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Pantazatos SP, Ogden T, Melhem NM, Brent DA, Lesanpezeshki M, Burke A, Keilp JG, Miller JM, Mann JJ. Smaller cornu ammonis (CA3) as a potential risk factor for suicidal behavior in mood disorders. J Psychiatr Res 2023; 163:262-269. [PMID: 37244064 DOI: 10.1016/j.jpsychires.2023.05.051] [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: 11/28/2022] [Revised: 05/05/2023] [Accepted: 05/15/2023] [Indexed: 05/29/2023]
Abstract
Mood disorders and suicidal behavior have moderate heritability and familial transmission, and are associated with smaller hippocampal volumes. However, it is unclear whether hippocampal alterations reflect heritable risk or epigenetic effects of childhood adversity, compensatory mechanisms, illness-related changes, or treatment effects. We sought to separate the relationships of hippocampal substructure volumes to mood disorder, suicidal behavior, and risk and resilience to both by examining high familial risk individuals (HR) who have passed the age of greatest risk for psychopathology onset. Structural brain imaging and hippocampal substructure segmentation quantified Cornu Ammonis (CA1-4), dentate gyrus, and subiculum gray matter volumes in healthy volunteers (HV, N = 25) and three groups with one or more relatives reporting early-onset mood disorder and suicide attempt: 1. Unaffected HR (N = 20); 2. HR with lifetime mood disorder and no suicide attempt (HR-MOOD, N = 25); and 3. HR with lifetime mood disorder and a previous suicide attempt (HR-MOOD + SA, N = 18). Findings were tested in an independent cohort not selected for family history (HV, N = 47; MOOD, N = 44; and MOOD + SA, N = 21). Lower CA3 volume was found in HR (vs. HV), consistent with the direction of previously published findings in MOOD+SA (vs. HV and MOOD), suggesting the finding reflects a familial biological risk marker, not illness or treatment-related sequelae, of suicidal behavior and mood disorder. Familial suicide risk may be mediated in part by smaller CA3 volume. The structure may serve as a risk indicator and therapeutic target for suicide prevention strategies in high-risk families.
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Affiliation(s)
- Spiro P Pantazatos
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA.
| | - Todd Ogden
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, NY, USA; Mailman School of Public Health, Columbia University, New York, USA
| | - Nadine M Melhem
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - David A Brent
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Mohammad Lesanpezeshki
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Ainsley Burke
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - John G Keilp
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Jeffrey M Miller
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - J John Mann
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA.
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Shunkai L, Su T, Zhong S, Chen G, Zhang Y, Zhao H, Chen P, Tang G, Qi Z, He J, Zhu Y, Lv S, Song Z, Miao H, Hu Y, Jia Y, Wang Y. Abnormal dynamic functional connectivity of hippocampal subregions associated with working memory impairment in melancholic depression. Psychol Med 2023; 53:2923-2935. [PMID: 34870570 DOI: 10.1017/s0033291721004906] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Previous studies have demonstrated structural and functional changes of the hippocampus in patients with major depressive disorder (MDD). However, no studies have analyzed the dynamic functional connectivity (dFC) of hippocampal subregions in melancholic MDD. We aimed to reveal the patterns for dFC variability in hippocampus subregions - including the bilateral rostral and caudal areas and its associations with cognitive impairment in melancholic MDD. METHODS Forty-two treatment-naive MDD patients with melancholic features and 55 demographically matched healthy controls were included. The sliding-window analysis was used to evaluate whole-brain dFC for each hippocampal subregions seed. We assessed between-group differences in the dFC variability values of each hippocampal subregion in the whole brain and cognitive performance on the MATRICS Consensus Cognitive Battery (MCCB). Finally, association analysis was conducted to investigate their relationships. RESULTS Patients with melancholic MDD showed decreased dFC variability between the left rostral hippocampus and left anterior lobe of cerebellum compared with healthy controls (voxel p < 0.005, cluster p < 0.0125, GRF corrected), and poorer cognitive scores in working memory, verbal learning, visual learning, and social cognition (all p < 0.05). Association analysis showed that working memory was positively correlated with the dFC variability values of the left rostral hippocampus-left anterior lobe of the cerebellum (r = 0.338, p = 0.029) in melancholic MDD. CONCLUSIONS These findings confirmed the distinct dynamic functional pathway of hippocampal subregions in patients with melancholic MDD, and suggested that the dysfunction of hippocampus-cerebellum connectivity may be underlying the neural substrate of working memory impairment in melancholic MDD.
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Affiliation(s)
- Lai Shunkai
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Ting Su
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Guangmao Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Yiliang Zhang
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Hui Zhao
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Pan Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Guixian Tang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Zhangzhang Qi
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Jiali He
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Yunxia Zhu
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Sihui Lv
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Zijin Song
- School of Management, Jinan University, Guangzhou 510316, China
| | - Haofei Miao
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Yilei Hu
- School of Management, Jinan University, Guangzhou 510316, China
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
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3
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Fu X, Yang X, Cui X, Liu F, Li H, Yan M, Xie G, Guo W. Overlapping and segregated changes of functional hubs in melancholic depression and non-melancholic depression. J Psychiatr Res 2022; 154:123-131. [PMID: 35933856 DOI: 10.1016/j.jpsychires.2022.07.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 07/13/2022] [Accepted: 07/20/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Previous research found associations between neuropsychiatric disorders and patterns of highly connected "hub" nodes, which are crucial in coordinating brain functions. Melancholic depression is considered a relatively distinct and homogenous subtype of major depressive disorder (MDD), which responds better to pharmacological treatments than placebos or psychotherapies. Accordingly, melancholic depression probably has distinct neuropathological underpinnings. This study aims to examine the overlapping and segregated changes of functional hubs in melancholic and non-melancholic MDD. METHODS Thirty-one melancholic patients, 28 non-melancholic patients, and 32 healthy controls were included. Resting-state functional imaging data were analyzed using global functional connectivity. RESULTS Both melancholic and non-melancholic patients had increased GFC in the bilateral insula and decreased GFC in the PCC/precuneus compared to HCs. The distinction was that melancholic patients showed increased GFC in the bilateral thalamus, right inferior parietal lobule (IPL), and left cerebellum Crus I and decreased GFC in the left temporal lobe, whereas non-melancholic patients showed increased GFC in the left superior parietal lobe. Additionally, compared with non-melancholic patients, melancholic individuals displayed significant increases of GFC in the left IPL and cerebellum. CONCLUSION Increased GFC of the insula and decreased GFC of the PCC and precuneus are the common abnormalities of melancholic and non-melancholic MDD. Hyperconnectivity of the IPL and cerebellum might be distinctive neuropathological features of melancholic MDD.
