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Velioglu HA, Yıldız S, Ozdemir-Oktem E, Cankaya S, Lundmark AK, Ozsimsek A, Hanoglu L, Yulug B. Smoking affects global and regional brain entropy in depression patients regardless of depression: Preliminary findings. J Psychiatr Res 2024; 177:147-152. [PMID: 39018709 DOI: 10.1016/j.jpsychires.2024.07.002] [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: 04/02/2024] [Revised: 06/27/2024] [Accepted: 07/02/2024] [Indexed: 07/19/2024]
Abstract
OBJECTIVE This study examines the effect of smoking on global and regional brain entropy in patients with Major Depressive Disorder (MDD), aiming to elucidate the relationship between smoking habits and brain network complexity in depression. METHODS The study enrolled 24 MDD patients, divided into smokers and non-smokers, from Alanya Alaaddin Keykubat University and Istanbul Medipol University. Resting-state fMRI data were acquired and processed. The complexity of neuronal activity was assessed using dispersion entropy, with statistical significance determined by a suite of tests including Kolmogorov-Smirnov, Student's t-test, and Mann-Whitney U test. RESULTS The smoking cohort exhibited higher global brain entropy compared to the non-smoking group (p = 0.033), with significant differences in various brain networks, indicating that smoking may alter global brain activity and network dynamics in individuals with MDD. CONCLUSION The study provides evidence that smoking is associated with increased brain entropy in MDD patients, suggesting that chronic smoking may influence cognitive and emotional networks. This underscores the importance of considering smoking history in the treatment and prognosis of MDD. The findings call for further research to understand the mechanistic links between smoking, brain entropy, and depression.
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Affiliation(s)
- Halil Aziz Velioglu
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA; Functional Imaging and Cognitive-Affective Neuroscience Lab (fINCAN), Health Sciences and Technology Research Institute (SABITA), Istanbul Medipol University, Istanbul, Turkey
| | - Sultan Yıldız
- School of Engineering and Natural Sciences, Istanbul Medipol University, Istanbul, Turkey; Program of Neuroscience Ph.D., Graduate School of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
| | - Ece Ozdemir-Oktem
- Department of Neurology, School of Medicine, Alanya Alaaddin Keykubat University, Alanya, Turkey
| | - Seyda Cankaya
- Department of Neurology, School of Medicine, Alanya Alaaddin Keykubat University, Alanya, Turkey
| | | | - Ahmet Ozsimsek
- Department of Neurology, School of Medicine, Alanya Alaaddin Keykubat University, Alanya, Turkey
| | - Lütfü Hanoglu
- Department of Neurology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Burak Yulug
- Department of Neurology, School of Medicine, Alanya Alaaddin Keykubat University, Alanya, Turkey.
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Gan L, Wang L, Liu H, Wang G. Based on neural network cascade abnormal texture information dissemination of classification of patients with schizophrenia and depression. Brain Res 2024; 1830:148819. [PMID: 38403037 DOI: 10.1016/j.brainres.2024.148819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 02/11/2024] [Accepted: 02/20/2024] [Indexed: 02/27/2024]
Abstract
This study used MRI brain image segmentation to identify novel magnetic resonance imaging (MRI) biomarkers to distinguish patients with schizophrenia (SCZ), major depressive disorder (MD), and healthy control (HC). Brain texture measurements, including entropy and contrast, were calculated to capture variability in adjacent MRI voxel intensity. These measures are then applied to group classification in deep learning techniques and combined with hierarchical correlations to locate results. Texture feature maps were extracted from segmented brain MRI scans of 141 patients with schizophrenia (SCZ), 103 patients with major depressive disorder (MD) and 238 healthy controls (HC). Gray scale coassociation matrix (GLCM) is a monomer matrix calculated in a voxel cube. Deep learning methods were evaluated to determine the application capability of texture feature mapping in binary classification (SCZ vs. HC, MD vs. HC, SCZ vs. MD). The method is implemented by repeated nesting and cross-validation for feature selection. Regions that show the highest correlation (positive or negative). In this study, the authors successfully classified SCZ, MD and HC. This suggests that texture analysis can be used as an effective feature extraction method to distinguish different disease states. Compared with other methods, texture analysis can capture richer image information and improve classification accuracy in some cases. The classification accuracy of SCZ and HC, MD and HC, SCZ and MD reached 84.6%, 86.4% and 76.21%, respectively. Among them, SCZ and HC are the most significant features with high sensitivity and specificity.
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Affiliation(s)
- Linfeng Gan
- School of Railway Transportation, Shanghai Institute of Technology, Shanghai 201418, China
| | - Linfeng Wang
- School of Railway Transportation, Shanghai Institute of Technology, Shanghai 201418, China
| | - Hu Liu
- Peking University Health Science Center, Institute of Medical Technology, Beijing 100069, China.
| | - Gang Wang
- School of Railway Transportation, Shanghai Institute of Technology, Shanghai 201418, China
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Kieseppä T, Mäntylä R, Luoma K, Rikandi E, Jylhä P, Isometsä E. White Matter Hyperintensities after Five-Year Follow-Up and a Cross-Sectional FA Decrease in Bipolar I and Major Depressive Patients. Neuropsychobiology 2022; 81:39-50. [PMID: 34130283 DOI: 10.1159/000516234] [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: 11/16/2020] [Accepted: 03/30/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION An increase in brain white matter hyperintensities (WMHs) and a decrease in white matter fractional anisotrophy (FA) have been detected in bipolar I (BPI), II (BPII), and major depressive disorder (MDD) patients. Their relationship, and differences in diagnostic groups are obscure. Longitudinal studies are rare. OBJECTIVE After 5-year follow-up, we evaluated WMHs in BPI, BPII, and MDD patients as compared with controls, and studied the effects of clinical variables. We also explored the associations of clinical variables with cross-sectional whole brain FA. METHODS Eight BPI, 8 BPII, 6 MDD patients, and 19 controls participated in magnetic resonance imaging at baseline and follow-up. Diffusion weighted imaging was included at follow-up. WMHs were rated by the Coffey scale, and a tract-based spatial statistics method was used for diffusion data. The general linear model, ANOVA, Fisher's exact, Wilcoxon sign, and Kruskal-Wallis tests were used for statistical analyses. RESULTS Periventricular WMHs were increased in BPI patients (p = 0.047) and associated with the duration of disorder and lifetime occurrence of substance use disorder (p = 0.018). FA decrease was found in the corpus callosum of BPI patients (p < 0.01). MDD patients showed FA decrease in the right cerebellar middle peduncle (RCMP) (p < 0.01). In BPI patients, the duration of disorder associated with FA increase in RCMP (p < 0.05). No FA decrease was detected in patients with WMHs as compared with those without. CONCLUSIONS Preceding illness burden associated modestly with WMHs, and FA increase in RCMP in BPI patients. MDD patients had FA decrease in RCMP. No association with FA decrease and WMHs was found.
