1
|
Wu GR, Baeken C. Normative modeling analysis reveals corpus callosum volume changes in early and mid-to-late first episode major depression. J Affect Disord 2023; 340:10-16. [PMID: 37499915 DOI: 10.1016/j.jad.2023.07.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/19/2023] [Accepted: 07/23/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND It has been widely accepted that major depressive disorder (MDD) impacts brain structures including the Corpus Callosum (CC). However, this assumption is based on scarce literature data involving small sample sizes. Furthermore, it is still unclear whether such CC volume changes may already be present at a first depressive episode. METHODS To further investigate this question, we compared 369 first-episode MDD patients (mean age = 35 years (sd = 12), 249 females; 283 early onset, 86 mid-to-late onset) from the open-source REST meta-MDD database closely matched for age and gender to 490 never-depressed individuals (mean age = 37 years (sd = 14); 309 females) using Z-scores obtained from normative neuroanatomical modeling to assess individual variability in CC (sub)volumes. RESULTS Relative to the norms established by the healthy controls, first-episode MDD patients displayed CC volume (z-score) reductions in the entire CC (including the body), as did mid-to-late-onset first-episode MDD patients (age ≥ 45 y). In early-onset first-episode MDD patients (age ≤ 44 y), depression severity symptoms were related to volume increases in the entire CC, as well as the body and splenium. LIMITATIONS No data on depressive episode duration. Relatively small sample size for mid-to-late first-episode MDD patients. CONCLUSIONS Our data revealed CC (sub)volume differences in early versus mid-to-late onset first episode MDD. Especially at early onset, depression severity may result in neural white matter activity as potential reaction to stress influences. Our results underline the importance of prompt clinical interventions at early onset MDD.
Collapse
Affiliation(s)
- Guo-Rong Wu
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Southwest University, Chongqing, China; Faculty of Medicine and Health Sciences, Department of Head and Skin, Ghent Experimental Psychiatry (GHEP) lab, Ghent University, Ghent, Belgium.
| | - Chris Baeken
- Faculty of Medicine and Health Sciences, Department of Head and Skin, Ghent Experimental Psychiatry (GHEP) lab, Ghent University, Ghent, Belgium; Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Department of Psychiatry, Laarbeeklaan 101, 1090 Brussels, Belgium; Eindhoven University of Technology, Department of Electrical Engineering, Eindhoven, the Netherlands
| |
Collapse
|
2
|
Koyama Y, Fujiwara T, Murayama H, Machida M, Inoue S, Shobugawa Y. Association between adverse childhood experiences and brain volumes among Japanese community-dwelling older people: Findings from the NEIGE study. CHILD ABUSE & NEGLECT 2022; 124:105456. [PMID: 34991011 DOI: 10.1016/j.chiabu.2021.105456] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 12/19/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) can affect later-life health outcomes via brain structural differences. However, there is no sufficient empirical evidence about whether brain morphological differences remain until old ages. OBJECTIVE We examined the association between ACEs and brain volumes among older individuals. PARTICIPANTS AND SETTING Residents aged 65-84 years in Tokamachi City, Japan, were randomly recruited, and 491 participants were included in the analysis. METHODS ACEs were assessed with a self-reported questionnaire. The volumes of seven brain regions of interests were evaluated via structural magnetic resonance imaging. RESULTS In total, 143 (27.1%) participants experienced one ACE and 33 (6.7%) two or more ACEs. Participants with two or more ACEs had a larger anterior cingulate cortex volume (B = 0.346, 95% confidence interval [CI] = 0.04 to 0.66) and smaller hippocampal (B = -0.287, 95% CI = -0.58 to 0.001) and amygdala (B = -0.313, 95% CI = -0.59 to -0.03) volumes. Interestingly, we observed a distinct association between deprivation and threat. That is, deprivation was associated with a smaller amygdala volume (B = -0.164, 95% CI = -0.32 to -0.01) and threat with a larger anterior cingulate cortex volume (B = 0.401, 95% CI = 0.11 to 0.70). CONCLUSIONS ACEs were associated with the volumes of brain regions such as anterior cingulate cortex, hippocampus, and amygdala, which are responsible for emotion and self-regulation in older population. The effect of ACEs on the amygdala was commonly driven by deprivation experiences and that on the anterior cingulate cortex by threat.
