MADRS). Secondarily, we investigated changes in resting-state functional connectivity. RESULTS The MADRS total score was reduced more in the multidomain intervention group than in the supportive therapy group during the 12 weeks (intervention × time interaction, P = =0.007). After correction for multiple comparisons, the multidomain intervention group exhibited a lower MADRS total score at week 12 (score difference 5.117; P = =0.029). At follow-up, the multidomain intervention group also exhibited less functional connectivity between the posterior cingulate cortex and left inferior parietal lobule within the default mode network (FDR < 0.1). LIMITATIONS Caution is needed in the interpretation of the results, considering the small sample size and high percentage of female participants. CONCLUSIONS A 12-week multidomain intervention resulted in a greater reduction of depressive symptoms among the elderly with major depressive disorder than their counterparts who received supportive therapy.
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Affiliation(s)
- Hyun Woong Roh
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea; Department of Brain Science, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Chang Hyung Hong
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Hyun Kook Lim
- Department of Psychiatry, The Catholic University of Korea College of Medicine, Yeouido St. Mary's Hospital, Seoul, Republic of Korea
| | - Ki Jung Chang
- Department of Psychiatry, Ajou Good Hospital, Suwon, Republic of Korea
| | - Haena Kim
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Na-Rae Kim
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Jin Wook Choi
- Department of Radiology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Kang Soo Lee
- Department of Psychiatry, CHA University School of Medicine, CHA Bundang Medical Center, Bundang, Republic of Korea
| | - Sun-Mi Cho
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Bumhee Park
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Republic of Korea; Office of Biostatistics, Ajou University School of Medicine, Suwon, Republic of Korea.
| | - Sang Joon Son
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea.
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Boda E. Myelin and oligodendrocyte lineage cell dysfunctions: New players in the etiology and treatment of depression and stress‐related disorders. Eur J Neurosci 2019; 53:281-297. [DOI: 10.1111/ejn.14621] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 10/06/2019] [Accepted: 11/12/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Enrica Boda
- Department of Neuroscience Rita Levi‐Montalcini University of Turin Turin Italy
- Neuroscience Institute Cavalieri Ottolenghi (NICO) University of Turin Turin Italy
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Wang Z, Yuan Y, You J, Zhang Z. Disrupted structural brain connectome underlying the cognitive deficits in remitted late-onset depression. Brain Imaging Behav 2019; 14:1600-1611. [DOI: 10.1007/s11682-019-00091-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Frau-Pascual A, Fogarty M, Fischl B, Yendiki A, Aganj I. Quantification of structural brain connectivity via a conductance model. Neuroimage 2019; 189:485-496. [PMID: 30677502 PMCID: PMC6585945 DOI: 10.1016/j.neuroimage.2019.01.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 11/27/2018] [Accepted: 01/12/2019] [Indexed: 02/07/2023] Open
Abstract
Connectomics has proved promising in quantifying and understanding the effects of development, aging and an array of diseases on the brain. In this work, we propose a new structural connectivity measure from diffusion MRI that allows us to incorporate direct brain connections, as well as indirect ones that would not be otherwise accounted for by standard techniques and that may be key for the better understanding of function from structure. From our experiments on the Human Connectome Project dataset, we find that our measure of structural connectivity better correlates with functional connectivity than streamline tractography does, meaning that it provides new structural information related to function. Through additional experiments on the ADNI-2 dataset, we demonstrate the ability of this new measure to better discriminate different stages of Alzheimer's disease. Our findings suggest that this measure is useful in the study of the normal brain structure, and for quantifying the effects of disease on the brain structure.