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Affiliation(s)
- Tuula Kieseppä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Finnish Institute for Health and Welfare, Public Health and Welfare, Mental Health, Helsinki, Finland
| | - Riitta Mäntylä
- Department of Radiology, HUS Medical Imaging Center, Hyvinkää Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Katariina Luoma
- Department of Radiology, HUS Medical Imaging Center, Meilahti Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Eva Rikandi
- Finnish Institute for Health and Welfare, Public Health and Welfare, Mental Health, Helsinki, Finland.,Department of Neuroscience and Biomedical Engineering, and Advanced Magnetic Imaging Center, Aalto NeuroImaging, Aalto University School of Science, Espoo, Finland.,Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Pekka Jylhä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Finnish Institute for Health and Welfare, Public Health and Welfare, Mental Health, Helsinki, Finland
| | - Erkki Isometsä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Finnish Institute for Health and Welfare, Public Health and Welfare, Mental Health, Helsinki, Finland
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4
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Wang KW, Xu YM, Lou CB, Huang J, Feng C. The etiologies of post-stroke depression: Different between lacunar stroke and non-lacunar stroke. Clinics (Sao Paulo) 2022; 77:100095. [PMID: 36027756 PMCID: PMC9424932 DOI: 10.1016/j.clinsp.2022.100095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 06/10/2022] [Accepted: 07/18/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Depression is common after both lacunar stroke and non-lacunar stroke and might be associated with lesion locations as proven by some studies. This study aimed to identify whether lesion location was critical for depression after both lacunar and non-lacunar strokes. METHODS A cohort of ischemic stroke patients was assigned to either a lacunar stroke group or a non-lacunar stroke group after a brain MRI scan. Neurological deficits and treatment response was evaluated during hospitalization. The occurrence of depression was evaluated 3 months later. Logistic regressions were used to identify the independent risk factors for depression after lacunar and non-lacunar stroke respectively. RESULTS 83 of 246 patients with lacunar stroke and 71 of 185 patients with non-lacunar stroke developed depression. Infarctions in the frontal cortex, severe neurological deficits, and a high degree of handicap were identified as the independent risk factors for depression after non-lacunar stroke, while lesion location was not associated with depression after lacunar stroke. CONCLUSION The main determinants for depression after lacunar and non-lacunar stroke were different. Lesion location was critical only for depression after non-lacunar stroke.
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Affiliation(s)
- Ke-Wu Wang
- The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, China
| | - Yang-Miao Xu
- The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, China
| | - Chao-Bin Lou
- The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, China
| | - Jing Huang
- Shanghai Xuhui Central Hospital, Shanghai, China
| | - Chao Feng
- The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, China.
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5
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Shan W, Duan Y, Zheng Y, Wu Z, Chan SW, Wang Q, Gao P, Liu Y, He K, Wang Y. Segmentation of Cerebral Small Vessel Diseases-White Matter Hyperintensities Based on a Deep Learning System. Front Med (Lausanne) 2021; 8:681183. [PMID: 34901045 PMCID: PMC8656685 DOI: 10.3389/fmed.2021.681183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 09/28/2021] [Indexed: 11/23/2022] Open
Abstract
Objective: Reliable quantification of white matter hyperintensities (WHMs) resulting from cerebral small vessel diseases (CSVD) is essential for understanding their clinical impact. We aim to develop and clinically validate a deep learning system for automatic segmentation of CSVD-WMH from fluid-attenuated inversion recovery (FLAIR) imaging using large multicenter data. Method: A FLAIR imaging dataset of 1,156 patients diagnosed with CSVD associated WMH (median age, 54 years; 653 males) obtained between September 2018 and September 2019 from Beijing Tiantan Hospital was retrospectively analyzed in this study. Locations of CSVD-WMH on the FLAIR scans were manually marked by two experienced neurologists. Using the manually labeled data of 996 patients (development set), a U-shaped novel 2D convolutional neural network (CNN) architecture was trained for automatic segmentation of CSVD-WMH. The segmentation performance of the network was evaluated with per pixel and lesion level dice scores using an independent internal test set (n = 160) and a multi-center external test set (n = 90, three medical centers). The clinical suitability of the segmentation results, classified as acceptable, acceptable with minor revision, acceptable with major revision, and not acceptable, was analyzed by three independent neuroradiologists. The inter-neuroradiologists agreement rate was assessed by the Kendall-W test. Results: On the internal and external test sets, the proposed CNN architecture achieved per pixel and lesion level dice scores of 0.72 (external test set), and they were significantly better than the state-of-the-art deep learning architectures proposed for WMH segmentation. In the clinical evaluation, neuroradiologists observed the segmentation results for 95% of the patients were acceptable or acceptable with a minor revision. Conclusions: A deep learning system can be used for automated, objective, and clinically meaningful segmentation of CSVD-WMH with high accuracy.
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Affiliation(s)
- Wei Shan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Center for Clinical Medicine of Neurological Diseases, Beijing, China.,Beijing Institute for Brain Disorders, Beijing, China
| | - Yunyun Duan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yu Zheng
- National Center for Clinical Medicine of Neurological Diseases, Beijing, China
| | - Zhenzhou Wu
- National Center for Clinical Medicine of Neurological Diseases, Beijing, China
| | - Shang Wei Chan
- National Center for Clinical Medicine of Neurological Diseases, Beijing, China
| | - Qun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Center for Clinical Medicine of Neurological Diseases, Beijing, China.,Beijing Institute for Brain Disorders, Beijing, China
| | - Peiyi Gao
- National Center for Clinical Medicine of Neurological Diseases, Beijing, China
| | - Yaou Liu
- National Center for Clinical Medicine of Neurological Diseases, Beijing, China
| | - Kunlun He
- Laboratory of Translational Medicine, Chinese PLA General Hospital, Beijing, China.,Key Laboratory of Ministry of Industry and Information Technology of Biomedical Engineering and Translational Medicine, Chinese PLA General Hospital, Beijing, China
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Center for Clinical Medicine of Neurological Diseases, Beijing, China
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6
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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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7
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Gunning FM, Oberlin LE, Schier M, Victoria LW. Brain-based mechanisms of late-life depression: Implications for novel interventions. Semin Cell Dev Biol 2021; 116:169-179. [PMID: 33992530 PMCID: PMC8548387 DOI: 10.1016/j.semcdb.2021.05.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/26/2021] [Accepted: 05/01/2021] [Indexed: 12/11/2022]
Abstract
Late-life depression (LLD) is a particularly debilitating illness. Older adults suffering from depression commonly experience poor outcomes in response to antidepressant treatments, medical comorbidities, and declines in daily functioning. This review aims to further our understanding of the brain network dysfunctions underlying LLD that contribute to disrupted cognitive and affective processes and corresponding clinical manifestations. We provide an overview of a network model of LLD that integrates the salience network, the default mode network (DMN) and the executive control network (ECN). We discuss the brain-based structural and functional mechanisms of LLD with an emphasis on their link to clinical subtypes that often fail to respond to available treatments. Understanding the brain networks that underlie these disrupted processes can inform the development of targeted interventions for LLD. We propose behavioral, cognitive, or computational approaches to identifying novel, personalized interventions that may more effectively target the key cognitive and affective symptoms of LLD.
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Affiliation(s)
- Faith M Gunning
- Department of Psychiatry, Weill Cornell Medicine, New York, NY 10065, USA.
| | - Lauren E Oberlin
- Department of Psychiatry, Weill Cornell Medicine, New York, NY 10065, USA
| | - Maddy Schier
- Department of Psychiatry, Weill Cornell Medicine, New York, NY 10065, USA
| | - Lindsay W Victoria
- Department of Psychiatry, Weill Cornell Medicine, New York, NY 10065, USA.
