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Karolczak K, Kostanek J, Soltysik B, Konieczna L, Baczek T, Kostka T, Watala C. Relationships between Plasma Concentrations of Testosterone and Dihydrotestosterone and Geriatric Depression Scale Scores in Men and Women Aged 60-65 Years-A Multivariate Approach with the Use of Quade's Test. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12507. [PMID: 36231806 PMCID: PMC9566053 DOI: 10.3390/ijerph191912507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
The potential role of testosterone and dihydrotestosterone in the pathogenesis of depression in older subjects is poorly recognized and understood. The current study examines the symptoms of depression in males and females at the age of 60-65 using a short version (15 questions) of the Geriatric Depression Scale (GDS) questionnaire. Blood plasma levels of androgens were estimated by LC/MS/MS. Total GDS score calculated for males were not found to be significantly associated with plasma levels of testosterone or dihydrotestosterone. Older men with higher plasma testosteronemia were more likely to report being in good spirits most of the time, but more willing to stay at home than undertake outside activities. The men with higher plasma levels of dihydrotestosterone also perceived themselves as being in good spirits most of the time. Older men with higher testosterone were more likely to report having more problems with their memory than others. No significant associations were found between plasma levels of androgens and GDS scores in older women; however, some tendencies suggest that testosterone and dihydrotestosterone may act as antidepressants in older women.
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Affiliation(s)
- Kamil Karolczak
- Department of Haemostatic Disorders, Medical University of Lodz, ul. Mazowiecka 6/8, 92-215 Lodz, Poland
| | - Joanna Kostanek
- Department of Haemostatic Disorders, Medical University of Lodz, ul. Mazowiecka 6/8, 92-215 Lodz, Poland
| | - Bartlomiej Soltysik
- Department of Geriatrics, Healthy Aging Research Center (HARC), Medical University of Lodz, pl. Hallera 1, 90-647 Lodz, Poland
| | - Lucyna Konieczna
- Department of Pharmaceutical Chemistry, Medical University of Gdańsk, ul. Hallera 107, 80-416 Gdańsk, Poland
| | - Tomasz Baczek
- Department of Pharmaceutical Chemistry, Medical University of Gdańsk, ul. Hallera 107, 80-416 Gdańsk, Poland
| | - Tomasz Kostka
- Department of Geriatrics, Healthy Aging Research Center (HARC), Medical University of Lodz, pl. Hallera 1, 90-647 Lodz, Poland
| | - Cezary Watala
- Department of Haemostatic Disorders, Medical University of Lodz, ul. Mazowiecka 6/8, 92-215 Lodz, Poland
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Dalby RB, Eskildsen SF, Videbech P, Rosenberg R, Østergaard L. Cerebral hemodynamics and capillary dysfunction in late-onset major depressive disorder. Psychiatry Res Neuroimaging 2021; 317:111383. [PMID: 34508953 DOI: 10.1016/j.pscychresns.2021.111383] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 08/22/2021] [Accepted: 08/31/2021] [Indexed: 02/06/2023]
Abstract
In major depressive disorder (MDD), perfusion changes in cortico-limbic pathways are interpreted as altered neuronal activity, but they could also signify changes in neurovascular coupling due to altered capillary function. To examine capillary function in late-onset MDD, 22 patients and 22 age- and gender-matched controls underwent perfusion MRI. We measured normalized cerebral blood flow (nCBF), cerebral blood volume (nCBV), and relative transit-time heterogeneity (RTH). Resulting brain oxygenation was estimated in terms of oxygen tension and normalized metabolic rate of oxygen (nCMRO2). Patients revealed signs of capillary dysfunction (elevated RTH) in the anterior prefrontal cortex and ventral anterior cingulate cortex bilaterally and in the left insulate cortex compared to controls, bilateral hypometabolism (parallel reductions of nCBV, nCBF, and CMRO2) but preserved capillary function in the subthalamic nucleus and globus pallidus bilaterally, and hyperactivity with preserved capillary function (increased nCBF) in the cerebellum and brainstem. Our data support that perfusion changes in deep nuclei and cerebellum reflect abnormally low and high activity, respectively, in MDD patients, but suggest that microvascular pathology affects neurovascular coupling in ventral circuits. We speculate that microvascular pathology is important for our understanding of etiology of late-onset MDD as well as infererences about resulting brain activity changes.