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Affiliation(s)
- Xiaoya Fu
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Xiaolun Yang
- Department of Stomatology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Xilong Cui
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Feng Liu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, 300000, China
| | - Huabing Li
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Meiqi Yan
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Guangrong Xie
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
| | - Wenbin Guo
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China; Department of Psychiatry, The Third People's Hospital of Foshan, Foshan, Guangdong, 528000, China; Department of Psychiatry, Qiqihar Medical University, Qiqihar, Heilongjiang, 161006, China.
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Deng Z, Jiang X, Liu W, Zhao W, Jia L, Sun Q, Xie Y, Zhou Y, Sun T, Wu F, Kong L, Tang Y. The aberrant dynamic amplitude of low-frequency fluctuations in melancholic major depressive disorder with insomnia. Front Psychiatry 2022; 13:958994. [PMID: 36072459 PMCID: PMC9441487 DOI: 10.3389/fpsyt.2022.958994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/29/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Insomnia is considered one of the manifestations of sleep disorders, and its intensity is linked to the treatment effect or suicidal thoughts. Major depressive disorder (MDD) is classified into various subtypes due to heterogeneous symptoms. Melancholic MDD has been considered one of the most common subtypes with special sleep features. However, the brain functional mechanisms in melancholic MDD with insomnia remain unclear. MATERIALS AND METHODS Melancholic MDD and healthy controls (HCs, n = 46) were recruited for the study. Patients were divided into patients with melancholic MDD with low insomnia (mMDD-LI, n = 23) and patients with melancholic MDD with high insomnia (mMDD-HI, n = 30), according to the sleep disturbance subscale of the 17-item Hamilton Depression Rating Scale. The dynamic amplitude of low-frequency fluctuation was employed to investigate the alterations of brain activity among the three groups. Then, the correlations between abnormal dALFF values of brain regions and the severity of symptoms were investigated. RESULTS Lower dALFF values were found in the mMDD-HI group in the right middle temporal gyrus (MTG)/superior temporal gyrus (STG) than in the mMDD-LI (p = 0.014) and HC groups (p < 0.001). Melancholic MDD groups showed decreased dALFF values than HC in the right middle occipital gyri (MOG)/superior occipital gyri (SOG), the right cuneus, the bilateral lingual gyrus, and the bilateral calcarine (p < 0.05). Lower dALFF values than HC in the left MOG/SOG and the left cuneus in melancholic MDD groups were found, but no significant difference was found between the mMDD-LI group and HC group (p = 0.079). Positive correlations between the dALFF values in the right MTG/STG and HAMD-SD scores (the sleep disturbance subscale of the HAMD-17) in the mMDD-HI group (r = 0.41, p = 0.042) were found. In the pooled melancholic MDD, the dALFF values in the right MOG/SOG and the right cuneus (r = 0.338, p = 0.019), the left MOG/SOG and the left cuneus (r = 0.299, p = 0.039), and the bilateral lingual gyrus and the bilateral calcarine (r = 0.288, p = 0.047) were positively correlated with adjusted HAMD scores. CONCLUSION The occipital cortex may be related to depressive symptoms in melancholic MDD. Importantly, the right MTG/STG may play a critical role in patients with melancholic MDD with more severe insomnia.
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Affiliation(s)
- Zijing Deng
- Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China.,Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Xiaowei Jiang
- Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China.,Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Wen Liu
- Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China.,Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Wenhui Zhao
- Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China.,Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Linna Jia
- Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China.,Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Qikun Sun
- Department of Radiation Oncology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yu Xie
- Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yifang Zhou
- Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China.,Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Ting Sun
- Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China.,Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Feng Wu
- Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China.,Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Lingtao Kong
- Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China.,Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yanqing Tang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Department of Gerontology, The First Affiliated Hospital of China Medical University, Shenyang, China
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5
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Shared and distinct homotopic connectivity changes in melancholic and non-melancholic depression. J Affect Disord 2021; 287:268-275. [PMID: 33799047 DOI: 10.1016/j.jad.2021.03.038] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 03/10/2021] [Accepted: 03/15/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Previous studies have revealed different neuroimaging features between melancholic and non-melancholic major depressive disorder (MDD). However, homotopic connectivity of melancholic and non-melancholic MDD remains unknown. The present study aimed to explore common and distinct homotopic connectivity patterns of melancholic and non-melancholic MDD and their associations with clinical characteristics. METHODS Sixty-four patients with MDD and thirty-two healthy controls were scanned by resting-state functional magnetic resonance imaging (fMRI). Voxel-mirrored homotopic connectivity (VMHC) and pattern classification were applied to analyze the imaging data. RESULTS Relative to healthy controls, melancholic patients displayed decreased VMHC in the fusiform gyrus, posterior cingulate cortex (PCC), superior occipital gyrus (SOG), postcentral gyrus and precentral/postcentral gyrus, and non-melancholic patients displayed decreased VMHC in the PCC. Compared with non-melancholic patients, melancholic patients displayed reduced VMHC in the precentral gyrus and precentral/postcentral gyrus. Support vector machine (SVM) results exhibited VMHC in the precentral gyrus could distinguish melancholic patients from non-melancholic patients with more than 0.6 for specificity, sensitivity and accuracy. CONCLUSION The study demonstrated common and distinct homotopic connectivity patterns in melancholic and non-melancholic patients. Decreased VMHC in the PCC may be a state-related change for depression, and reduced VMHC in the precentral gyrus and postcentral gyrus may be a distinctive neurobiological feature for melancholic MDD. VMHC in precentral gyrus might be served as potential imaging markers to discriminate melancholic patients from non-melancholic MDD.
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Nolan M, Roman E, Nasa A, Levins KJ, O'Hanlon E, O'Keane V, Willian Roddy D. Hippocampal and Amygdalar Volume Changes in Major Depressive Disorder: A Targeted Review and Focus on Stress. CHRONIC STRESS 2020; 4:2470547020944553. [PMID: 33015518 PMCID: PMC7513405 DOI: 10.1177/2470547020944553] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 06/28/2020] [Indexed: 02/06/2023]
Abstract
Medial temporal lobe structures have long been implicated in the pathogenesis of
major depressive disorder. Although findings of smaller hippocampal and
amygdalar volumes are common, inconsistencies remain in the literature. In this
targeted review, we examine recent and significant neuroimaging papers examining
the volumes of these structures in major depressive disorder. A targeted
PubMed/Google Scholar search was undertaken focusing on volumetric neuroimaging
studies of the hippocampus and amygdala in major depressive disorder. Where
possible, mean volumes and accompanying standard deviations were extracted
allowing computation of Cohen’s ds effect sizes. Although not a
meta-analysis, this allows a broad comparison of volume changes across studies.