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Affiliation(s)
- Aina Frau-Pascual
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
| | - Morgan Fogarty
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Bruce Fischl
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA; Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Anastasia Yendiki
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Iman Aganj
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA; Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA, USA
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Lam CLM, Liu HL, Huang CM, Wai YY, Lee SH, Yiend J, Lin C, Lee TMC. The neural correlates of perceived energy levels in older adults with late-life depression. Brain Imaging Behav 2018; 13:1397-1405. [PMID: 30159766 PMCID: PMC6732126 DOI: 10.1007/s11682-018-9940-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Late-life depression is common among older adults. Although white-matter abnormality is highly implicated, the extent to which the corticospinal tract is associated with the pathophysiology of late-life depression is unclear. The current study aims to investigate the white-matter structural integrity of the corticospinal tract and determine its cognitive and functional correlates in older adults with late-life depression. Twenty-eight older adults with clinical depression and 23 healthy age-matched older adults participated in the study. The white matter volume and the white matter hyperintensities (WMHs) of the corticospinal tract, as well as the global WMHs, were measured. Psychomotor processing speed, severity of depression, perceived levels of energy and physical functioning were measured to examine the relationships among the correlates in the depressed participants. The right corticospinal tract volume was significantly higher in depressed older adults relative to healthy controls. Moreover, the right corticospinal tract volume was significantly associated with the overall severity of depression and accounted for 17% of its variance. It further attenuated the relationship between the severity of depression and perceived levels of energy. Our findings suggested that higher volume in the right corticospinal tract is implicated in LLD and may relate to lower perceived levels of energy experienced by older adults with depression.
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Affiliation(s)
- Charlene L M Lam
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong.,Laboratory of Neuropsychology, The University of Hong Kong, Pokfulam, Hong Kong.,Institute of Clinical Neuropsychology, The University of Hong Kong, Pokfulam, Hong Kong
| | - Ho-Ling Liu
- Department of Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Chih-Mao Huang
- College of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan
| | - Yau-Yau Wai
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shwu-Hua Lee
- Department of Psychiatry, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jenny Yiend
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Chemin Lin
- Department of Psychiatry, Chang Gung Memorial Hospital, Keelung City, Taiwan.
| | - Tatia M C Lee
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong. .,Laboratory of Neuropsychology, The University of Hong Kong, Pokfulam, Hong Kong. .,Institute of Clinical Neuropsychology, The University of Hong Kong, Pokfulam, Hong Kong.
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Czéh B, Nagy SA. Clinical Findings Documenting Cellular and Molecular Abnormalities of Glia in Depressive Disorders. Front Mol Neurosci 2018. [PMID: 29535607 PMCID: PMC5835102 DOI: 10.3389/fnmol.2018.00056] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Depressive disorders are complex, multifactorial mental disorders with unknown neurobiology. Numerous theories aim to explain the pathophysiology. According to the “gliocentric theory”, glial abnormalities are responsible for the development of the disease. The aim of this review article is to summarize the rapidly growing number of cellular and molecular evidences indicating disturbed glial functioning in depressive disorders. We focus here exclusively on the clinical studies and present the in vivo neuroimaging findings together with the postmortem molecular and histopathological data. Postmortem studies demonstrate glial cell loss while the in vivo imaging data reveal disturbed glial functioning and altered white matter microstructure. Molecular studies report on altered gene expression of glial specific genes. In sum, the clinical findings provide ample evidences on glial pathology and demonstrate that all major glial cell types are affected. However, we still lack convincing theories explaining how the glial abnormalities develop and how exactly contribute to the emotional and cognitive disturbances. Abnormal astrocytic functioning may lead to disturbed metabolism affecting ion homeostasis and glutamate clearance, which in turn, affect synaptic communication. Abnormal oligodendrocyte functioning may disrupt the connectivity of neuronal networks, while microglial activation indicates neuroinflammatory processes. These cellular changes may relate to each other or they may indicate different endophenotypes. A theory has been put forward that the stress-induced inflammation—mediated by microglial activation—triggers a cascade of events leading to damaged astrocytes and oligodendroglia and consequently to their dysfunctions. The clinical data support the “gliocentric” theory, but future research should clarify whether these glial changes are truly the cause or simply the consequences of this devastating disorder.