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8
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Korda AI, Ruef A, Neufang S, Davatzikos C, Borgwardt S, Meisenzahl EM, Koutsouleris N. Identification of voxel-based texture abnormalities as new biomarkers for schizophrenia and major depressive patients using layer-wise relevance propagation on deep learning decisions. Psychiatry Res Neuroimaging 2021; 313:111303. [PMID: 34034096 PMCID: PMC9060641 DOI: 10.1016/j.pscychresns.2021.111303] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 05/03/2021] [Accepted: 05/07/2021] [Indexed: 01/27/2023]
Abstract
Non-segmented MRI brain images are used for the identification of new Magnetic Resonance Imaging (MRI) biomarkers able to differentiate between schizophrenic patients (SCZ), major depressive patients (MD) and healthy controls (HC). Brain texture measures such as entropy and contrast, capturing the neighboring variation of MRI voxel intensities, were computed and fed into deep learning technique for group classification. Layer-wise relevance was applied for the localization of the classification results. Texture feature map of non-segmented brain MRI scans were extracted from 141 SCZ, 103 MD and 238 HC. The gray level co-occurrence matrix (GLCM) was calculated on a voxel-by-voxel basis in a cube of voxels. Deep learning tested if texture feature map could predict diagnostic group membership of three classes under a binary classification (SCZ vs. HC, MD vs. HC, SCZ vs. MD). The method was applied in a repeated nested cross-validation scheme and cross-validated feature selection. The regions with the highest relevance (positive/negative) are presented. The method was applied on non-segmented images reducing the computation complexity and the error associated with segmentation process.
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Affiliation(s)
- A I Korda
- Department of Psychiatry and Psychotherapy, University Hospital Lübeck (UKSH), Ratzeburger Allee 160, 23562 Lübeck, Germany.
| | - A Ruef
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Nussbaumstr. 7, 80336 Munich, Germany
| | - S Neufang
- Department of Psychiatry and Psychotherapy, University Hospital Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - C Davatzikos
- Department of Radiology, University of Pennsylvania School of Medicine, 3700 Hamilton Walk, Philadelphia, PA 19104, United States
| | - S Borgwardt
- Department of Psychiatry and Psychotherapy, University Hospital Lübeck (UKSH), Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - E M Meisenzahl
- Department of Psychiatry and Psychotherapy, University Hospital Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - N Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Nussbaumstr. 7, 80336 Munich, Germany
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Song CR, Kang NO, Bang M, Park CI, Choi TK, Lee SH. Initial white matter connectivity differences between remitters and non-remitters of patients with panic disorder after 6 months of pharmacotherapy. Neurosci Lett 2021; 751:135826. [PMID: 33727131 DOI: 10.1016/j.neulet.2021.135826] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 03/05/2021] [Accepted: 03/09/2021] [Indexed: 12/28/2022]
Abstract
Panic disorder (PD) is a harmful mental condition that causes relapsed and persistent impairment. In the treatment of PD, the prognosis for PD should be considered. However, the relationship between pharmacotherapy and biomarkers, for predicting a better response through neuroimaging, is a little known. The purpose of the present study was to examine whether there would be the initial white matter (WM) regions associated with the remission in 6 months. A total of 104 patients with PD were investigated in the study. After six months, there were 17 remission patients with PD and 81 non-remission patients. The Panic Disorder Severity Scale, Albany Panic and Phobia Questionnaire, Anxiety Sensitivity Inventory-Revised, Beck Anxiety Inventory, and Beck Depression Inventory were assessed for all patients at baseline. We compared the diffusion indices between remission and non-remission group at 6 months using Tract-Based Spatial Statistics. The results showed that the fractional anisotropy (FA) values were significantly higher in the non-remitter group compared with those in the remitter group in the WM regions, such as the posterior corona radiata and superior longitudinal fasciculus, at the 6 month evaluation. The logistic regression analysis with clinical symptom severity and FA values of the WM regions as covariates showed that FA values in those regions and the Beck Depression Inventory-II predicted poor remission. This study suggests that posterior corona radiata and superior longitudinal fasciculus are related to potential predictive factors of 6-month remission in patients with PD. WM regions associated with the long-term remission should be verified with further investigations.
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Affiliation(s)
- Chae Rim Song
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea; Clinical Counseling Psychology Graduate School, CHA University, Seongnam, Republic of Korea
| | - Na-Ok Kang
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Minji Bang
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Chun Il Park
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Tae-Kiu Choi
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea; Department of Clinical Pharmacology and Therapeutics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.
| | - Sang-Hyuk Lee
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea; Department of Clinical Pharmacology and Therapeutics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.
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10
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Kim YK, Han KM. Neural substrates for late-life depression: A selective review of structural neuroimaging studies. Prog Neuropsychopharmacol Biol Psychiatry 2021; 104:110010. [PMID: 32544600 DOI: 10.1016/j.pnpbp.2020.110010] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 06/05/2020] [Accepted: 06/09/2020] [Indexed: 12/15/2022]
Abstract
Recent neuroimaging studies have characterized the pathophysiology of late-life depression (LLD) as a dysfunction of the brain networks involved in the regulation of emotion, motivational behavior, cognitive control, executive function, and self-referential thinking. In this article, we reviewed LLD-associated structural neuroimaging markers such as white matter hyperintensity (WMH), white matter integrity measured by diffusion tensor imaging, cortical and subcortical volumes, and cortical thickness, which may provide a structural basis for brain network dysfunction in LLD. LLD was associated with greater severity or volumes of deep, periventricular, or overall WMH and with decreased white matter integrity in the brain regions belonging to the fronto-striatal-limbic circuits and reduced white matter tract integrity which connects these circuits, such as the cingulum, corpus callosum, or uncinate fasciculus. Decreased volumes or cortical thickness in the prefrontal cortex, orbitofrontal cortex, anterior and posterior cingulate cortex, several temporal and parietal regions, hippocampus, amygdala, striatum, thalamus, and the insula were associated with LLD. These structural neuroimaging findings were also associated with cognitive dysfunction, which is a prominent clinical feature in LLD. Several structural neuroimaging markers including the WMH burden, white matter integrity, and cortical and subcortical volumes predicted antidepressant response in LLD. These structural neuroimaging findings support the hypothesis that disruption of the brain networks involved in emotion regulation and cognitive processing by impaired structural connectivity is strongly associated with the pathophysiology of LLD.
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Affiliation(s)
- Yong-Ku Kim
- Department of Psychiatry, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Kyu-Man Han
- Department of Psychiatry, College of Medicine, Korea University, Seoul, Republic of Korea.
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11
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Kim HJ, Bang M, Lee KS, Choi TK, Park CI, Lee SH. Effects of BDNF Val66Met Polymorphism on White Matter Microalterations of the Corpus Callosum in Patients with Panic Disorder in Korean Populations. Psychiatry Investig 2020; 17:967-975. [PMID: 33017888 PMCID: PMC7596279 DOI: 10.30773/pi.2020.0186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 08/05/2020] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE The brain-derived neurotrophic factor (BDNF) Val66Met (rs6265) polymorphism is suggested to be associated with the pathophysiology of anxiety disorders, including panic disorder (PD). Although the fronto-limbic white matter (WM) microstructures have been investigated, the corpus callosum (CC) has not yet been studied regarding its relationship with BDNF Val66Met polymorphism in PD. METHODS Ninety-five PD patients were enrolled. The Neuroticism, the Anxiety Sensitivity Inventory-Revised, Panic Disorder Severity Scale, and Beck Depression Inventory-II (BDI-II) were administered. Voxel-wise statistical analysis of diffusion tensor imaging data was performed within the CC regions using Tract-Based Spatial Statistics. RESULTS The GG genotype in BDNF Val66Met polymorphism has significantly higher fractional anisotropy (FA) values of the body and splenium of the CC, neuroticism and depressive symptom scale scores than the non-GG genotype in PD. The FA values of the body of the CC in the two groups were significantly different independent of age, sex, neuroticism, and BDI-II. CONCLUSION Our findings demonstrate that the BDNF Val66Met polymorphism is associated with WM connectivity of the body and splenium of the CC, and may be related to neuroticism and depressive symptoms in PD. Additionally, the CC connectivity according to BDNF polymorphism may play a role in the pathophysiology of PD.