Thirty-nine studies in total were assessed. Hippocampal substructures and
amygdale substructures were investigated in 11 and 2 studies, respectively. The
hippocampus was more consistently smaller than the amygdala across studies,
which is reflected in the larger cumulative difference in volume found with the
Cohen’s ds calculations. The left and right hippocampi were,
respectively, 92% and 91.3% of the volume found in controls, and the left and
right amygdalae were, respectively, 94.8% and 92.6% of the volume of controls
across all included studies. The role of stress in temporal lobe structure
volume reduction in major depressive disorder is discussed.
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Affiliation(s)
- Mark Nolan
- Department of Psychiatry, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Elena Roman
- Department of Psychiatry, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Anurag Nasa
- Department of Psychiatry, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Kirk J Levins
- Department of Anaesthesia, Intensive Care and Pain Medicine, St. Vincent's University Hospital, Dublin, Ireland
| | - Erik O'Hanlon
- Department of Psychiatry, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Veronica O'Keane
- Department of Psychiatry, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Darren Willian Roddy
- Department of Psychiatry, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
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The brain-adipocyte-gut network: Linking obesity and depression subtypes. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2019; 18:1121-1144. [PMID: 30112671 DOI: 10.3758/s13415-018-0626-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Major depressive disorder (MDD) and obesity are dominant and inter-related health burdens. Obesity is a risk factor for MDD, and there is evidence MDD increases risk of obesity. However, description of a bidirectional relationship between obesity and MDD is misleading, as closer examination reveals distinct unidirectional relationships in MDD subtypes. MDD is frequently associated with weight loss, although obesity promotes MDD. In contrast, MDD with atypical features (MDD-AF) is characterised by subsequent weight gain and obesity. The bases of these distinct associations remain to be detailed, with conflicting findings clouding interpretation. These associations can be viewed within a systems biology framework-the psycho-immune neuroendocrine (PINE) network shared between MDD and metabolic disorders. Shared PINE subsystem perturbations may underlie increased MDD in overweight and obese people (obesity-associated depression), while obesity in MDD-AF (depression-associated obesity) involves more complex interactions between behavioural and biomolecular changes. In the former, the chronic PINE dysfunction triggering MDD is augmented by obesity-dependent dysregulation in shared networks, including inflammatory, leptin-ghrelin, neuroendocrine, and gut microbiome systems, influenced by chronic image-associated psychological stress (particularly in younger or female patients). In MDD-AF, behavioural dysregulation, including hypersensitivity to interpersonal rejection, fundamentally underpins energy imbalance (involving hyperphagia, lethargy, hypersomnia), with evolving obesity exaggerating these drivers via positive feedback (and potentially augmenting PINE disruption). In both settings, sex and age are important determinants of outcome, associated with differences in emotional versus cognitive dysregulation. A systems biology approach is recommended for further research into the pathophysiological networks underlying MDD and linking depression and obesity.
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Roddy DW, Farrell C, Doolin K, Roman E, Tozzi L, Frodl T, O'Keane V, O'Hanlon E. The Hippocampus in Depression: More Than the Sum of Its Parts? Advanced Hippocampal Substructure Segmentation in Depression. Biol Psychiatry 2019; 85:487-497. [PMID: 30528746 DOI: 10.1016/j.biopsych.2018.08.021] [Citation(s) in RCA: 145] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 08/03/2018] [Accepted: 08/20/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Hippocampal volume reduction is the most replicated finding in neuroimaging studies of major depressive disorder (MDD). Varying hippocampal volume definition is a well-established problem in this field. Given that hippocampal function can be mapped onto anatomically defined substructures and that detailed examination of substructure volumes is now possible, we examined different hippocampal composite measures in MDD to look for hippocampal markers of MDD. METHODS Magnetic resonance imaging brain scans were compared between 80 patients with a range of MDD duration and 83 healthy control subjects. High-resolution T1-weighted and T2-weighted-fluid-attenuated inversion recovery magnetic resonance images were examined using the automated hippocampal substructure module in FreeSurfer 6.0. Between-group volumetric assessments were performed at substructure and composite substructures levels. RESULTS Patients with MDD showed a bilateral pattern of volume reduction in principal hippocampal substructures: the cornu ammonis (CA1-CA4), dentate gyrus, and subiculum. Changes were more pronounced on the left of these structures and in recurrent depression. CA2 to CA4 were the only substructures reduced in first-presentation depression. Overall changes were most marked in the left CA1, and CA1 volume was a predictor of illness duration. CONCLUSIONS Hippocampal involvement in MDD is confined to principal substructures only. Differences between patients with MDD and healthy control subjects increased with progressively restricted hippocampal definitions, with the left CA1 emerging as a potential marker of MDD. Changes were more extensive in patients with recurrent, as opposed to first-presentation, MDD, suggesting a hippocampal disease process. These findings identify core hippocampal regions in the pathology of MDD, suggesting a potential marker of disease progression in MDD.
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Affiliation(s)
- Darren W Roddy
- Department of Psychiatry, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland; Department of Physiology, School of Medicine, University College Dublin, Dublin, Ireland.
| | - Chloe Farrell
- Department of Psychiatry, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Kelly Doolin
- Department of Psychiatry, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Elena Roman
- Department of Psychiatry, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Leonardo Tozzi
- Department of Psychiatry and Psychotherapy, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Thomas Frodl
- Department of Psychiatry, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland; Department of Psychiatry and Psychotherapy, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Veronica O'Keane
- Department of Psychiatry, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Erik O'Hanlon
- Department of Psychiatry, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland; Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
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9
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Xin LM, Chen L, Su YA, Yang FD, Wang G, Fang YR, Lu Z, Yang HC, Hu J, Chen ZY, Huang Y, Sun J, Wang XP, Li HC, Zhang JB, Osser DN, Si TM. Prevalence and clinical features of atypical depression among patients with major depressive disorder in China. J Affect Disord 2019; 246:285-289. [PMID: 30594041 DOI: 10.1016/j.jad.2018.12.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 12/06/2018] [Accepted: 12/15/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Little is known about the demographic and clinical features of the atypical subtype of major depressive disorder (MDD) patients in China. This study set out to investigate the prevalence of atypical depression in MDD patients in China, and identify its demographic and clinical features. METHODS The study was conducted in 13 major psychiatric hospitals or in the psychiatric units of general hospitals in China, and recruited a sample of 1172 patients diagnosed with MDD. The patients' demographic and clinical features and prescriptions of psychotropic drugs were collected using a standardized questionnaire designed for the study. RESULTS The prevalence of atypical depression was 15.3%. In multiple logistic regression analyses, compared to the non-atypical depression patients, the atypical depression patients were more likely to have depressive episodes with suicide ideation and attempts (OR = 1.49, 95% CI = 1.06, 2.10, P = 0.023), depressive episodes with psychotic features (OR = 2.15, 95% CI = 1.43, 3.22, P < 0.001), seasonal depressive episodes (OR = 1.77, 95% CI = 1.12, 2.78, P = 0.014), an earlier age of onset (OR = 0.98, 95% CI = 0.96, 0.99, P = 0.001), and lifetime depressive episodes (OR = 1.07, 95% CI = 1.01, 1.13, P = 0.020). LIMITATIONS The assessment of atypical features was not based on a validated rating scale. CONCLUSION Our results indicate that atypical depression is common in Chinese patients with MDD. MDD with atypical features may be more severe and debilitating than patients with non-atypical features.