Collapse
Affiliation(s)
- Yuna Koyama
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.
| | - Hiroshi Murayama
- Research Team for Social participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Masaki Machida
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan; Department of Infection Prevention and Control, Tokyo Medical University Hospital, Tokyo, Japan
| | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan
| | - Yugo Shobugawa
- Division of International Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| |
Collapse
|
3
|
Lecei A, van Winkel R. Hippocampal pattern separation of emotional information determining risk or resilience in individuals exposed to childhood trauma: Linking exposure to neurodevelopmental alterations and threat anticipation. Neurosci Biobehav Rev 2020; 108:160-170. [DOI: 10.1016/j.neubiorev.2019.11.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 11/15/2019] [Accepted: 11/15/2019] [Indexed: 12/29/2022]
|
4
|
Karstens AJ, Ajilore O, Rubin LH, Yang S, Zhang A, Leow A, Kumar A, Lamar M. Investigating the separate and interactive associations of trauma and depression on brain structure: implications for cognition and aging. Int J Geriatr Psychiatry 2017; 32. [PMID: 28643948 PMCID: PMC5638677 DOI: 10.1002/gps.4755] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Trauma and depression are associated with brain structural alterations; their combined effects on these outcomes are unclear. We previously reported a negative effect of trauma, independent of depression, on verbal learning and memory; less is known about underlying structural associates. We investigated separate and interactive associations of trauma and depression on brain structure. METHODS Adults aged 30-89 (N = 203) evaluated for depression (D+) and trauma history (T+) using structured clinical interviews were divided into 53 D+T+, 42 D+T-, 50 D-T+, and 58 D-T-. Multivariable linear regressions examined the separate and interactive associations of depression and trauma with prefrontal and temporal lobe cortical thickness composites and hippocampal volumes adjusting for age, sex, predicted verbal IQ, comorbid anxiety, and vascular risk. Significant results informed analyses of tract-based structural connectomic measures of efficiency and centrality. RESULTS Trauma, independent of depression, was associated with greater left prefrontal cortex (PFC) thickness, in particular the medial orbitofrontal cortex and pars orbitalis. A trauma × depression interaction was observed for the right PFC in age-stratified analyses: Older D + T+ had reduced PFC thickness compared with older D - T+ individuals. Regardless of age, trauma was associated with more left medial orbitofrontal cortex efficiency and less pars orbitalis centrality. In the T+ group, left pars orbitalis cortical thickness and centrality negatively correlated with verbal learning. CONCLUSIONS Trauma, independent of depression, associated with altered PFC characteristics, morphologically and in terms of structural network communication and influence. Additionally, findings suggest that there may be a combined effect of trauma and depression in older adults. Copyright © 2017 John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
- Aimee J. Karstens
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, 60612
| | - Olusola Ajilore
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, 60612
| | - Leah H. Rubin
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, 60612
| | - Shaolin Yang
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, 60612,Department of Bioengineering, University of Illinois at Chicago, Chicago, IL, 60612
| | - Aifeng Zhang
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, 60612
| | - Alex Leow
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, 60612,Department of Bioengineering, University of Illinois at Chicago, Chicago, IL, 60612
| | - Anand Kumar
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, 60612
| | - Melissa Lamar
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, 60612,Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, 60612,Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, 60612
| |
Collapse
|
5
|