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Affiliation(s)
- Rikke B Dalby
- Center of Functionally Integrative Neuroscience (CFIN) / MINDLab, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Centre for Psychiatric Research, Aarhus University Hospital, Risskov, Denmark; Department of Radiology, Section of Neuroradiology, Aarhus University Hospital, Aarhus, Denmark.
| | - Simon F Eskildsen
- Center of Functionally Integrative Neuroscience (CFIN) / MINDLab, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Poul Videbech
- Center for Neuropsychiatric Depression Research, Mental Health Center Glostrup, Glostrup, Denmark
| | - Raben Rosenberg
- Centre for Psychiatric Research, Aarhus University Hospital, Risskov, Denmark; Centre of Psychiatry Amager, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Leif Østergaard
- Center of Functionally Integrative Neuroscience (CFIN) / MINDLab, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Neuroradiology Research Unit, Department of Radiology, Section of Neuroradiology, Aarhus University Hospital, Aarhus, Denmark
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Kihira S, Koo C, Nael K, Belani P. Regional Parieto-occipital Hypoperfusion on Arterial Spin Labeling Associates with Major Depressive Disorder. Open Neuroimag J 2020. [DOI: 10.2174/1874440002013010030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Reduced cerebral blood flow in parieto-occipital regions has been reported in neurodegenerative disorders using ASL. We aimed to investigate neuropsychiatric and neurodegenerative comorbidities that may associate with parieto-occipital region hypoperfusion.
Methods:
This was a retrospective single-center study. Between March 2017 to May 2018, adult patients who underwent brain MRI with the inclusion of ASL perfusion and who had bilateral reductions of CBF in the parieto-occipital regions were included. ASL was performed using a pseudo-continuous arterial spin labeling (pCASL) technique on 1.5T MR system. Age and gender-matched patients with no perfusion defect were concurrently collected. Comorbidity data was collected from EMR, including major depressive disorder, Alzheimer’s disease, Parkinson’s disease, Schizophrenia, anxiety disorder, hypertension, diabetes mellitus type II, coronary artery disease, and chronic kidney disease. A Pearson’s Chi-Square test was performed to assess for comorbidities associated with hypoperfusion of the parieto-occipital lobes.
Results:
Our patient cohort consisted of 93 patients with bilateral hypoperfusion in the parieto-occipital lobes and 93 age and gender-matched patients without corresponding perfusion defects based on ASL-CBF. Among the comorbidities assessed, there was a statistically significant association between hypoperfusion of the parieto-occipital lobes and major depressive disorder (p=0.004) and Parkinson’s disease (p=0.044). There was no statistically significant association for Alzheimer’s disease, generalized anxiety disorder, diabetes mellitus type II, hypertension, coronary artery disease, or chronic kidney disease.
Conclusion:
Major depressive disorder may be linked to regional parieto-occipital hypoperfusion on ASL.
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Dafsari FS, Bewernick B, Biewer M, Christ H, Domschke K, Froelich L, Hellmich M, Luppa M, Peters O, Ramirez A, Riedel-Heller S, Schramm E, Vry MS, Wagner M, Hautzinger M, Jessen F. Cognitive behavioural therapy for the treatment of late life depression: study protocol of a multicentre, randomized, observer-blinded, controlled trial (CBTlate). BMC Psychiatry 2019; 19:423. [PMID: 31881995 PMCID: PMC6935201 DOI: 10.1186/s12888-019-2412-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 12/17/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Late-life depression (LLD) is one of the most prevalent mental disorders in old age. It is associated with various adverse outcomes and frequent use of health care services thereby remaining a serious public health concern. Compared with depression in early adulthood, most treatment options of LLD are less effective. Psychotherapy may be particularly beneficial for LLD due to specific psychological conditions in old age and a low risk of side effects. Although cognitive behavioural therapy (CBT) is highly established and effective in depression in young and mid-life there is only a limited number of small studies on CBT in LLD. An LLD-specific CBT has not yet been compared to an active, but unspecific supportive psychological intervention in a multicentre trial. METHODS Here we present the design of the CBTlate trial, which is a multicentre, randomized, observer-blinded, active-controlled, parallel group trial. CBTlate aims at including 248 patients with LLD of both genders at 7 sites in Germany. The purpose of the study is to test the hypothesis that a 15-session individually-delivered CBT specific for LLD is of superior efficacy in reducing symptoms of depression in comparison with a supportive unspecific intervention (SUI) of the same quantity. The intervention includes 8 weeks of individual treatment sessions twice per week and a follow-up period of 6 months after randomization. The primary end point is the severity of depression at the end of treatment measured by the self-rated 30-item Geriatric Depression Scale (GDS). Secondary endpoints include depressive symptoms at week 5 and at follow-up (6 months after randomization). Additional secondary endpoints include the change of depressive symptoms assessed with a clinician-rating-scale and a patient reported outcome instrument for major depressive disorder, anxiety symptoms, sleep, cognition, quality of life, and overall health status from baseline to end-of treatment and to end of follow-up. Add-on protocols include MRI and the collection of blood samples. DISCUSSION This study is the first multicentre trial of a specific CBT intervention for LLD compared to an unspecific supportive psychological intervention administered in a specialist setting. It has important implications for developing and implementing efficient psychotherapeutic strategies for LLD and may be a significant step to broaden treatment options for people suffering from LLD. TRIAL REGISTRATION ClinicalTrials.gov (NCT03735576, registered on 24 October 2018); DRKS (DRKS00013769, registered on 28 June 2018).