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Affiliation(s)
- Li-Min Xin
- Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital and Peking University Institute of Mental Health, Beijing 100191, China; Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China
| | - Lin Chen
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China
| | - Yun-Ai Su
- Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital and Peking University Institute of Mental Health, Beijing 100191, China.
| | - Fu-De Yang
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China
| | - Gang Wang
- Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yi-Ru Fang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zheng Lu
- Shanghai Tongji Hospital, Tongji University Medical School, Shanghai, China
| | - Hai-Chen Yang
- Division of Mood Disorders, Shenzhen Mental Health Centre, Shenzhen, Guangdong Province, China
| | - Jian Hu
- The First Hospital of Harbin Medical University, Harbin, China
| | - Zhi-Yu Chen
- Hangzhou Seventh People's Hospital, Hangzhou, China
| | - Yi Huang
- West China Hospital, Sichuan University, Chengdu, China
| | - Jing Sun
- The Affiliated Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Xiao-Ping Wang
- Mental Health Institute, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Hui-Chun Li
- The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jin-Bei Zhang
- The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - David N Osser
- Harvard Medical School Department of Psychiatry and VA Boston Healthcare System, Boston, MA, United States
| | - Tian-Mei Si
- Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital and Peking University Institute of Mental Health, Beijing 100191, China.
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10
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Dunlop BW, Mayberg HS. Neuroimaging Advances for Depression. CEREBRUM : THE DANA FORUM ON BRAIN SCIENCE 2017; 2017:cer-16-17. [PMID: 30210664 PMCID: PMC6132047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Depression is one of the world's most prevalent mental health problems, with as many as 350 million sufferers worldwide and close to 20 million sufferers in the US. While neuroimaging applications for identifying various types of depression have made enormous strides in recent years, no findings have been sufficiently replicated or considered significant enough to warrant application in clinical settings. Our authors are well equipped to tell us what the future may bring.
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11
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Sahin S, Okluoglu Önal T, Cinar N, Bozdemir M, Çubuk R, Karsidag S. Distinguishing Depressive Pseudodementia from Alzheimer Disease: A Comparative Study of Hippocampal Volumetry and Cognitive Tests. Dement Geriatr Cogn Dis Extra 2017; 7:230-239. [PMID: 28868066 PMCID: PMC5566711 DOI: 10.1159/000477759] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 05/18/2017] [Indexed: 12/24/2022] Open
Abstract
Background and Aim Depressive pseudodementia (DPD) is a condition which may develop secondary to depression. The aim of this study was to contribute to the differential diagnosis between Alzheimer disease (AD) and DPD by comparing the neurocognitive tests and hippocampal volume. Materials and Methods Patients who met criteria of AD/DPD were enrolled in the study. All patients were assessed using the Wechsler Memory Scale (WMS), clock-drawing test, Stroop test, Benton Facial Recognition Test (BFRT), Boston Naming Test, Mini-Mental State Examination (MMSE), and Geriatric Depression Scale (GDS). Hippocampal volume was measured by importing the coronal T1-weighted magnetic resonance images to the Vitrea 2 workstation. Results A significant difference was found between the AD and DPD groups on the WMS test, clock-drawing test, Stroop test, Boston Naming Test, MMSE, GDS, and left hippocampal volume. A significant correlation between BFRT and bilateral hippocampal volumes was found in the AD group. No correlation was found among parameters in DPD patients. Conclusions Our results suggest that evaluation of facial recognition and left hippocampal volume may provide more reliable evidence for distinguishing DPD from AD. Further investigations combined with functional imaging techniques including more patients are needed.
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Affiliation(s)
- Sevki Sahin
- Department of Neurology, Faculty of Medicine, Maltepe University, Istanbul, Turkey
| | - Tugba Okluoglu Önal
- Department of Neurology, Faculty of Medicine, Maltepe University, Istanbul, Turkey
| | - Nilgun Cinar
- Department of Neurology, Faculty of Medicine, Maltepe University, Istanbul, Turkey
| | - Meral Bozdemir
- Department of Psychology, Faculty of Humanities and Social Sciences, Maltepe University, Istanbul, Turkey
| | - Rahmi Çubuk
- Department of Radiology, Faculty of Medicine, Maltepe University, Istanbul, Turkey
| | - Sibel Karsidag
- Department of Neurology, Faculty of Medicine, Maltepe University, Istanbul, Turkey
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12
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Abstract
The history and present status of the definition, prevalence, neurobiology, and treatment of atypical depression (AD) is presented. The concept of AD has evolved through the years, and currently, in Diagnostic and Statistical Manual of Mental Disorders (DSM), Fifth Edition, the specifier of depressive episode with atypical feature is present for both diagnostic groups, that is, depressive disorders and bipolar and related disorders. This specifier includes mood reactivity, hyperphagia, hypersomnia, leaden paralysis, and interpersonal rejection sensitivity. Prevalence rates of AD are variable, depending on the criteria, methodology, and settings. The results of epidemiological studies using DSM criteria suggest that 15%-29% of depressed patients have AD, and the results of clinical studies point to a prevalence of 18%-36%. A relationship of AD with bipolar depression, seasonal depression, and obesity has also been postulated. Pathogenic research has been mostly focused on distinguishing AD from melancholic depression. The differences have been found in biochemical studies in the areas of hypothalamic-pituitary-adrenal axis, inflammatory markers, and the leptin system, although the results obtained are frequently controversial. A number of findings concerning such differences have also been obtained using neuroimaging and neurophysiological and neuropsychological methods. An initial concept of AD as a preferentially monoamine oxidase inhibitor-responsive depression, although confirmed in some further studies, is of limited use nowadays. Currently, despite numerous drug trials, there are no comprehensive treatment guidelines for AD. We finalize the article by describing the future research perspectives for the definition, neurobiology, and treatment. A better specification of diagnostic criteria and description of clinical picture, a genome-wide association study of AD, and establishing updated treatment recommendations for this clinical phenomenon should be the priorities for the coming years.