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Affiliation(s)
- Boldizsár Czéh
- Neurobiology of Stress Research Group, Szentágothai Research Center, University of Pécs, Pécs, Hungary.,Department of Laboratory Medicine, University of Pécs, Medical School, Pécs, Hungary
| | - Szilvia A Nagy
- Neurobiology of Stress Research Group, Szentágothai Research Center, University of Pécs, Pécs, Hungary.,Department of Neurosurgery, University of Pécs, Medical School, Pécs, Hungary.,MTA-PTE, Clinical Neuroscience MR Research Group, Pécs, Hungary.,Pécs Diagnostic Centre, Pécs, Hungary
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Harada K, Ikuta T, Nakashima M, Watanuki T, Hirotsu M, Matsubara T, Yamagata H, Watanabe Y, Matsuo K. Altered Connectivity of the Anterior Cingulate and the Posterior Superior Temporal Gyrus in a Longitudinal Study of Later-life Depression. Front Aging Neurosci 2018; 10:31. [PMID: 29472854 PMCID: PMC5809471 DOI: 10.3389/fnagi.2018.00031] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 01/26/2018] [Indexed: 12/12/2022] Open
Abstract
Patients with later-life depression (LLD) show abnormal gray matter (GM) volume, white matter (WM) integrity and functional connectivity in the anterior cingulate cortex (ACC) and posterior superior temporal gyrus (pSTG), but it remains unclear whether these abnormalities persist over time. We examined whether structural and functional abnormalities in these two regions are present within the same subjects during depressed vs. remitted phases. Sixteen patients with LLD and 30 healthy subjects were studied over a period of 1.5 years. Brain images obtained with a 3-Tesla magnetic resonance imaging (MRI) system were analyzed by voxel-based morphometry of the GM volume, and diffusion tensor imaging (DTI) and resting-state functional MRI were used to assess ACC–pSTG connectivity. Patients with LLD in the depressed and remitted phases showed significantly smaller GM volume in the left ACC and left pSTG than healthy subjects. Both patients with LLD in the depressed and remitted phases had significantly higher diffusivities in the WM tract of the left ACC–pSTG than healthy subjects. Remitted patients with LLD showed lower functional ACC–pSTG connectivity compared to healthy subjects. No difference was found in the two regions between depressed and remitted patients in GM volume, structural or functional connectivity. Functional ACC–pSTG connectivity was positively correlated with lower global function during remission. Our preliminary data show that structural and functional abnormalities of the ACC and pSTG occur during LLD remission. Our findings tentatively reveal the brain pathophysiology involved in LLD and may aid in developing neuroanatomical biomarkers for this condition.
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Affiliation(s)
- Kenichiro Harada
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Toshikazu Ikuta
- Department of Communication Sciences and Disorders, School of Applied Sciences, University of Mississippi, Jackson, MS, United States
| | - Mami Nakashima
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan.,Nagato-Ichinomiya Hospital, Shimonoseki, Japan
| | - Toshio Watanuki
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Masako Hirotsu
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Toshio Matsubara
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan.,Health Administration Center, Yamaguchi University Organization for University Education, Yamaguchi, Japan
| | - Hirotaka Yamagata
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Yoshifumi Watanabe
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Koji Matsuo
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan
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Smagula SF, Beach S, Rosso AL, Newman AB, Schulz R. Brain Structural Markers and Caregiving Characteristics as Interacting Correlates of Caregiving Strain. Am J Geriatr Psychiatry 2017; 25:582-591. [PMID: 28336265 PMCID: PMC5584683 DOI: 10.1016/j.jagp.2017.02.