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Affiliation(s)
- Hyun-Ju Kim
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Minji Bang
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Kang Soo Lee
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Tai Kiu Choi
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Chun Il Park
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Sang-Hyuk Lee
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.,Department of Clinical Pharmacology and Therapeutics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
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12
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Lee S, Pyun SB, Choi KW, Tae WS. Shape and Volumetric Differences in the Corpus Callosum between Patients with Major Depressive Disorder and Healthy Controls. Psychiatry Investig 2020; 17:941-950. [PMID: 32933236 PMCID: PMC7538242 DOI: 10.30773/pi.2020.0157] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 07/29/2020] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the morphometric differences in the corpus callosum between patients with major depressive disorder (MDD) and healthy controls and analyze their relationship to gray matter changes. METHODS Twenty female MDD patients and 21 healthy controls (HCs) were included in the study. To identify the difference in the regional gray matter concentration (GMC), VBM was performed with T1 magnetic resonance imaging. The shape analysis of the corpus callosum was processed. Diffusion tensor imaging (DTI) fiber-tracking was performed to identify the regional tract pathways in the damaged corpus callosal areas. RESULTS In the shape analysis, regional shape contractions in the rostrum and splenium were found in the MDD patients. VBM analysis showed a significantly lower white matter concentration in the genu and splenium, and a significantly lower GMC in the frontal, limbic, insular, and temporal regions of the MDD patients compared to the HCs. In DTI fiber-tracking, the fibers crossing the damaged areas of the genu, rostrum, and splenium were anatomically connected to the areas of lower GMC in MDD patients. CONCLUSION These findings support that major depressive disorder may be due to disturbances in multiple neuronal circuits, especially those associated with the corpus callosum.
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Affiliation(s)
- Sekwang Lee
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - Sung-Bom Pyun
- Department of Physical Medicine and Rehabilitation, Korea University College of Medicine, Seoul, Republic of Korea.,Brain Convergence Research Center, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Kwan Woo Choi
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Woo-Suk Tae
- Brain Convergence Research Center, Korea University Anam Hospital, Seoul, Republic of Korea
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13
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Dalby RB, Eskildsen SF, Videbech P, Frandsen J, Mouridsen K, Sørensen L, Jeppesen P, Bek T, Rosenberg R, Østergaard L. Oxygenation differs among white matter hyperintensities, intersected fiber tracts and unaffected white matter. Brain Commun 2019; 1:fcz033. [PMID: 32954272 PMCID: PMC7425421 DOI: 10.1093/braincomms/fcz033] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 08/27/2019] [Accepted: 10/01/2019] [Indexed: 01/15/2023] Open
Abstract
White matter hyperintensities of presumed vascular origin are frequently observed on magnetic resonance imaging in normal aging. They are typically found in cerebral small vessel disease and suspected culprits in the etiology of complex age- and small vessel disease-related conditions, such as late-onset depression. White matter hyperintensities may interfere with surrounding white matter metabolic demands by disrupting fiber tract integrity. Meanwhile, risk factors for small vessel disease are thought to reduce tissue oxygenation, not only by reducing regional blood supply, but also by impairing capillary function. To address white matter oxygen supply–demand balance, we estimated voxel-wise capillary density as an index of resting white matter metabolism, and combined estimates of blood supply and capillary function to calculate white matter oxygen availability. We conducted a cross-sectional study with structural, perfusion- and diffusion-weighted magnetic resonance imaging in 21 patients with late-onset depression and 21 controls. We outlined white matter hyperintensities and used tractography to identify the tracts they intersect. Perfusion data comprised cerebral blood flow, blood volume, mean transit time and relative transit time heterogeneity—the latter a marker of capillary dysfunction. Based on these, white matter oxygenation was calculated as the steady state cerebral metabolic rate of oxygen under the assumption of normal tissue oxygen tension and vice versa. The number, volume and perfusion characteristics of white matter hyperintensities did not differ significantly between groups. Hemodynamic data showed white matter hyperintensities to have lower blood flow and blood volume, but higher relative transit time heterogeneity, than normal-appearing white matter, resulting in either reduced capillary metabolic rate of oxygen or oxygen tension. Intersected tracts showed significantly lower blood flow, blood volume and capillary metabolic rate of oxygen than normal-appearing white matter. Across groups, lower lesion oxygen tension was associated with higher lesion number and volume. Compared with normal-appearing white matter, tissue oxygenation is significantly reduced in white matter hyperintensities as well as the fiber tracts they intersect, independent of parallel late-onset depression. In white matter hyperintensities, reduced microvascular blood volume and concomitant capillary dysfunction indicate a severe oxygen supply–demand imbalance with hypoxic tissue injury. In intersected fiber tracts, parallel reductions in oxygenation and microvascular blood volume are consistent with adaptations to reduced metabolic demands. We speculate, that aging and vascular risk factors impair white matter hyperintensity perfusion and capillary function to create hypoxic tissue injury, which in turn affect the function and metabolic demands of the white matter tracts they disrupt.
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Affiliation(s)
- Rikke B Dalby
- Center of Functionally Integrative Neuroscience & MINDLab, Aarhus University Hospital, 8200 Aarhus C., Denmark.,Centre for Psychiatric Research, Aarhus University Hospital, 8340 Risskov, Denmark.,Department of Neuroradiology, Aarhus University Hospital, 8200 Aarhus N., Denmark
| | - Simon F Eskildsen
- Center of Functionally Integrative Neuroscience & MINDLab, Aarhus University Hospital, 8200 Aarhus C., Denmark
| | - Poul Videbech
- Center for Neuropsychiatric Depression Research, Mental Health Center Glostrup, 2600 Glostrup, Denmark
| | - Jesper Frandsen
- Center of Functionally Integrative Neuroscience & MINDLab, Aarhus University Hospital, 8200 Aarhus C., Denmark
| | - Kim Mouridsen
- Center of Functionally Integrative Neuroscience & MINDLab, Aarhus University Hospital, 8200 Aarhus C., Denmark
| | - Leif Sørensen
- Department of Neuroradiology, Aarhus University Hospital, 8200 Aarhus N., Denmark
| | - Peter Jeppesen
- Department of Ophthalmology, Aarhus University Hospital, 8200 Aarhus N., Denmark
| | - Toke Bek
- Department of Ophthalmology, Aarhus University Hospital, 8200 Aarhus N., Denmark
| | - Raben Rosenberg
- Centre of Psychiatry Amager, Mental Health Services in the Capital Region of Denmark, 2300 Copenhagen S., Denmark
| | - Leif Østergaard
- Center of Functionally Integrative Neuroscience & MINDLab, Aarhus University Hospital, 8200 Aarhus C., Denmark.,Department of Neuroradiology, Aarhus University Hospital, 8200 Aarhus N., Denmark
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14
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Salo KI, Scharfen J, Wilden ID, Schubotz RI, Holling H. Confining the Concept of Vascular Depression to Late-Onset Depression: A Meta-Analysis of MRI-Defined Hyperintensity Burden in Major Depressive Disorder and Bipolar Disorder. Front Psychol 2019; 10:1241. [PMID: 31214072 PMCID: PMC6555192 DOI: 10.3389/fpsyg.2019.01241] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 05/10/2019] [Indexed: 12/14/2022] Open
Abstract
Background: The vascular depression hypothesis emphasizes the significance of vascular lesions in late-life depression. At present, no meta-analytic model has investigated whether a difference in hyperintensity burden compared to controls between late-life and late-onset depression is evident. By including a substantial number of studies, focusing on a meaningful outcome measure, and considering several moderating and control variables, the present meta-analysis investigates the severity of hyperintensity burden in major depressive disorder (MDD) and bipolar disorder (BD). A major focus of the present meta-analysis refers to the role of age at illness onset. It is analyzed whether late-onset rather than late-life depression characterizes vascular depression. Method: In total, 68 studies were included in the meta-analysis and a multilevel random effects model was calculated using Hedges' g as the effect size measure. Results: The severity of hyperintensity burden was significantly greater in the patient group compared to the control group. This effect was evident regarding the whole patient group (g = 0.229) as well as both depression subgroups, with a significantly greater effect in BD (g = 0.374) compared to MDD (g = 0.189). Hyperintensity burden was more pronounced in late-onset depression than in early-onset depression or late-life depression. A considerable heterogeneity between the included studies was observed, which is reflected by the large variability in effects sizes. Conclusion: In conclusion, the present meta-analysis underscores the association of hyperintensities with MDD and BD. Especially late-onset depression is associated with an increased hyperintensity burden, which is in line with the vascular depression hypothesis. The results suggest that it might be more feasible to confine the concept of vascular depression specifically to late-onset depression as opposed to late-life depression. Further research is needed to understand the causal mechanisms that might underlie the relation between hyperintensity burden and depression.