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Affiliation(s)
| | - Janusz K Rybakowski
- Department of Adult Psychiatry.,Department of Child and Adolescent Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
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13
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Zhu Y, Duan X, Cheng X, Cheng X, Li X, Zhang L, Liu P, Su S, Duan JA, Dong TTX, Tsim KWK, Huang F. Kai-Xin-San, a standardized traditional Chinese medicine formula, up-regulates the expressions of synaptic proteins on hippocampus of chronic mild stress induced depressive rats and primary cultured rat hippocampal neuron. JOURNAL OF ETHNOPHARMACOLOGY 2016; 193:423-432. [PMID: 27660009 DOI: 10.1016/j.jep.2016.09.037] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 09/01/2016] [Accepted: 09/18/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Kai-xin-san (KXS), composed of Ginseng Radix et Rhizoma, Polygalae Radix, Acori Tatarinowii Rhizoma and Poria, is a famous Chinese medicinal formula applied for treating stress-related psychiatric disease with the symptoms such as depression, forgetfulness and dizziness. Dependent on the symptom differentiation of patients, the composition ratio of KXS was varied and one ratio of 3:2:2:3 was widely applied. However, its molecular mechanism has seldom been investigated. PURPOSE We aimed to reveal the action mechanism of KXS on anti-depression on synaptic protein regulation in both in vivo and in vitro models. STUDY DESIGN/METHODS Firstly, the anti-depression effect of KXS was evaluated on a chronic mild stress induced depressive animal model and the mRNA expressions of various synaptic proteins in hippocampus of the depressive rat brains were determined. Then, KXS with different ratios as well as single herb were further evaluated on rat primary cultured hippocampus neurons and the possible signaling pathway was explored. RESULTS Intra-gastric administration of a chemically standardized KXS for only 6h significantly alleviated the CUMS-induced depressive symptoms displayed by enhanced sucrose consumption and this effect was maintained after daily treatment for seven days. Simultaneously, the mRNA expressions of various synaptic proteins in hippocampus were regulated. Among these synaptic proteins, synaptotagmin (pre-synaptic marker) and post synaptic density protein (post-synaptic marker), with the higher altered magnitude on animal model, were further evaluated on rat primary cultured hippocampus neurons. After neuronal cultures treated with three ratios of KXS at the early and late stages of its life episode, the expression levels of synaptotagmin and PSD95 were both enhanced dramatically via stimulating cAMP dependent pathway. However, different ratio exerted different efficacy. The ratio with higher amounts of Ginseng Radix et Rhizoma and Polygalae Radix showed better effect in early life episode while higher amounts of Acori Tatarinowii Rhizoma and Poria behaved better in late life episode. The contribution of single herb on expressions of synaptic proteins was also evaluated. CONCLUSIONS KXS was beneficial for synaptogenesis by inducing synaptic protein expressions, which might account for its anti-depression effect.
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Affiliation(s)
- Yue Zhu
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China.
| | - Xiuzhu Duan
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
| | - Xiaoxuan Cheng
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
| | - Xiaonan Cheng
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
| | - Xu Li
- Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, China
| | - Liu Zhang
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
| | - Pei Liu
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
| | - Shulan Su
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
| | - Jin-Ao Duan
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China.
| | - Tina Ting-Xia Dong
- Division of Life Science and Center for Chinese Medicine, Division of Life Science, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
| | - Karl Wah-Keung Tsim
- Division of Life Science and Center for Chinese Medicine, Division of Life Science, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
| | - Fei Huang
- Department of Endocrinology, Suzhou Hospital of traditional Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Suzhou, Jiangsu Province, China
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14
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Szymkowicz SM, McLaren ME, O'Shea A, Woods AJ, Anton SD, Dotson VM. Depressive symptoms modify age effects on hippocampal subfields in older adults. Geriatr Gerontol Int 2016; 17:1494-1500. [PMID: 27696657 DOI: 10.1111/ggi.12901] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2016] [Revised: 07/05/2016] [Accepted: 07/24/2016] [Indexed: 12/27/2022]
Abstract
AIM Major depression is associated with hippocampal volume changes, especially in late-life depression. These changes usually consist of volume reductions, but depression-related increases in hippocampal volume have also been reported. Subfield analysis has identified structural changes primarily in the cornu ammonis (CA) 1, CA2-3 and subiculum of the hippocampus in individuals with major depression; however, it is unclear whether lower levels of depressive symptoms are also associated volume reduction, or if depressive symptoms interact with age to impact hippocampal subfields. The current study addressed these questions. METHODS A total of 43 community-dwelling older adults completed the Center for Epidemiologic Studies Depression Scale and underwent magnetic resonance imaging. Hippocampal subfield segmentation was carried out using an automated procedure, and left and right volumes from CA1, CA2-3, and the subiculum served as outcome measures. Multiple hierarchical regressions were carried out with age, Center for Epidemiologic Studies Depression Scale scores and their interaction as the independent variables, and sex and total intracranial volume as covariates. RESULTS Higher Center for Epidemiologic Studies Depression Scale scores were associated with less age-related volumetric decreases in the right subiculum and right CA1. CONCLUSIONS Age-related atrophy in the hippocampus might be counteracted by depressive symptom-related enlargement of CA1 and the subiculum. More research is required to better understand the functional significance of this relationship. Geriatr Gerontol Int 2017; 17: 1494-1500.