Geerlings MI, Gerritsen L. Late-Life Depression, Hippocampal Volumes, and Hypothalamic-Pituitary-Adrenal Axis Regulation: A Systematic Review and Meta-analysis. Biol Psychiatry 2017; 82:339-350. [PMID: 28318491 DOI: 10.1016/j.biopsych.2016.12.032] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 12/20/2016] [Accepted: 12/21/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND We systematically reviewed and meta-analyzed the association of late-life depression (LLD) with hippocampal volume (HCV) and total brain volume (TBV), and of cortisol levels with HCV, including subgroup analyses of depression characteristics and methodological aspects. METHODS We searched PubMed and Embase for original studies that examined the cross-sectional relationship between LLD and HCV or TBV, and 46 studies fulfilled the inclusion criteria. Standardized mean differences (Hedges' g) between LLD and control subjects were calculated from crude or adjusted brain volumes using random effects. Standardized Fisher transformations of the correlations between cortisol levels and HCVs were calculated using random effects. RESULTS We included 2702 LLD patients and 11,165 control subjects from 35 studies examining HCV. Relative to control subjects, patients had significantly smaller HCVs (standardized mean difference = -0.32 [95% confidence interval, -0.44 to -0.19]). Subgroup analyses showed that late-onset depression was more strongly associated with HCV than early-onset depression. In addition, effect sizes were larger for case-control studies, studies with lower quality, and studies with small sample size, and were almost absent in cohort studies and studies with larger sample sizes. For TBV, 2523 patients and 7880 control subjects from 31 studies were included. The standardized mean difference in TBV between LLD and control subjects was -0.10 (95% confidence interval, -0.16 to -0.04). Of the 12 studies included, higher levels of cortisol were associated with smaller HCV (correlation = -0.11 [95% confidence interval, -0.18 to -0.04]). CONCLUSIONS While an overall measure of LLD may be associated with smaller HCVs, differentiating clinical aspects of LLD and examining methodological issues show that this relationship is not straightforward.
Collapse
Affiliation(s)
- Mirjam I Geerlings
- University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands.
| | - Lotte Gerritsen
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
6
|
Karstens AJ, Rubin LH, Shankman SA, Ajilore O, Libon DJ, Kumar A, Lamar M. Investigating the separate and interactive associations of trauma and depression on neurocognition in urban dwelling adults. J Psychiatr Res 2017; 89:6-13. [PMID: 28130995 PMCID: PMC5373989 DOI: 10.1016/j.jpsychires.2017.01.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 01/06/2017] [Accepted: 01/12/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Trauma and depression have each been associated with neurocognitive alterations, but their combined effect on neurocognition is unclear. We investigated the separate and interactive associations of trauma and depression on neurocognition in a sample of ethnically diverse urban dwellers, and explored the impact of age on these effects. METHODS 284 adults aged 30-89 were divided into groups based on their current depression and trauma history. Individuals meeting DSM-IV criteria for depression were considered Depressed (D+) and individuals rated through diagnostic interview as having trauma history were considered positive for Trauma (T+). Resulting Ns were 73 D+T+, 56 D+T-, 68 D-T+, and 87 D-T-. A principal component analysis of neuropsychological scores resulted in a 3-factor solution representing verbal learning/memory/recognition (VERBAL-LMR), visual learning/memory/recognition, and speeded attention/cognitive flexibility accounting for 70.21% of the variance. RESULTS Multivariable linear regressions adjusting for age revealed that Trauma, regardless of Depression, is associated with worse VERBAL-LMR performance. This Trauma association was driven by verbal list and prose passages learning and memory, but not recognition memory. Age-stratified (<60 versus ≥60 years) regressions revealed the Trauma association was only significant for older adults. No main or interactive effects for Depression were observed. CONCLUSIONS Trauma, regardless of Depression, is associated with worse verbal learning and memory, but not recognition performance. These results suggest that trauma exposure may negatively impact neurocognition. Clinicians working with adults in urban settings should query for trauma in addition to depression when considering subjective and objective measures of neurocognitive functioning, particularly in older adults.