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Affiliation(s)
- Katharina I. Salo
- Department of Psychology and Sports Sciences, Institute of Psychology, Westfälische Wilhelms-Universität, Münster, Germany
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15
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The neural markers of MRI to differentiate depression and panic disorder. Prog Neuropsychopharmacol Biol Psychiatry 2019; 91:72-78. [PMID: 29705713 DOI: 10.1016/j.pnpbp.2018.04.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 04/05/2018] [Accepted: 04/23/2018] [Indexed: 12/23/2022]
Abstract
Depression and panic disorder (PD) share the common pathophysiology from the perspectives of neurotransmitters. The relatively high comorbidity between depression and PD contributes to the substantial obstacles to differentiate from depression and PD, especially for the brain pathophysiology. There are significant differences in the diagnostic criteria between depression and PD. However, the paradox of similar pathophysiology and different diagnostic criteria in these two disorders were still the issues needing to be addressed. Therefore the clarification of potential difference in the field of neuroscience and pathophysiology between depression and PD can help the clinicians and scientists to understand more comprehensively about significant differences between depression and PD. The researchers should be curious about the underlying difference of pathophysiology beneath the significant distinction of clinical symptoms. In this review article, I tried to find some evidences for the differences between depression and PD, especially for neural markers revealed by magnetic resonance imaging (MRI). The distinctions of structural and functional alterations in depression and PD are reviewed. From the structural perspectives, PD seems to have less severe gray matter alterations in frontal and temporal lobes than depression. The study of white matter microintegrity reveals more widespread alterations in fronto-limbic circuit of depression patients than PD patients, such as the uncinate fasciculus and anterior thalamic radiation. PD might have a more restrictive pattern of structural alterations when compared to depression. For the functional perspectives, the core site of depression pathophysiology is the anterior subnetwork of resting-state network, such as anterior cingulate cortex, which is not significantly altered in PD. A possibly emerging pattern of fronto-limbic distinction between depression and PD has been revealed by these explorative reports. The future trend for machine learning and pattern recognition might confirm the differentiation pattern between depression and PD based on the explorative results.
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16
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Østergaard L, Jørgensen MB, Knudsen GM. Low on energy? An energy supply-demand perspective on stress and depression. Neurosci Biobehav Rev 2018; 94:248-270. [DOI: 10.1016/j.neubiorev.2018.08.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 07/09/2018] [Accepted: 08/13/2018] [Indexed: 12/17/2022]
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17
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Gbyl K, Videbech P. Electroconvulsive therapy increases brain volume in major depression: a systematic review and meta-analysis. Acta Psychiatr Scand 2018; 138:180-195. [PMID: 29707778 DOI: 10.1111/acps.12884] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/08/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The main purpose of this review was to synthesise evidence on ECT's effects on brain's structure. METHOD A systematic literature review of longitudinal studies of depressed patients treated with ECT using magnetic resonance imaging (MRI) and meta-analysis of ECT's effect on hippocampal volume. RESULTS Thirty-two studies with 467 patients and 285 controls were included. The MRI studies did not find any evidence of ECT-related brain damage. All but one of the newer MRI volumetric studies found ECT-induced volume increases in certain brain areas, most consistently in hippocampus. Meta-analysis of effect of ECT on hippocampal volume yielded pooled effect size: g = 0.39 (95% CI = 0.18-0.61) for the right hippocampus and g = 0.31 (95% CI = 0.09-0.53) for the left. The DTI studies point to an ECT-induced increase in the integrity of white matter pathways in the frontal and temporal lobes. The results of correlations between volume increases and treatment efficacy were inconsistent. CONCLUSION The MRI studies do not support the hypothesis that ECT causes brain damage; on the contrary, the treatment induces volume increases in fronto-limbic areas. Further studies should explore the relationship between these increases and treatment effect and cognitive side effects.
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Affiliation(s)
- K Gbyl
- Centre for Neuropsychiatric Depression Research, Mental Health Centre Glostrup, Glostrup, Denmark
| | - P Videbech
- Centre for Neuropsychiatric Depression Research, Mental Health Centre Glostrup, Glostrup, Denmark
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18
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Wassertheil-Smoller S, Qi Q, Dave T, Mitchell BD, Jackson RD, Liu S, Park K, Salinas J, Dunn EC, Leira EC, Xu H, Ryan K, Smoller JW. Polygenic Risk for Depression Increases Risk of Ischemic Stroke: From the Stroke Genetics Network Study. Stroke 2018; 49:543-548. [PMID: 29438084 PMCID: PMC5909718 DOI: 10.1161/strokeaha.117.018857] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 12/11/2017] [Accepted: 12/20/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE Although depression is a risk factor for stroke in large prospective studies, it is unknown whether these conditions have a shared genetic basis. METHODS We applied a polygenic risk score (PRS) for major depressive disorder derived from European ancestry analyses by the Psychiatric Genomics Consortium to a genome-wide association study of ischemic stroke in the Stroke Genetics Network of National Institute of Neurological Disorders and Stroke. Included in separate analyses were 12 577 stroke cases and 25 643 controls of European ancestry and 1353 cases and 2383 controls of African ancestry. We examined the association between depression PRS and ischemic stroke overall and with pathogenic subtypes using logistic regression analyses. RESULTS The depression PRS was associated with higher risk of ischemic stroke overall in both European (P=0.025) and African ancestry (P=0.011) samples from the Stroke Genetics Network. Ischemic stroke risk increased by 3.0% (odds ratio, 1.03; 95% confidence interval, 1.00-1.05) for every 1 SD increase in PRS for those of European ancestry and by 8% (odds ratio, 1.08; 95% confidence interval, 1.04-1.13) for those of African ancestry. Among stroke subtypes, elevated risk of small artery occlusion was observed in both European and African ancestry samples. Depression PRS was also associated with higher risk of cardioembolic stroke in European ancestry and large artery atherosclerosis in African ancestry persons. CONCLUSIONS Higher polygenic risk for major depressive disorder is associated with increased risk of ischemic stroke overall and with small artery occlusion. Additional associations with ischemic stroke subtypes differed by ancestry.