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Affiliation(s)
- Sarah M Szymkowicz
- Department of Clinical & Health Psychology, University of Florida, Gainesville, Florida, USA
| | - Molly E McLaren
- Department of Clinical & Health Psychology, University of Florida, Gainesville, Florida, USA
| | - Andrew O'Shea
- Department of Aging & Geriatric Research, University of Florida, Gainesville, Florida, USA.,Department of Center for Cognitive Aging & Memory, University of Florida, Gainesville, Florida, USA
| | - Adam J Woods
- Department of Aging & Geriatric Research, University of Florida, Gainesville, Florida, USA.,Department of Center for Cognitive Aging & Memory, University of Florida, Gainesville, Florida, USA.,Department of Neuroscience, University of Florida, Gainesville, Florida, USA
| | - Stephen D Anton
- Department of Aging & Geriatric Research, University of Florida, Gainesville, Florida, USA
| | - Vonetta M Dotson
- Department of Clinical & Health Psychology, University of Florida, Gainesville, Florida, USA.,Department of Neuroscience, University of Florida, Gainesville, Florida, USA
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15
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Rogers MA, Yamasue H, Kasai K. Antidepressant Medication May Moderate the Effect of Depression Duration on Hippocampus Volume. J PSYCHOPHYSIOL 2016. [DOI: 10.1027/0269-8803/a000148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Hippocampus volume has been frequently, but not universally reported to be reduced in people with major depression relative to age-matched healthy controls. Among the potential reasons for this discrepancy in finding across studies is the effect of antidepressant medication. Hippocampus volume was determined by MRI (1.5 Tesla) for 10 people diagnosed with major depression for who detailed history of depression and antidepressant treatment history were known, and 10 age-matched healthy controls with no history of depression. Left, but not right, hippocampus volumes were significantly smaller in the patient group compared to the controls. Furthermore, there was a significant correlation such that left hippocampus volume was smaller with increasing lifetime duration of depression. However, this relationship was moderated by a significant correlation such that greater lifetime duration of antidepressant medication was associated with larger left hippocampus volume. The findings support the contention that antidepressant medication may act to normalize hippocampus volume.
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Affiliation(s)
- Mark A. Rogers
- Cognitive Neuroscience Unit, School of Psychology, Faculty of Health, Deakin University, Victoria, Australia
| | - Hidenori Yamasue
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Hongo, Bunkyo-ku, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Hongo, Bunkyo-ku, Japan
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16
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Malykhin N, Coupland N. Hippocampal neuroplasticity in major depressive disorder. Neuroscience 2015; 309:200-13. [DOI: 10.1016/j.neuroscience.2015.04.047] [Citation(s) in RCA: 103] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 04/17/2015] [Accepted: 04/21/2015] [Indexed: 01/31/2023]
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17
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Monden R, Wardenaar KJ, Stegeman A, Conradi HJ, de Jonge P. Simultaneous Decomposition of Depression Heterogeneity on the Person-, Symptom- and Time-Level: The Use of Three-Mode Principal Component Analysis. PLoS One 2015; 10:e0132765. [PMID: 26177365 PMCID: PMC4503625 DOI: 10.1371/journal.pone.0132765] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 06/18/2015] [Indexed: 11/29/2022] Open
Abstract
Although heterogeneity of depression hinders research and clinical practice, attempts to reduce it with latent variable models have yielded inconsistent results, probably because these techniques cannot account for all interacting sources of heterogeneity at the same time. Therefore, to simultaneously decompose depression heterogeneity on the person-, symptom and time-level, three-mode Principal Component Analysis (3MPCA) was applied to data of 219 Major Depression patients, who provided Beck Depression Inventory assessments every three months for two years. The resulting person-level components were correlated with external baseline clinical and demographic variables. The 3MPCA extracted two symptom-level components (‘cognitive’, ‘somatic-affective’), two time-level components (‘improving’, ‘persisting’) and three person-level components, characterized by different interaction-patterns between the symptom- and time-components (‘severe non-persisting’, ‘somatic depression’ and ‘cognitive depression’). This model explained 28% of the total variance and 65% when also incorporating the general trend in the data). Correlations with external variables illustrated the content differentiation between the person-components. Severe non-persisting depression was positively correlated with psychopathology (r=0.60) and negatively with quality of life (r=-0.50). Somatic depression was negatively correlated with physical functioning (r=-0.45). Cognitive depression was positively correlated with neuroticism (r=0.38) and negatively with self-esteem (r=-0.47). In conclusion, 3MPCA decomposes depression into homogeneous entities, while accounting for the interactions between different sources of heterogeneity, which shows the utility of the technique to investigate the underlying structure of complex psychopathology data and could help future development of better empirical depression subtypes.
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Affiliation(s)
- Rei Monden
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- * E-mail:
| | - Klaas J. Wardenaar
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Alwin Stegeman
- Department of Psychometrics and Statistics, Heijmans Institute for Psychological Research, University of Groningen, Groningen, The Netherlands
| | - Henk Jan Conradi
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Peter de Jonge
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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18
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Ota M, Noda T, Sato N, Hattori K, Hori H, Sasayama D, Teraishi T, Nagashima A, Obu S, Higuchi T, Kunugi H. White matter abnormalities in major depressive disorder with melancholic and atypical features: A diffusion tensor imaging study. Psychiatry Clin Neurosci 2015; 69:360-8. [PMID: 25384997 DOI: 10.1111/pcn.12255] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 11/03/2014] [Accepted: 11/06/2014] [Indexed: 11/28/2022]
Abstract
AIM The DSM-IV recognizes some subtypes of major depressive disorder (MDD). It is known that the effectiveness of antidepressants differs among the MDD subtypes, and thus the differentiation of the subtypes is important. However, little is known as to structural brain changes in MDD with atypical features (aMDD) in comparison with MDD with melancholic features (mMDD), which prompted us to examine possible differences in white matter integrity assessed with diffusion tensor imaging (DTI) between these two subtypes. METHODS Subjects were 21 patients with mMDD, 24 with aMDD, and 37 age- and sex-matched healthy volunteers whose DTI data were obtained by 1.5 tesla magnetic resonance imaging. We compared fractional anisotropy and mean diffusivity value derived from DTI data on a voxel-by-voxel basis among the two diagnostic groups and healthy subjects. RESULTS There were significant decreases of fractional anisotropy and increases of mean diffusivity in patients with MDD compared with healthy subjects in the corpus callosum, inferior fronto-occipital fasciculus, and left superior longitudinal fasciculus. However, we detected no significant difference in any brain region between mMDD and aMDD. CONCLUSION Our results suggest that patients with MDD had reduced white matter integrity in some regions; however, there was no major difference between aMDD and mMDD.