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 02/05/2017] [Accepted: 02/16/2017] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To evaluate the association between brain structural markers and caregiving strain among older informal caregivers. DESIGN A secondary data analysis combining data from the Caregiver Health Effects Study (1993-1994) and the Cardiovascular Health Study MRI examination (1992-1994). SETTING Four United States communities. PARTICIPANTS Co-residing spousal caregivers (N = 237; mean age: 76.2 years, SD: 2.2 years). MEASUREMENTS Visually rated ventricular and white matter (WM) grades from magnetic resonance imaging, caregiving strain defined as "emotional or physical strain associated with providing care" for any of 12 activities of daily living (ADLs) and instrumental activities of daily living (IADLs), plus measures of caregiving characteristics and caregiver's health. RESULTS Overall, 56% of caregivers reported strain. We detected an interaction where strain was very common (>82%) among caregivers who helped with four or more IADLs, regardless of WM grades, and among caregivers with the worst WM grades (WM grades ≥4), regardless of the number of IADLs they helped with. Among caregivers helping with fewer than four IADLs, having WM grade 4 or greater was associated with a 55% higher prevalence ratio for reporting strain. This association remained statistically significant but was most markedly attenuated by adjustments for: care recipient's memory and behavioral problems, caregiver's depression symptoms, and caregiver's ADL impairment. CONCLUSIONS Caregiving strain is very common among older informal caregivers who provide help with many IADLs, and among caregivers who help with fewer IADLs, but have manifest signs of white matter pathology. Modern quantitative-neuroimaging studies are needed to evaluate whether more subtle variability in brain structure confers caregiving strain and the related health consequences.
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Affiliation(s)
- Stephen F Smagula
- Department of Psychiatry, Western Psychiatric Institute and Clinic of University of Pittsburgh Medical Center, Pittsburgh, PA.
| | - Scott Beach
- University Center for Social and Urban Research, Graduate School of Public Health, University of Pittsburgh, PA
| | - Andrea L Rosso
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA
| | - Anne B Newman
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA
| | - Richard Schulz
- Department of Psychiatry, Western Psychiatric Institute and Clinic of University of Pittsburgh Medical Center, Pittsburgh, PA
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15
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Smagula SF, Lotrich F, Aizenstein HJ, Diniz BS, Krystek J, Wu GF, Mulsant BH, Butters MA, Reynolds CF, Lenze EJ. Immunological biomarkers associated with brain structure and executive function in late-life depression: exploratory pilot study. Int J Geriatr Psychiatry 2017; 32:692-699. [PMID: 27282141 PMCID: PMC5772975 DOI: 10.1002/gps.4512] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 04/27/2016] [Accepted: 05/02/2016] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Several immunological biomarkers are altered in late-life major depressive disorder (LLD). Immunological alterations could contribute to LLD's consequences, but little is known about the relations between specific immunological biomarkers and brain health in LLD. We performed an exploratory pilot study to identify, from several candidates, the specific immunological biomarkers related to important aspects of brain health that are altered in LLD (brain structure and executive function). METHODS Adults (n = 31) were at least 60 years old and had major depressive disorder. A multiplex immunoassay assessed 13 immunological biomarkers, and we examined their associations with structural MRI (grey matter volume and white matter hyperintensity volume (WMH)) and executive function (Color-Word Interference and Trail-Making tests) measures. RESULTS Vascular endothelial growth factor (VEGF) and the chemokine eotaxin had significant negative associations with grey matter volume (VEGF: n = 31, r = -0.65; eotaxin: n = 29, r = -0.44). Tumor necrosis factor alpha (TNF-α) had a significant positive relationship with WMHs (n = 30, r = 0.52); interferon-γ (IFN-γ) and macrophage inflammatory protein-1α (MIP-1α) were also significantly associated with WMHs (IFN-γ: n = 31, r = 0.48; MIP-1α: n = 29, r = 0.45). Only eotaxin was associated with executive function (set-shifting performance as measured with the Trail-making test: n = 33, r = -0.43). CONCLUSIONS Immunological markers are associated with brain structure in LLD. We found the immunological correlates of grey and white matter differ. Prospective studies are needed to evaluate whether these immunological correlates of brain health increase the risk of LLD's consequences. Eotaxin, which correlated with both grey matter volume and set-shifting performance, may be particularly relevant to neurodegeneration and cognition in LLD. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Stephen F. Smagula
- Department of Psychiatry, Western Psychiatric Institute and Clinic of University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Francis Lotrich