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Affiliation(s)
- Sylvia Wassertheil-Smoller
- From the Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (S.W.-S., Q.Q.); University of Maryland School of Medicine, Baltimore (T.D., B.D.M., H.X., K.R.); Department of Medicine, Ohio State University, Columbus (R.D.J.); Department of Epidemiology (S.L.) and Department of Medicine (S.L.), Brown School of Public Health and Alpert Medical School, Providence, RI; Division of Cardiology, University of Florida, Gainesville (K.P.); Department of Neurology (J.S.) and Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Center for Genomic Medicine (E.C.D., J.W.S.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology, Carver College of Medicine (E.C.L.) and Department of Epidemiology, College of Public Health (E.C.L.), University of Iowa, Iowa City.
| | - Qibin Qi
- From the Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (S.W.-S., Q.Q.); University of Maryland School of Medicine, Baltimore (T.D., B.D.M., H.X., K.R.); Department of Medicine, Ohio State University, Columbus (R.D.J.); Department of Epidemiology (S.L.) and Department of Medicine (S.L.), Brown School of Public Health and Alpert Medical School, Providence, RI; Division of Cardiology, University of Florida, Gainesville (K.P.); Department of Neurology (J.S.) and Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Center for Genomic Medicine (E.C.D., J.W.S.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology, Carver College of Medicine (E.C.L.) and Department of Epidemiology, College of Public Health (E.C.L.), University of Iowa, Iowa City
| | - Tushar Dave
- From the Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (S.W.-S., Q.Q.); University of Maryland School of Medicine, Baltimore (T.D., B.D.M., H.X., K.R.); Department of Medicine, Ohio State University, Columbus (R.D.J.); Department of Epidemiology (S.L.) and Department of Medicine (S.L.), Brown School of Public Health and Alpert Medical School, Providence, RI; Division of Cardiology, University of Florida, Gainesville (K.P.); Department of Neurology (J.S.) and Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Center for Genomic Medicine (E.C.D., J.W.S.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology, Carver College of Medicine (E.C.L.) and Department of Epidemiology, College of Public Health (E.C.L.), University of Iowa, Iowa City
| | - Braxton D Mitchell
- From the Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (S.W.-S., Q.Q.); University of Maryland School of Medicine, Baltimore (T.D., B.D.M., H.X., K.R.); Department of Medicine, Ohio State University, Columbus (R.D.J.); Department of Epidemiology (S.L.) and Department of Medicine (S.L.), Brown School of Public Health and Alpert Medical School, Providence, RI; Division of Cardiology, University of Florida, Gainesville (K.P.); Department of Neurology (J.S.) and Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Center for Genomic Medicine (E.C.D., J.W.S.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology, Carver College of Medicine (E.C.L.) and Department of Epidemiology, College of Public Health (E.C.L.), University of Iowa, Iowa City
| | - Rebecca D Jackson
- From the Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (S.W.-S., Q.Q.); University of Maryland School of Medicine, Baltimore (T.D., B.D.M., H.X., K.R.); Department of Medicine, Ohio State University, Columbus (R.D.J.); Department of Epidemiology (S.L.) and Department of Medicine (S.L.), Brown School of Public Health and Alpert Medical School, Providence, RI; Division of Cardiology, University of Florida, Gainesville (K.P.); Department of Neurology (J.S.) and Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Center for Genomic Medicine (E.C.D., J.W.S.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology, Carver College of Medicine (E.C.L.) and Department of Epidemiology, College of Public Health (E.C.L.), University of Iowa, Iowa City
| | - Simin Liu
- From the Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (S.W.-S., Q.Q.); University of Maryland School of Medicine, Baltimore (T.D., B.D.M., H.X., K.R.); Department of Medicine, Ohio State University, Columbus (R.D.J.); Department of Epidemiology (S.L.) and Department of Medicine (S.L.), Brown School of Public Health and Alpert Medical School, Providence, RI; Division of Cardiology, University of Florida, Gainesville (K.P.); Department of Neurology (J.S.) and Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Center for Genomic Medicine (E.C.D., J.W.S.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology, Carver College of Medicine (E.C.L.) and Department of Epidemiology, College of Public Health (E.C.L.), University of Iowa, Iowa City
| | - Ki Park
- From the Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (S.W.-S., Q.Q.); University of Maryland School of Medicine, Baltimore (T.D., B.D.M., H.X., K.R.); Department of Medicine, Ohio State University, Columbus (R.D.J.); Department of Epidemiology (S.L.) and Department of Medicine (S.L.), Brown School of Public Health and Alpert Medical School, Providence, RI; Division of Cardiology, University of Florida, Gainesville (K.P.); Department of Neurology (J.S.) and Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Center for Genomic Medicine (E.C.D., J.W.S.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology, Carver College of Medicine (E.C.L.) and Department of Epidemiology, College of Public Health (E.C.L.), University of Iowa, Iowa City
| | - Joel Salinas
- From the Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (S.W.-S., Q.Q.); University of Maryland School of Medicine, Baltimore (T.D., B.D.M., H.X., K.R.); Department of Medicine, Ohio State University, Columbus (R.D.J.); Department of Epidemiology (S.L.) and Department of Medicine (S.L.), Brown School of Public Health and Alpert Medical School, Providence, RI; Division of Cardiology, University of Florida, Gainesville (K.P.); Department of Neurology (J.S.) and Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Center for Genomic Medicine (E.C.D., J.W.S.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology, Carver College of Medicine (E.C.L.) and Department of Epidemiology, College of Public Health (E.C.L.), University of Iowa, Iowa City
| | - Erin C Dunn
- From the Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (S.W.-S., Q.Q.); University of Maryland School of Medicine, Baltimore (T.D., B.D.M., H.X., K.R.); Department of Medicine, Ohio State University, Columbus (R.D.J.); Department of Epidemiology (S.L.) and Department of Medicine (S.L.), Brown School of Public Health and Alpert Medical School, Providence, RI; Division of Cardiology, University of Florida, Gainesville (K.P.); Department of Neurology (J.S.) and Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Center for Genomic Medicine (E.C.D., J.W.S.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology, Carver College of Medicine (E.C.L.) and Department of Epidemiology, College of Public Health (E.C.L.), University of Iowa, Iowa City
| | - Enrique C Leira
- From the Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (S.W.-S., Q.Q.); University of Maryland School of Medicine, Baltimore (T.D., B.D.M., H.X., K.R.); Department of Medicine, Ohio State University, Columbus (R.D.J.); Department of Epidemiology (S.L.) and Department of Medicine (S.L.), Brown School of Public Health and Alpert Medical School, Providence, RI; Division of Cardiology, University of Florida, Gainesville (K.P.); Department of Neurology (J.S.) and Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Center for Genomic Medicine (E.C.D., J.W.S.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology, Carver College of Medicine (E.C.L.) and Department of Epidemiology, College of Public Health (E.C.L.), University of Iowa, Iowa City
| | - Huichun Xu
- From the Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (S.W.-S., Q.Q.); University of Maryland School of Medicine, Baltimore (T.D., B.D.M., H.X., K.R.); Department of Medicine, Ohio State University, Columbus (R.D.J.); Department of Epidemiology (S.L.) and Department of Medicine (S.L.), Brown School of Public Health and Alpert Medical School, Providence, RI; Division of Cardiology, University of Florida, Gainesville (K.P.); Department of Neurology (J.S.) and Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Center for Genomic Medicine (E.C.D., J.W.S.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology, Carver College of Medicine (E.C.L.) and Department of Epidemiology, College of Public Health (E.C.L.), University of Iowa, Iowa City