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Affiliation(s)
- Forugh S. Dafsari
- Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50931 Cologne, Germany
- Max-Planck-Institute for Metabolism Research, Gleueler Str 50, 50931 Cologne, Germany
| | - Bettina Bewernick
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, 53105 Bonn, Germany
| | - Matthias Biewer
- Clinical Trials Centre Cologne, Gleueler Str 269, 50935 Cologne, Germany
| | - Hildegard Christ
- Institute of Medical Statistics and Computational Biology (IMSB), University of Cologne, Kerpener Str 62, 50931 Cologne, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 5, 79104 Freiburg, Germany
| | - Lutz Froelich
- Department of Geriatric Psychiatry Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, 68159 Mannheim, Germany
| | - Martin Hellmich
- Institute of Medical Statistics and Computational Biology (IMSB), University of Cologne, Kerpener Str 62, 50931 Cologne, Germany
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, 01403 Leipzig, Germany
| | - Oliver Peters
- Department of Psychiatry and Psychotherapy, Charité – Universitätsmedizin Berlin Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Alfredo Ramirez
- Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50931 Cologne, Germany
| | - Steffi Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, 01403 Leipzig, Germany
| | - Elisabeth Schramm
- Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 5, 79104 Freiburg, Germany
| | - Magnus-Sebastian Vry
- Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 5, 79104 Freiburg, Germany
| | - Michael Wagner
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, 53105 Bonn, Germany
| | - Martin Hautzinger
- Department of Clinical Psychology and Psychotherapy, Eberhard Karls University, Schleichstraße 4, 72076 Tuebingen, Germany
| | - Frank Jessen
- Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50931 Cologne, Germany
- German Center for Neurodegenerative Disease (DZNE), Sigmund-Freud-Str 27, 53127 Bonn, Germany
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Vlasova RM, Siddarth P, Krause B, Leaver AM, Laird KT, St. Cyr N, Narr KL, Lavretsky H. Resilience and White Matter Integrity in Geriatric Depression. Am J Geriatr Psychiatry 2018; 26:874-883. [PMID: 29803529 PMCID: PMC6086733 DOI: 10.1016/j.jagp.2018.04.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 04/10/2018] [Accepted: 04/16/2018] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Greater psychological resilience may protect against developing depression in a growing geriatric population. Identifying the neural correlates of resilience in geriatric depression could provide neurobiologic targets to inform clinical interventions. However, most prior neuroimaging studies have only considered the presence or absence of resilience and have not addressed the multifactorial nature of resilience. The current study aimed to establish the neural correlates of four factors of resilience in the depressed elderly. METHODS White matter integrity was assessed using diffusion-weighted magnetic resonance imaging data collected from 70 older adults with major depressive disorder. We used four resilience factors previously derived in an exploratory factor analysis of the Connor-Davidson Resilience Scale in a large sample of depressed older adults: 1, grit; 2, active coping self-efficacy; 3, accommodative coping self-efficacy; and 4, spirituality. RESULTS The resilience factor "grit" was positively associated with fractional anisotropy in the callosal region connecting prefrontal cortex and fractional anisotropy in cingulum fibers; however, the latter did not survive correction for multiple comparisons. CONCLUSION Structural integrity of major white matter pathways implicated in cognitive control and emotion regulation (i.e., connecting prefrontal cortex) was positively associated with the resilience factor "grit" in our sample of older adults with depression. Prospective studies are needed to determine the utility of the structural integrity of these pathways as a biomarker in predicting risk for depression and treatment response.