Collapse
Affiliation(s)
| | - Leah H. Rubin
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, 60612
| | - Stewart A. Shankman
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, 60612,Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, 60612
| | - Olusola Ajilore
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, 60612
| | - David J. Libon
- Department of Geriatrics and Gerontology, New Jersey Institute for Successful Aging, School of Osteopathic Medicine-Rowan University, Stratford, NJ 08084
| | - Anand Kumar
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, 60612
| | - Melissa Lamar
- Department of Psychology, University of Illinois at Chicago, Chicago, IL 60612, United States; Department of Psychiatry, University of Illinois at Chicago, Chicago, IL 60612, United States.
| |
Collapse
|
7
|
Teicher MH, Samson JA. Annual Research Review: Enduring neurobiological effects of childhood abuse and neglect. J Child Psychol Psychiatry 2016; 57:241-66. [PMID: 26831814 PMCID: PMC4760853 DOI: 10.1111/jcpp.12507] [Citation(s) in RCA: 637] [Impact Index Per Article: 79.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/24/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND Childhood maltreatment is the most important preventable cause of psychopathology accounting for about 45% of the population attributable risk for childhood onset psychiatric disorders. A key breakthrough has been the discovery that maltreatment alters trajectories of brain development. METHODS This review aims to synthesize neuroimaging findings in children who experienced caregiver neglect as well as from studies in children, adolescents and adults who experienced physical, sexual and emotional abuse. In doing so, we provide preliminary answers to questions regarding the importance of type and timing of exposure, gender differences, reversibility and the relationship between brain changes and psychopathology. We also discuss whether these changes represent adaptive modifications or stress-induced damage. RESULTS Parental verbal abuse, witnessing domestic violence and sexual abuse appear to specifically target brain regions (auditory, visual and somatosensory cortex) and pathways that process and convey the aversive experience. Maltreatment is associated with reliable morphological alterations in anterior cingulate, dorsal lateral prefrontal and orbitofrontal cortex, corpus callosum and adult hippocampus, and with enhanced amygdala response to emotional faces and diminished striatal response to anticipated rewards. Evidence is emerging that these regions and interconnecting pathways have sensitive exposure periods when they are most vulnerable. CONCLUSIONS Early deprivation and later abuse may have opposite effects on amygdala volume. Structural and functional abnormalities initially attributed to psychiatric illness may be a more direct consequence of abuse. Childhood maltreatment exerts a prepotent influence on brain development and has been an unrecognized confound in almost all psychiatric neuroimaging studies. These brain changes may be best understood as adaptive responses to facilitate survival and reproduction in the face of adversity. Their relationship to psychopathology is complex as they are discernible in both susceptible and resilient individuals with maltreatment histories. Mechanisms fostering resilience will need to be a primary focus of future studies.
Collapse
Affiliation(s)
- Martin H. Teicher
- Department of Psychiatry, Harvard Medical School, Boston, MA,Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
| | - Jacqueline A. Samson
- Department of Psychiatry, Harvard Medical School, Boston, MA,Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
| |
Collapse
|
8
|
Ryan J, Artero S, Carrière I, Maller JJ, Meslin C, Ritchie K, Ancelin ML. GWAS-identified risk variants for major depressive disorder: Preliminary support for an association with late-life depressive symptoms and brain structural alterations. Eur Neuropsychopharmacol 2016; 26:113-125. [PMID: 26391493 DOI: 10.1016/j.euroneuro.2015.08.022] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 08/28/2015] [Accepted: 08/29/2015] [Indexed: 11/30/2022]
Abstract
A number of genome-wide association studies (GWAS) have investigated risk factors for major depressive disorder (MDD), however there has been little attempt to replicate these findings in population-based studies of depressive symptoms. Variants within three genes, BICC1, PCLO and GRM7 were selected for replication in our study based on the following criteria: they were identified in a prior MDD GWAS study; a subsequent study found evidence that they influenced depression risk; and there is a solid biological basis for a role in depression. We firstly investigated whether these variants were associated with depressive symptoms in our population-based cohort of 929 elderly (238 with clinical depressive symptoms and 691 controls), and secondly to investigate associations with structural brain alterations. A number of nominally significant associations were identified, but none reached Bonferroni-corrected significance levels. Common SNPs in BICC1 and PCLO were associated with a 50% and 30% decreased risk of depression, respectively. PCLO rs2522833 was also associated with the volume of grey matter (p=1.6×10(-3)), and to a lesser extent with hippocampal volume and white matter lesions. Among depressed individuals rs9870680 (GRM7) was associated with the volume of grey and white matter (p=10(-4) and 8.3×10(-3), respectively). Our results provide some support for the involvement of BICC1 and PCLO in late-life depressive disorders and preliminary evidence that these genetic variants may also influence brain structural volumes. However effect sizes remain modest and associations did not reach corrected significance levels. Further large imaging studies are needed to confirm our findings.