| | - Kathleen Ryan
- From the Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (S.W.-S., Q.Q.); University of Maryland School of Medicine, Baltimore (T.D., B.D.M., H.X., K.R.); Department of Medicine, Ohio State University, Columbus (R.D.J.); Department of Epidemiology (S.L.) and Department of Medicine (S.L.), Brown School of Public Health and Alpert Medical School, Providence, RI; Division of Cardiology, University of Florida, Gainesville (K.P.); Department of Neurology (J.S.) and Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Center for Genomic Medicine (E.C.D., J.W.S.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology, Carver College of Medicine (E.C.L.) and Department of Epidemiology, College of Public Health (E.C.L.), University of Iowa, Iowa City
| | - Jordan W Smoller
- From the Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (S.W.-S., Q.Q.); University of Maryland School of Medicine, Baltimore (T.D., B.D.M., H.X., K.R.); Department of Medicine, Ohio State University, Columbus (R.D.J.); Department of Epidemiology (S.L.) and Department of Medicine (S.L.), Brown School of Public Health and Alpert Medical School, Providence, RI; Division of Cardiology, University of Florida, Gainesville (K.P.); Department of Neurology (J.S.) and Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Center for Genomic Medicine (E.C.D., J.W.S.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology, Carver College of Medicine (E.C.L.) and Department of Epidemiology, College of Public Health (E.C.L.), University of Iowa, Iowa City
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19
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Tully PJ, Debette S, Mazoyer B, Tzourio C. White Matter Lesions are Associated with Specific Depressive Symptom Trajectories among Incident Depression and Dementia Populations: Three-City Dijon MRI Study. Am J Geriatr Psychiatry 2017; 25:1311-1321. [PMID: 28688824 DOI: 10.1016/j.jagp.2017.06.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 04/27/2017] [Accepted: 06/02/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Evidence is mixed as to whether periventricular or deep white matter hyperintensities (WMHs) increase the risk for depressive symptoms, partly because of heterogeneity in depression measurement, short follow-up, and confounding by prodromal dementia. The study objective was to evaluate WMH volume in relation to discrete depressive symptoms over 10 years, stratifying by incident depression and dementia. METHODS In this prospective longitudinal cohort study of a representative population sample from Dijon, France, 1,440 participants aged 65-80 years (median age: 72 years; 59.5% women) without depression, dementia, or stroke at baseline were studied. Baseline T2-weighted images were obtained in a 1.5-T scanner to quantify WMHs (log cm3). Clinic visits were performed up to five times in a 10-year period to assess incident neurologic diseases and comorbidities. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale and converted to factor z scores, representing somatic symptoms, depressed affect, low positive affect, and interpersonal problems. RESULTS Periventricular WMH volume was uniquely associated with low positive affect among incident depression cases (β = 0.15; 95% confidence interval [CI]: 0.02-0.29; p = 0.026). Deep WMH volume was uniquely associated with depressed affect among incident dementia cases (β = 0.36; 95% CI: 0.05-0.68; p = 0.025). WMH volume (periventricular, deep, and total) was associated with interpersonal problems among persons who developed dementia with depression. CONCLUSION The findings highlight that regional WMH volumes and specific depressive symptoms have clinical and prognostic relevance to help differentiate between persons at risk for depression and dementia.
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Affiliation(s)
- Phillip J Tully
- Bordeaux Population Health, University of Bordeaux, INSERM U1219, Bordeaux, France; Department of Neuroepidemiology, University of Bordeaux, INSERM U1219, Bordeaux, France; Freemasons Foundation Centre for Men's Health, Discipline of Medicine, School of Medicine, University of Adelaide, Adelaide, Australia.
| | - Stephanie Debette
- Bordeaux Population Health, University of Bordeaux, INSERM U1219, Bordeaux, France; Department of Neuroepidemiology, University of Bordeaux, INSERM U1219, Bordeaux, France; Department of Neurology, Bordeaux University Hospital, Bordeaux, France; Department of Neurology, Framingham Heart Study, Boston University School of Medicine, Boston, MA
| | - Bernard Mazoyer
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, Bordeaux, France
| | - Christophe Tzourio
- Bordeaux Population Health, University of Bordeaux, INSERM U1219, Bordeaux, France; Department of Neuroepidemiology, University of Bordeaux, INSERM U1219, Bordeaux, France
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20
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Wu M, Aizenstein HJ. The Multi-Faceted Relationship between White Matter Lesions and Late-Life Depression. Am J Geriatr Psychiatry 2017; 25:1322-1325. [PMID: 29050911 PMCID: PMC10833147 DOI: 10.1016/j.jagp.2017.09.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 09/14/2017] [Indexed: 11/20/2022]
Affiliation(s)
- Minjie Wu
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Howard J Aizenstein
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA.
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21
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Park JH. Vascular Contributions to Late Life Depression. Curr Behav Neurosci Rep 2017. [DOI: 10.1007/s40473-017-0128-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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22
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Xiao Q, Wang F, Luo Y, Chen L, Chao F, Tan C, Gao Y, Huang C, Zhang L, Liang X, Tang J, Qi Y, Jiang L, Zhang Y, Zhou C, Tang Y. Exercise protects myelinated fibers of white matter in a rat model of depression. J Comp Neurol 2017; 526:537-549. [PMID: 29098693 DOI: 10.1002/cne.24350] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 10/21/2017] [Accepted: 10/24/2017] [Indexed: 12/14/2022]
Abstract
The antidepressive effects of exercise have been a focus of research and are hypothesized to remodel the brain networks constructed by myelinated fibers. However, whether the antidepressant effects of exercise are dependent on changes in white matter myelination are unknown. Therefore, we chose chronic unpredictable stress (CUS) as a model of depression and designed an experiment. After a 4-week CUS period, 40 animals were tested using the sucrose preference test (SPT) and the open field test (OFT). The depressed rats then underwent 4-week running exercise. Next, electron microscopy and unbiased stereological methods were used to investigate white matter changes in the rats. After the 4-week CUS stimulation, body weight, sucrose preference and scores on the OFT were significantly lower in the depression rats than in the unstressed rats (p < .05). After undergoing a 4-week running exercise, the depression rats showed a significantly greater sucrose preference than the depression control rats without running exercise (p < .05). Furthermore, the white matter parameters of the depression rats (including the white matter volumes, the length and volumes of myelinated fibers, and the volumes and thickness of the myelin sheaths) were significantly reduced after the CUS period (p < .05). However, these white matter parameters were significantly increased after running exercise (p < .05). The present study is the first to provide evidence that running exercise has positive effects on white matter and the myelinated fibers of white matter in depressed rats, and this evidence might provide an important theoretical basis for the exercise-mediated treatment of depression.