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Affiliation(s)
- Roza M. Vlasova
- Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
| | - Prabha Siddarth
- Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
| | - Beatrix Krause
- Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
| | - Amber M. Leaver
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, UCLA, Los Angeles, CA, USA
| | - Kelsey T. Laird
- Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
| | - Natalie St. Cyr
- Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
| | - Katherine L. Narr
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, UCLA, Los Angeles, CA, USA
| | - Helen Lavretsky
- Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, CA.
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Harper DG, Joe EB, Jensen JE, Ravichandran C, Forester BP. Brain levels of high-energy phosphate metabolites and executive function in geriatric depression. Int J Geriatr Psychiatry 2016; 31:1241-1249. [PMID: 26891040 DOI: 10.1002/gps.4439] [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: 07/14/2015] [Revised: 12/29/2015] [Accepted: 01/05/2016] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Depression in late life has been associated with difficulties in cognitive processing, particularly in the domains of executive function, processing speed and memory, and increases the risk of developing dementia suggesting a neurodegenerative phenotype. Mitochondrial dysfunction is frequently an early event in neurodegenerative illnesses and may be operative in patients with late life depression. Phosphorus magnetic resonance spectroscopy (31P MRS) allows for the quantification of bioenergetic molecules produced by mitochondria. METHODS Ten patients with late life depression and eight normal elderly controls were studied with Stroop color and interference tests, which are widely used measures of processing speed and executive function, respectively, followed by (31P) MRS 3-dimensional chemical-shift imaging measuring levels of adenosine triphosphate, phosphocreatine, inorganic phosphate, and pH over the whole brain. RESULTS In all subjects, gray matter phosphocreatine was positively associated with Stroop interference. Levels of white matter adenosine triphosphate were associated with Stroop interference in subjects with late life depression but not normal elderly. There was also a complementary association between white matter inorganic phosphate and Stroop interference in late life depression patients. CONCLUSIONS These findings suggest two independent sources of executive function dependence on bioenergetic state in the aging brain. The dependence of executive function performance in subjects with late life depression on ATP in white matter may be associated with mitochondrial impairment and is consistent with predictions of the vascular depression hypothesis. Further research with wider neuropsychological testing targeting bioenergetic markers could help clarify the scope of these effects. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- David G Harper
- Geriatric Psychiatry Program, McLean Hospital, Belmont, MA, USA. .,Harvard Medical School, Boston, MA, USA.
| | | | - J Eric Jensen
- Neuroimaging Center, McLean Hospital, Belmont, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Caitlin Ravichandran
- Laboratory for Psychiatric Biostatistics, McLean Hospital, Belmont, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Brent P Forester
- Geriatric Psychiatry Program, McLean Hospital, Belmont, MA, USA.,Harvard Medical School, Boston, MA, USA
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7
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Neurochemical correlation between major depressive disorder and neurodegenerative diseases. Life Sci 2016; 158:121-9. [DOI: 10.1016/j.lfs.2016.06.027] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 06/14/2016] [Accepted: 06/27/2016] [Indexed: 12/13/2022]
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IRS, information services and LIS research – a reminder about affect and the affective paradigm … and a question. LIBRARY HI TECH 2014. [DOI: 10.1108/lht-10-2013-0144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– A previous contribution argues in favour of a balance in emphasis between information communication technology (ICT); information retrieval systems (IRS) such as databases, library catalogues, repositories, Google Scholar, digital libraries, portals, search engines; and the users of these systems. This contribution aims to pursue the need to consider affect and an affective paradigm more prominently in the design, evaluation, promotion and use of IRS and library and information services (LIS).
Design/methodology/approach
– The contribution is written against the background of research in information behaviour, user studies, systems design, and information literacy.
Findings
– Although the literature from LIS and other disciplines notes an affective paradigm or even paradigms, it is not strongly positioned compared with the systems and cognitive paradigms. A growing body of research and work practices such as information representation and tagging, and information skills training, is taking a slant towards affect and emotion. The question, however, is whether current work is sufficient to argue for an affective paradigm complementary to the systems, cognitive and socio-cognitive paradigms, and how an affective paradigm should be introduced in training/education for LIS.
Originality/value
– Although there are a number of publications on affect and emotion, and references to an affective paradigm, this contribution is aimed at stimulating thought on whether we should prominently introduce the affective paradigm into LIS curricula as preparation for adding more value to IRS, library services, and in dealing with emotion-laden jobs, and if so, how.