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Affiliation(s)
- Miho Ota
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Takamasa Noda
- Department of Psychiatry, National Center Hospital of Neurology and Psychiatry, Tokyo, Japan
| | - Noriko Sato
- Department of Radiology, National Center Hospital of Neurology and Psychiatry, Tokyo, Japan
| | - Kotaro Hattori
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Hiroaki Hori
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Daimei Sasayama
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Toshiya Teraishi
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Anna Nagashima
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Satoko Obu
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | | | - Hiroshi Kunugi
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
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Travis S, Coupland NJ, Silversone PH, Huang Y, Fujiwara E, Carter R, Seres P, Malykhin NV. Dentate gyrus volume and memory performance in major depressive disorder. J Affect Disord 2015; 172:159-64. [PMID: 25451411 DOI: 10.1016/j.jad.2014.09.048] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 09/30/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) has shown lower hippocampal volume in major depressive disorder (MDD). Patients with MDD have consistently demonstrated worse performance than healthy controls a number of memory tests. Memory functions within the hippocampus in healthy younger subjects appear to be linked to cornu ammonis (CA1-3) and dentate gyrus (DG) subfields. Therefore, the main goal of the present study was to investigate whether memory deficits in MDD patients are related to reduction in hippocampal subfields volumes, particularly DG and CA 1-3. METHODS 15 MDD patients meeting DSM-IV criteria for MDD with moderate or severe episodes were recruited, together with 15 healthy controls. We used T2-weighted 2D Fast Spin Echo (FSE) and T1-weighted 3D MPRAGE sequences at 4.7 T to compare hippocampal subfield volumes at 0.09 μl voxel volume. Participants were administered the Wechsler Memory Scale. RESULTS MDD patients underperformed in several episodic visual memory tasks, as well as in visual working memory, compared to healthy controls. Global hippocampal volumes were similar between groups; however, MDD patients showed significantly reduced DG volumes within the hippocampal body. Duration of depression correlated with MDD patients׳ total volumes in the hippocampal body and CA1-3 and DG subfields within it. LIMITATIONS Our study sample was relatively small and the majority of patients were on antidepressant treatment. CONCLUSIONS Our findings suggest that DG volumes in particular may be worthy of further study to further elucidate their precise role in MDD, both by itself as well as in relation to memory.
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Affiliation(s)
- Scott Travis
- Centre for Neuroscience, University of Alberta, Edmonton, Alberta, Canada
| | | | - Peter H Silversone
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Yushan Huang
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Esther Fujiwara
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Rawle Carter
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Peter Seres
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Nikolai V Malykhin
- Centre for Neuroscience, University of Alberta, Edmonton, Alberta, Canada; Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada; Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada.
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20
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Degree of contribution (DoC) feature selection algorithm for structural brain MRI volumetric features in depression detection. Int J Comput Assist Radiol Surg 2014; 10:1003-16. [DOI: 10.1007/s11548-014-1130-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Accepted: 11/04/2014] [Indexed: 10/24/2022]
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21
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A magnetic resonance imaging study of hippocampal, amygdala and subgenual prefrontal cortex volumes in major depression subtypes: melancholic versus psychotic depression. J Affect Disord 2013; 146:197-204. [PMID: 23021193 DOI: 10.1016/j.jad.2012.09.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Revised: 06/01/2012] [Accepted: 09/04/2012] [Indexed: 11/23/2022]
Abstract
BACKGROUND Volumetric studies examining brain structure in depression subtypes are limited and inconclusive. The aim of the current study was to compare the volumes of brain regions previously implicated in depression among patients with melancholic major depressive disorder (MDD), patients with psychotic MDD and normal controls. METHODS Twenty two patients with melancholic MDD, 17 with psychotic MDD and 18 normal controls were included in the study. Hippocampal (HV), amygdala (AV), anterior (ASCV) and posterior (PSCV) subgenual cortex volumes were measured on magnetic resonance volumetric images. RESULTS There were no volumetric differences between patients with melancholic and psychotic subgroups. We identified larger AVs and smaller left ASCVs in both patient groups compared to controls with medium to large effect sizes. Regression analysis revealed that AVs were predicted by the presence of depression, late depression-onset, insomnia and left hippocampal tail volume in patients, but not in controls. There were no differences in HVs, right ASCVs and PSCVs across the 3 groups. LIMITATIONS Small sample size, a possible inclusion of paracingulate gyrus in ASCV and PSCV tracings, significant differences in education level and medication status are discussed as limitations. CONCLUSIONS Diagnostically delineated melancholic and psychotic MDD patients do not differ in medial temporal and cingulate volumes. However, significant volumetric differences were detected between both patient-groups and controls.
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22
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Towards automated detection of depression from brain structural magnetic resonance images. Neuroradiology 2013; 55:567-84. [PMID: 23338839 DOI: 10.1007/s00234-013-1139-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Accepted: 01/07/2013] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Depression is a major issue worldwide and is seen as a significant health problem. Stigma and patient denial, clinical experience, time limitations, and reliability of psychometrics are barriers to the clinical diagnoses of depression. Thus, the establishment of an automated system that could detect such abnormalities would assist medical experts in their decision-making process. This paper reviews existing methods for the automated detection of depression from brain structural magnetic resonance images (sMRI). METHODS Relevant sources were identified from various databases and online sites using a combination of keywords and terms including depression, major depressive disorder, detection, classification, and MRI databases. Reference lists of chosen articles were further reviewed for associated publications. RESULTS The paper introduces a generic structure for representing and describing the methods developed for the detection of depression from sMRI of the brain. It consists of a number of components including acquisition and preprocessing, feature extraction, feature selection, and classification. CONCLUSION Automated sMRI-based detection methods have the potential to provide an objective measure of depression, hence improving the confidence level in the diagnosis and prognosis of depression.
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Schuhmacher A, Mössner R, Jessen F, Scheef L, Block W, Belloche AC, Lennertz L, Welper H, Höfels S, Pfeiffer U, Wagner M, Maier W, Schwab S, Zobel A. Association of amygdala volumes with cortisol secretion in unipolar depressed patients. Psychiatry Res 2012; 202:96-103. [PMID: 22698761 DOI: 10.1016/j.pscychresns.2011.09.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Revised: 09/13/2011] [Accepted: 09/14/2011] [Indexed: 01/08/2023]
Abstract
Major depressive disorder (MDD) is accompanied by morphological changes of brain structures which are of great importance in the neural circuitry mediating depression like the hippocampus and the amygdala. Hyperactivity of the hypothalamic-pituitary-adrenocortical (HPA) system resulting in enhanced glucocorticoid secretion can often be observed during depression and has been thought to play an important role in inducing these morphological changes. We used magnetic resonance imaging to investigate alterations of amygdala and hippocampal volumes in 86 in-patients with unipolar depression and 87 healthy controls, and we then correlated amygdala and hippocampal volumes of 76 in-patients with the area under the curve of cortisol secretion in the dexamethasone/corticotropin releasing hormone (Dex/CRH) test at baseline and during short-term antidepressant therapy. In line with recently published studies both left and right amygdala volumes of patients in a first depressive episode were smaller than those of healthy controls. Patients with recurrent depressive episodes showed a reduction of hippocampal volumes, while amygdala volumes were normal. Larger left and right amygdala volumes correlated with a more pronounced reduction of HPA activity, measured by the cortisol secretion in the combined DEX/CRH test, during antidepressant therapy in patients with recurrent depressive episodes.