- Department of Psychiatry, Western Psychiatric Institute and Clinic of University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Howard J. Aizenstein
- Department of Psychiatry, Western Psychiatric Institute and Clinic of University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Breno S. Diniz
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Jeffrey Krystek
- Department of Psychiatry, Western Psychiatric Institute and Clinic of University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Gregory F. Wu
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
| | - Benoit H. Mulsant
- Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada
| | - Meryl A. Butters
- Department of Psychiatry, Western Psychiatric Institute and Clinic of University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Charles F. Reynolds
- Department of Psychiatry, Western Psychiatric Institute and Clinic of University of Pittsburgh Medical Center, Pittsburgh, PA, USA,Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Eric J. Lenze
- Healthy Mind Lab, Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
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Choi WH, Jung WS, Um YH, Lee CU, Park YH, Lim HK. Cerebral vascular burden on hippocampal subfields in first-onset drug-naïve subjects with late-onset depression. J Affect Disord 2017; 208:47-53. [PMID: 27744126 DOI: 10.1016/j.jad.2016.08.070] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 08/24/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Although there is substantial evidence of associations between frontal-striatal circuits and cerebral vascular burden in late-onset depression (LOD), relationships between vascular burden and hippocampal subfields are not clear. The purpose of this study was to investigate relationships between cerebral vascular burden and hippocampal subfield volume in LOD patients. METHODS Fifty subjects with LOD and 50 group-matched healthy control subjects underwent magnetic resonance imaging scanning. Hippocampal subfields volumes were measured and compared between the groups. In addition, association patterns between white matter hyperintensity (WMH) volumes, clinical measures and hippocampal subfield volumes were investigated in the LOD group. RESULTS Subjects with LOD exhibited significant hippocampal volume reductions in the total hippocampus, cornu ammonis (CA) 1 and 3 and dentate gyrus (DG) areas compared with healthy subjects. Total WMH volume was negatively correlated with left total hippocampal volume and CA1 in the LOD group. In addition, depression severity was negatively associated with left and right CA3 volumes in the LOD group. LIMITATION Our findings of distinctive relationships between WMH and hippocampal subfields demonstrate a simple correlation, but do not prove causation CONCLUSION: This study is the first to elaborate distinctive association patterns between hippocampal subfield volumes and cerebral vascular burden in LOD. These structural changes in the hippocampal CA1, CA3 and DG areas might be at the core of the underlying neurobiological mechanisms of hippocampal dysfunction in LOD. However, longitudinal studies will be needed to identify the mechanisms of these structural changes.
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Affiliation(s)
- Woo Hee Choi
- Department of Radiology, Division of Nuclear Medicine The Saint Vincent Hospital, The College of Medicine, The Catholic University of Korea, Republic of Korea
| | - Won Sang Jung
- Department of Radiology The Saint Vincent Hospital, The College of Medicine, The Catholic University of Korea, Republic of Korea
| | - Yoo Hyun Um
- Department of Psychiatry, The Saint Vincent Hospital, The College of Medicine, The Catholic University of Korea, Republic of Korea
| | - Chang Uk Lee
- Department of Psychiatry, The Seoul St. Mary's Hospital, The College of Medicine, The Catholic University of Korea, Republic of Korea
| | - Young Ha Park
- Department of Radiology, Division of Nuclear Medicine The Saint Vincent Hospital, The College of Medicine, The Catholic University of Korea, Republic of Korea
| | - Hyun Kook Lim
- Department of Psychiatry, The Saint Vincent Hospital, The College of Medicine, The Catholic University of Korea, Republic of Korea.
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Barch DM, Carter CS. Functional and Structural Brain Connectivity in Psychopathology. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2016; 1:196-198. [DOI: 10.1016/j.bpsc.2016.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Accepted: 03/27/2016] [Indexed: 01/01/2023]
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