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Abstract
Although depression in old age is less common than depression in younger populations, it still affects more than 1 million community-living older adults. Depression in late life has been associated with reduced quality of life and increased mortality from both suicide and illness. Its causes are multifactorial but are prominently related to both biologic and social factors. Psychological factors, although less studied in elders, are also important in understanding its cause. In this article, multiple facets of late-life depression are reviewed, including its clinical presentation, epidemiology, and biopsychosocial causes.
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Affiliation(s)
- Rehan Aziz
- Department of Psychiatry, Institute of Living, Hartford Hospital, 200 Retreat Avenue, Hartford, CT 06106, USA; Department of Psychiatry, Yale University School of Medicine, 300 George Street, Suite 901, New Haven, CT 06511, USA; Department of Psychiatry, University of Connecticut Health Center, Building L, MC 1410, 263 Farmington Avenue, Farmington, CT 06030, USA.
| | - David C. Steffens
- Department of Psychiatry, University of Connecticut Health Center, Building L, MC 1410, 263 Farmington Avenue, Farmington, CT 06030, USA
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The age-by-disease interaction hypothesis of late-life depression. Am J Geriatr Psychiatry 2013; 21:418-32. [PMID: 23570886 PMCID: PMC3549303 DOI: 10.1016/j.jagp.2013.01.053] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Revised: 04/20/2012] [Accepted: 06/19/2012] [Indexed: 12/28/2022]
Abstract
The phenomenologic diagnosis of depression is successful in increasing diagnostic reliability, but it is a classification scheme without biologic bases. One subtype of depression for which evidence suggests a unique biologic basis is late-life depression (LLD), with first onset of symptoms after the age of 65. LLD is common and poses a significant burden on affected individuals, caretakers, and society. The pathophysiology of LLD includes disruptions of the neural network underlying mood, which can be conceptualized as the result of dysfunction in multiple underlying biologic processes. Here, we briefly review current LLD hypotheses and then describe the characteristics of molecular brain aging and their overlap with disease processes. Furthermore, we propose a new hypothesis for LLD, the age-by-disease interaction hypothesis, which posits that the clinical presentation of LLD is the integrated output of specific biologic processes that are pushed in LLD-promoting directions by changes in gene expression naturally occurring in the brain during aging. Hence, the brain is led to a physiological state that is more susceptible to LLD, because additional pushes by genetic, environmental, and biochemical factors may now be sufficient to generate dysfunctional states that produce depressive symptoms. We put our propositions together into a decanalization model to aid in illustrating how age-related biologic changes of the brain can shift the repertoire of available functional states in a prodepression direction, and how additional factors can readily lead the system into distinct and stable maladaptive phenotypes, including LLD. This model brings together basic research on neuropsychiatric and neurodegenerative diseases more closely with the investigation of normal aging. Specifically, identifying biologic processes affected during normal aging may inform the development of new interventions for the prevention and treatment of LLD.
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[Anxiety and depression in the elderly]. ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2013; 58:336-56. [PMID: 23224953 DOI: 10.13109/zptm.2012.58.4.336] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This paper deals with diagnostics and prevalence of depression and anxiety in the elderly, their biological, psychological, and social risk factors, and the effectiveness of psychotherapy and pharmacotherapy. METHODS The results are based on an overview of the literature reflecting reviews and meta-analyses. RESULTS In the elderly, there is a substantial danger of confounding psychogenic with medical or drug-induced symptoms. Self-assessment scales may be useful for screening, but the results should be confirmed by an expert interview. Based on the available research, we cannot yet be sure whether the prevalence of depression and anxiety in the elderly population is in fact higher, lower, or equal to younger age groups. More women are afflicted with depression or anxiety than men. Pharmacotherapy (preferably antidepressants) and psychotherapy are effective for treating anxiety and depression in the elderly, with medium to high effect sizes. To date it is not possible to provide evidence-based treatment recommendations for the type or the setting of psychotherapy. DISCUSSION More research on this topic is needed.