Collapse
Affiliation(s)
- Joanne Ryan
- Inserm, U1061, Montpellier F-34093; Université Montpellier, Montpellier F-34000, France; Disease Epigenetics Group, Murdoch Childrens Research Institute & Department of Paediatrics, University of Melbourne, Parkville 3052, Victoria, Australia.
| | - Sylvaine Artero
- Inserm, U1061, Montpellier F-34093; Université Montpellier, Montpellier F-34000, France
| | - Isabelle Carrière
- Inserm, U1061, Montpellier F-34093; Université Montpellier, Montpellier F-34000, France
| | - Jerome J Maller
- Monash Alfred Psychiatry Research Centre, The Alfred & Monash University Central Clinical School, Melbourne 3004, Victoria, Australia
| | - Chantal Meslin
- Centre for Mental Health Research, Australian National University, ACT, Canberra 0200, Australia
| | - Karen Ritchie
- Inserm, U1061, Montpellier F-34093; Université Montpellier, Montpellier F-34000, France; Faculty of Medicine, Imperial College, London SW7 2AZ, United Kingdom
| | - Marie-Laure Ancelin
- Inserm, U1061, Montpellier F-34093; Université Montpellier, Montpellier F-34000, France
| |
Collapse
|
9
|
Education modulates the impact of white matter lesions on the risk of mild cognitive impairment and dementia. Am J Geriatr Psychiatry 2014; 22:1336-45. [PMID: 24021219 PMCID: PMC4143478 DOI: 10.1016/j.jagp.2013.06.002] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Revised: 04/24/2013] [Accepted: 06/05/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Conflicting results have been reported regarding the association between white matter lesions (WML) and cognitive impairment. We hypothesized that education, a marker of cognitive reserve (CR), could modulate the effects of WML on the risk of mild cognitive impairment (MCI) or dementia. METHODS We followed 500 healthy subjects from a cohort of community-dwelling persons aged 65 years and over (ESPRIT Project). At baseline, WML volume was measured using a semi-automatic method on T2-weighted MRI. Standardized cognitive and neurological evaluations were repeated after 2, 4, and 7 years. The sample was dichotomized according to education level into low (≤8 years) and high (>8 years) education groups. Cox proportional hazard models were constructed to study the association between WML and risk of MCI/dementia. RESULTS The interaction between education level and WML volume reached significance (p = 0.017). After adjustment for potential confounders, the association between severe WML and increased MCI/dementia risk was significant in the low education group (≤8 years) (p = 0.02, hazard ratio [HR]: 3.77 [1.29-10.99]), but not in the high education group (>8 years) (p = 0.82, HR: 1.07 [0.61-1.87]). CONCLUSIONS Severe WML significantly increases the risk of developing MCI/dementia over a 7-year period in low educated participants. Subjects with higher education levels were seen to be more likely to be resilient to the deleterious effects of severe WML. The CR hypothesis suggests several avenues for dementia prevention.