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Affiliation(s)
- Anna Schuhmacher
- Department of Psychiatry and Psychotherapy, University of Bonn, Germany
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Magnetic resonance imaging studies in unipolar depression: systematic review and meta-regression analyses. Eur Neuropsychopharmacol 2012; 22:1-16. [PMID: 21723712 DOI: 10.1016/j.euroneuro.2011.05.003] [Citation(s) in RCA: 353] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2010] [Revised: 03/28/2011] [Accepted: 05/11/2011] [Indexed: 01/25/2023]
Abstract
Previous meta-analyses of structural MRI studies have shown diffuse cortical and sub-cortical abnormalities in unipolar depression. However, the presence of duplicate publications, recruitment of particular age groups and the selection of specific regions of interest means that there is uncertainty about the balance of current research. Moreover, the lack of systematic exploration of highly significant heterogeneity has prevented the generalisability of finding. A systematic review and random-effects meta-analysis was carried out to estimate effect sizes. Possible publication bias, and the impact of various study design characteristics on the magnitude of the observed effect size were systematically explored. The aim of this study was 1) to include structural MRI studies systematically comparing unipolar depression with bipolar disorder and healthy volunteers; 2) to consider all available structures of interest without specific age limits, avoiding data duplication, and 3) to explore the influence of factors contributing to the measured effect sizes systematically with meta-regression analyses. Unipolar depression was characterised by reduced brain volume in areas involved in emotional processing, including the frontal cortex, orbitofrontal cortex, cingulate cortex, hippocampus and striatum. There was also evidence of pituitary enlargement and an excess of white matter hyperintensity volume in unipolar depression. Factors which influenced the magnitude of the observed effect sizes were differences in methods, clinical variables, pharmacological interventions and sample age.
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Corrigan FM, Fisher JJ, Nutt DJ. Autonomic dysregulation and the Window of Tolerance model of the effects of complex emotional trauma. J Psychopharmacol 2011; 25:17-25. [PMID: 20093318 DOI: 10.1177/0269881109354930] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This paper reviews the Window of Tolerance model of the long-term effects of the severe emotional trauma associated with childhood abuse, a model which can also be applied to adult trauma of sufficient severity to cause post-traumatic stress disorder, chronic dysthymic disorders and chronic anxiety disorders. Dysfunctional behaviours such as deliberate self-harm and substance abuse are seen as efforts to regulate an autonomic nervous system which is readily triggered into extreme states by reminders of the original traumatic events. While midbrain areas such as the periaqueductal gray mediate instant defence responses to traumatic events and their memory triggers it is proposed that ascending monoaminergic tracts are implicated in longer-term changes in mood and arousal. An imbalance of ascending dopaminergic tracts may drive rapid fluctuations in level of arousal and in the associated mood, drive and motivation. Animal models of depression frequently use traumatic experiences of pain, isolation or social defeat to induce changes in mesolimbic and mesocortical dopamine systems which may alter prefrontal cortical control of midbrain defence responses. A focus on the pharmacology of the Window of Tolerance could provide advances in drug treatments for promoting emotional regulation in those who are suffering from the chronic sequelae of traumatic experiences.
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Affiliation(s)
- F M Corrigan
- Argyll & Bute Hospital, Lochgilphead, Argyll, UK.
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Dotson VM, Zonderman AB, Davatzikos C, Kraut MA, Resnick SM. Frontal Atrophy and Attention Deficits in Older Adults with a History of Elevated Depressive Symptoms. Brain Imaging Behav 2009; 3:358. [PMID: 20161651 DOI: 10.1007/s11682-009-9078-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Studies of older adults with depressive disorders indicate greater cognitive deficits and brain alterations than would be expected for their age. There is some evidence that these findings are present after a single episode of depression, but this work has been cross-sectional in nature. We investigated both cross-sectional and longitudinal associations between a history of elevated depressive symptoms (HDS), frontal lobe volumes, and cognitive performance within the context of normal age-related changes over time in the Baltimore Longitudinal Study of Aging. After controlling for age, HDS was associated with smaller total frontal gray matter volumes and with smaller regional volumes in the cingulate gyrus and orbitofrontal cortex. Men, but not women, with HDS showed deficits in auditory attention span at older ages. Results confirm previous reports that even a single episode of depression is associated with adverse outcomes in older adults but suggest that HDS does not affect longitudinal trajectories of cognitive and brain volume change.
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Affiliation(s)
- Vonetta M Dotson
- Laboratory of Personality and Cognition, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD
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Dotson VM, Davatzikos C, Kraut MA, Resnick SM. Depressive symptoms and brain volumes in older adults: a longitudinal magnetic resonance imaging study. J Psychiatry Neurosci 2009; 34:367-75. [PMID: 19721847 PMCID: PMC2732743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2008] [Revised: 05/20/2009] [Accepted: 06/10/2009] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Late-life depression is associated with decreased brain volumes, particularly in frontal and temporal areas. Evidence suggests that depressive symptoms at a subclinical level are also associated with brain atrophy in these regions, but most of these associations are based on cross-sectional data. Our objective was to investigate both cross-sectional and longitudinal relations between sub-threshold depressive symptoms and brain volumes in older adults and to examine whether these associations are modified by age. METHODS In total, 110 dementia-free adults from the neuroimaging substudy of the Baltimore Longitudinal Study of Aging aged 56 years and older at baseline participated in this study. Participants received annual evaluations for up to 9 years, during which structural magnetic resonance imaging (MRI) scans were acquired and depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale. RESULTS Mean depressive symptom scores over time were associated with grey matter volume reductions in the left temporal lobe. Depressive symptoms were associated with brain volume reductions with advancing age in the cingulate gyrus and orbitofrontal cortex. Moreover, individuals with higher mean depressive symptom scores showed a faster rate of volume decline in left frontal white matter. Depressive symptoms were not associated with hippocampus volumes. LIMITATIONS Limitations include the relative homogeneity of our primarily white and highly educated sample, the lack of information about age at onset of depressive symptoms and potential limitations of the automated brain volume registration. CONCLUSION Our results suggest that depressive symptoms, even at a subthreshold level, are associated with volume reductions in specific frontal and temporal brain regions, particularly with advancing age.
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Affiliation(s)
- Vonetta M. Dotson
- Correspondence to: Dr. V.M. Dotson, Department of Clinical and Health Psychology, University of Florida, P.O. Box 100165, Gainesville FL 32610-0165; fax 352 273-6532;
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