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12
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Chen JD, Liu F, Xun GL, Chen HF, Hu MR, Guo XF, Xiao CQ, Wooderson SC, Guo WB, Zhao JP. Early and late onset, first-episode, treatment-naive depression: same clinical symptoms, different regional neural activities. J Affect Disord 2012; 143:56-63. [PMID: 22749158 DOI: 10.1016/j.jad.2012.05.025] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2012] [Revised: 05/19/2012] [Accepted: 05/19/2012] [Indexed: 01/20/2023]
Abstract
BACKGROUND Patients with early onset depression (EOD) and late onset depression (LOD) have distinctive risk factors and clinical pictures. Using regional homogeneity (ReHo) approach, we were to test the hypothesis of the different abnormal neural activity between patients with EOD or LOD. METHODS Fifteen patients with EOD, 15 patients with LOD, 15 young healthy subjects (HS) and 15 old HS participated in the study. ReHo approach was employed to analyze the scans. RESULTS ANOVA analysis revealed widespread differences in ReHo values among the four groups throughout frontal, parietal, temporal, occipital cortex, cerebellum and limbic regions. Compared to LOD group, EOD group had higher ReHo in right precuneus (PCu) and bilateral superior frontal gyrus, and lower ReHo in left superior temporal gyrus. Compared to young HS, lower ReHo in left parahippocampal gyrus and higher ReHo in left fusiform gyrus and bilateral superior frontal gyrus were seen in EOD group; in contrast, in LOD group, lower ReHo in right PCu and higher ReHo in left superior temporal gyrus and left Crus I of the cerebellum were observed. Further ROC analysis suggested that the mean ReHo values in right PCu and bilateral superior frontal gyrus could serve as markers to identify patients with EOD from individuals with LOD. LIMITATION The large age gap may limit the translational value of our findings. CONCLUSIONS Patients with EOD and those with LOD have abnormal neural activities in different brain regions, although the two groups share the same symptoms.
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Affiliation(s)
- Jin-dong Chen
- Mental Health Institute, the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
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Liu F, Hu M, Wang S, Guo W, Zhao J, Li J, Xun G, Long Z, Zhang J, Wang Y, Zeng L, Gao Q, Wooderson SC, Chen J, Chen H. Abnormal regional spontaneous neural activity in first-episode, treatment-naive patients with late-life depression: a resting-state fMRI study. Prog Neuropsychopharmacol Biol Psychiatry 2012; 39:326-31. [PMID: 22796277 DOI: 10.1016/j.pnpbp.2012.07.004] [Citation(s) in RCA: 136] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Revised: 06/29/2012] [Accepted: 07/03/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND The previous resting perfusion or task-based studies have provided evidence of functional changes in the brains of patients with late-life depression (LLD). Little is known, so far, about the changes in the spontaneous brain activity in LLD during the resting state. The aim of this study was to investigate the spontaneous neural activity in first-episode, treatment-naive patients with LLD by using resting-state functional magnetic resonance imaging (fMRI). METHODS A novel analytical method, coherence-based regional homogeneity (Cohe-ReHo), was used to assess regional spontaneous neural activity during the resting state in 15 first-episode, treatment-naive patients with LLD and 15 age- and gender-matched healthy controls. RESULTS Compared to the healthy controls, the LLD group showed significantly decreased Cohe-ReHo in left caudate nucleus, right anterior cingulate gyrus, left dorsolateral prefrontal cortex, right angular gyrus, bilateral medial prefrontal cortex, and right precuneus, while significantly increased Cohe-ReHo in left cerebellum posterior lobe, left superior temporal gyrus, bilateral supplementary motor area, and right postcentral gyrus (p<0.005, corrected for multiple comparisons). CONCLUSIONS These findings indicated abnormal spontaneous neural activity was distributed extensively in first-episode, treatment-naive patients with LLD during the resting state. Our results might supply a novel way to look into the underlying pathophysiology mechanisms of patients with LLD.
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Affiliation(s)
- Feng Liu
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, China
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Saulin A, Savli M, Lanzenberger R. Serotonin and molecular neuroimaging in humans using PET. Amino Acids 2011; 42:2039-57. [PMID: 21947614 DOI: 10.1007/s00726-011-1078-9] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Accepted: 09/05/2011] [Indexed: 02/07/2023]
Abstract
The serotonergic system is one of the most important modulatory neurotransmitter systems in the human brain. It plays a central role in major physiological processes and is implicated in a number of psychiatric disorders. Along with the dopaminergic system, it is also one of the phylogenetically oldest human neurotransmitter systems and one of the most diverse, with 14 different receptors identified up to this day, many of whose function remains to be understood. The system's functioning is even more diverse than the number of its receptors, since each is implicated in a number of different processes. This review aims at illustrating the distribution and summarizing the main functions of the serotonin (5-hydroxytryptamin, 5-HT) receptors as well as the serotonin transporter (SERT, 5-HTT), the vesicular monoamine transporter 2, monoamine oxidase type A and 5-HT synthesis in the human brain. Recent advances in in vivo quantification of these different receptors and enzymes that are part of the serotonergic system using positron emission tomography are described.
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Affiliation(s)
- Anne Saulin
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
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