Collapse
|
10
|
Mortamais M, Reynes C, Brickman AM, Provenzano FA, Muraskin J, Portet F, Berr C, Touchon J, Bonafé A, le Bars E, Maller JJ, Meslin C, Sabatier R, Ritchie K, Artero S. Spatial distribution of cerebral white matter lesions predicts progression to mild cognitive impairment and dementia. PLoS One 2013; 8:e56972. [PMID: 23457645 PMCID: PMC3572965 DOI: 10.1371/journal.pone.0056972] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Accepted: 01/17/2013] [Indexed: 11/18/2022] Open
Abstract
CONTEXT White matter lesions (WML) increase the risk of dementia. The relevance of WML location is less clear. We sought to determine whether a particular WML profile, based on the density and location of lesions, could be associated with an increased risk of mild cognitive impairment (MCI) or dementia over the following 7 years. METHODS In 426 healthy subjects from a cohort of community-dwelling people aged 65 years and over (ESPRIT Project), standardized cognitive and neurological evaluations were repeated after 2, 4 and 7 years. Patterns of WML were computed with a supervised data mining approach (decision trees) using the regional WML volumes (frontal, parietal, temporal, and occipital regions) and the total WML volume estimated at baseline. Cox proportional hazard models were then constructed to study the association between WML patterns and risk of MCI/dementia. RESULTS Total WML volume and percentage of WML in the temporal region proved to be the best predictors of progression to MCI and dementia. Specifically, severe total WML load with a high proportion of lesions in the temporal region was significantly associated with the risk of developing MCI or dementia. CONCLUSIONS Above a certain threshold of damage, a pattern of WML clustering in the temporal region identifies individuals at increased risk of MCI or dementia. As this WML pattern is observed before the onset of clinical symptoms, it may facilitate the detection of patients at risk of MCI/dementia.
Collapse
Affiliation(s)
- Marion Mortamais
- Inserm, U1061, La Colombière Hospital, Montpellier, France
- University of Montpellier 1, Montpellier, France
| | - Christelle Reynes
- University of Montpellier 1, Montpellier, France
- EA 2415, Faculté de Pharmacie, Montpellier, France
| | - Adam M. Brickman
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, College of Physicians and Surgeons, New York, New York, United States of America
| | - Frank A. Provenzano
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, College of Physicians and Surgeons, New York, New York, United States of America
| | - Jordan Muraskin
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, College of Physicians and Surgeons, New York, New York, United States of America
| | - Florence Portet
- Inserm, U1061, La Colombière Hospital, Montpellier, France
- Unité Transversale des Troubles Neurologiques du Sujet Âgé, CHU Caremeau, Centre Ruffi, Pôle de Gériatrie, CHU Nîmes, Nîmes, France
- Montpellier University Hospital, University Department of Adult Psychiatry, La Colombière Hospital, CHU de Montpellier, Montpellier, France
| | - Claudine Berr
- Inserm, U1061, La Colombière Hospital, Montpellier, France
- University of Montpellier 1, Montpellier, France
| | - Jacques Touchon
- Inserm, U1061, La Colombière Hospital, Montpellier, France
- University of Montpellier 1, Montpellier, France
| | - Alain Bonafé
- University of Montpellier 1, Montpellier, France
- CHRU Montpellier, Montpellier, France
| | - Emmanuelle le Bars
- University of Montpellier 1, Montpellier, France
- CHRU Montpellier, Montpellier, France
| | - Jerome J. Maller
- Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, Melbourne, Australia
| | - Chantal Meslin
- Centre for Mental Health Research, Australian National University, Canberra, Australia
| | - Robert Sabatier
- University of Montpellier 1, Montpellier, France
- EA 2415, Faculté de Pharmacie, Montpellier, France
| | - Karen Ritchie
- Inserm, U1061, La Colombière Hospital, Montpellier, France
- University of Montpellier 1, Montpellier, France
- Faculty of Medicine, Imperial College, London, United Kingdom
| | - Sylvaine Artero
- Inserm, U1061, La Colombière Hospital, Montpellier, France
- University of Montpellier 1, Montpellier, France
- * E-mail:
| |
Collapse
|