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Affiliation(s)
- Qian Xiao
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P.R. China.,Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing, P.R. China.,Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine, Ministry of Education, Chongqing Medical University, Chongqing, P.R. China
| | - Feifei Wang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P.R. China.,Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing, P.R. China
| | - Yanmin Luo
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P.R. China.,Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing, P.R. China.,Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine, Ministry of Education, Chongqing Medical University, Chongqing, P.R. China
| | - Linmu Chen
- Department of Pharmacy, Chongqing Medical University, Chongqing, P.R. China
| | - Fenglei Chao
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P.R. China.,Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing, P.R. China
| | - Chuanxue Tan
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P.R. China.,Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing, P.R. China
| | - Yuan Gao
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P.R. China.,Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing, P.R. China.,Department of Geriatrics, The First Affiliated Hospital, Chongqing Medical University, Chongqing, P.R. China
| | - Chunxia Huang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P.R. China.,Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing, P.R. China.,Department of Physiology, Chongqing Medical University, Chongqing, P.R. China
| | - Lei Zhang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P.R. China.,Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing, P.R. China
| | - Xin Liang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P.R. China.,Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing, P.R. China
| | - Jing Tang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P.R. China.,Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing, P.R. China
| | - Yingqing Qi
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P.R. China.,Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing, P.R. China
| | - Lin Jiang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P.R. China.,Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing, P.R. China.,Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine, Ministry of Education, Chongqing Medical University, Chongqing, P.R. China
| | - Yi Zhang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P.R. China.,Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing, P.R. China.,Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine, Ministry of Education, Chongqing Medical University, Chongqing, P.R. China
| | - Chunni Zhou
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P.R. China.,Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing, P.R. China.,Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine, Ministry of Education, Chongqing Medical University, Chongqing, P.R. China
| | - Yong Tang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P.R. China.,Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing, P.R. China
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23
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van Agtmaal MJM, Houben AJHM, Pouwer F, Stehouwer CDA, Schram MT. Association of Microvascular Dysfunction With Late-Life Depression: A Systematic Review and Meta-analysis. JAMA Psychiatry 2017; 74:729-739. [PMID: 28564681 PMCID: PMC5710252 DOI: 10.1001/jamapsychiatry.2017.0984] [Citation(s) in RCA: 183] [Impact Index Per Article: 26.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 03/26/2017] [Indexed: 12/14/2022]
Abstract
Importance The etiologic factors of late-life depression are still poorly understood. Recent evidence suggests that microvascular dysfunction is associated with depression, which may have implications for prevention and treatment. However, this association has not been systematically reviewed. Objective To examine the associations of peripheral and cerebral microvascular dysfunction with late-life depression. Data Sources A systematic literature search was conducted in MEDLINE and EMBASE for and longitudinal studies published since inception to October 16, 2016, that assessed the associations between microvascular dysfunction and depression. Study Selection Three independent researchers performed the study selection based on consensus. Inclusion criteria were a study population 40 years of age or older, a validated method of detecting depression, and validated measures of microvascular function. Data Extraction and Synthesis This systematic review and meta-analysis has been registered at PROSPERO (CRD42016049158) and is reported in accordance with the PRISMA and MOOSE guidelines. Data extraction was performed by an independent researcher. Main Outcomes and Measures The following 5 estimates of microvascular dysfunction were considered in participants with or without depression: plasma markers of endothelial function, albuminuria, measurements of skin and muscle microcirculation, retinal arteriolar and venular diameter, and markers for cerebral small vessel disease. Data are reported as pooled odds ratios (ORs) by use of the generic inverse variance method with the use of random-effects models. Results A total of 712 studies were identified; 48 were included in the meta-analysis, of which 8 described longitudinal data. Data from 43 600 participants, 9203 individuals with depression, and 72 441 person-years (mean follow-up, 3.7 years) were available. Higher levels of plasma endothelial biomarkers (soluble intercellular adhesion molecule-1: OR, 1.58; 95% CI, 1.28-1.96), white matter hyperintensities (OR, 1.29; 95% CI, 1.19-1.39), cerebral microbleeds (OR, 1.18; 95% CI, 1.03-1.34), and cerebral (micro)infarctions (OR, 1.30; 95% CI, 1.21-1.39) were associated with depression. Among the studies available, no significant associations of albuminuria and retinal vessel diameters with depression were reported. Longitudinal data showed a significant association of white matter hyperintensities with incident depression (OR, 1.19; 95% CI, 1.09-1.30). Conclusions and Relevance This meta-analysis shows that both the peripheral and cerebral forms of microvascular dysfunction are associated with higher odds of (incident) late-life depression. This finding may have clinical implications because microvascular dysfunction might provide a potential target for the prevention and treatment of depression.
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Affiliation(s)
- Marnix J. M. van Agtmaal
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands
- Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Alfons J. H. M. Houben
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands
- Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Frans Pouwer
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Coen D. A. Stehouwer
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands
- Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Miranda T. Schram
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands
- Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
- Heart and Vascular Center, Maastricht University Medical Center, Maastricht, the Netherlands
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24
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Gao Y, Ma J, Tang J, Liang X, Huang CX, Wang SR, Chen LM, Wang FF, Tan CX, Chao FL, Zhang L, Qiu X, Luo YM, Xiao Q, Du L, Xiao Q, Tang Y. White matter atrophy and myelinated fiber disruption in a rat model of depression. J Comp Neurol 2017; 525:1922-1933. [PMID: 28118485 DOI: 10.1002/cne.24178] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Revised: 01/13/2017] [Accepted: 01/16/2017] [Indexed: 01/17/2023]
Abstract
Brain imaging and postmortem studies have indicated that white matter abnormalities may contribute to the pathology and pathogenesis of depression. However, until now, no study has quantitatively investigated white matter changes in depression in rats. The current study used the chronic unpredictable stress (CUS) model of depression. Body weight and sucrose preference test (SPT) scores were assessed weekly. Upon successfully establishing the CUS animal model, all animals were tested using the SPT and the open field test (OFT). Then, transmission electron microscopy and unbiased stereological methods were used to investigate white matter changes in the rats. Compared with the control group, the body weight and sucrose preference of the CUS rats were significantly decreased (p < .001, p < .001, respectively). In the OFT, the total time spent and the total distance traveled in the inner area by the CUS rats were significantly lower than those of the control group (p = .002, p = .001, respectively). The stereological results revealed that white matter volume, the total volume, and the total length and mean diameter of myelinated fibers in the white matter of the CUS rats were significantly decreased compared to the control rats (p = .042, p = .038, p = .035, p = .019, respectively). The results of this study suggested that white matter atrophy and disruption of myelinated fibers in the white matter may contribute to the pathophysiology underlying depression, which might provide new targets for the development of novel therapeutic interventions for depression.
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Affiliation(s)
- Yuan Gao
- Department of Geriatrics, The First Affiliated Hospital, Chongqing Medical University, Chongqing, P. R. China.,Department of Histology and Embryology, Chongqing Medical University, Chongqing, P. R. China.,Laboratory of Stem Cells and Tissue Engineering, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing, P. R. China
| | - Jing Ma
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P. R. China.,Laboratory of Stem Cells and Tissue Engineering, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing, P. R. China
| | - Jing Tang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P. R. China.,Laboratory of Stem Cells and Tissue Engineering, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing, P. R. China
| | - Xin Liang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P. R. China.,Laboratory of Stem Cells and Tissue Engineering, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing, P. R. China
| | - Chun-Xia Huang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P. R. China.,Laboratory of Stem Cells and Tissue Engineering, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing, P. R. China.,Department of Physiology, Chongqing Medical University, Chongqing, P. R. China
| | - San-Rong Wang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P. R. China.,Laboratory of Stem Cells and Tissue Engineering, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing, P. R. China
| | - Lin-Mu Chen
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P. R. China.,Laboratory of Stem Cells and Tissue Engineering, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing, P. R. China
| | - Fei-Fei Wang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P. R. China.,Laboratory of Stem Cells and Tissue Engineering, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing, P. R. China
| | - Chuan-Xue Tan
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P. R. China.,Laboratory of Stem Cells and Tissue Engineering, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing, P. R. China
| | - Feng-Lei Chao
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P. R. China.,Laboratory of Stem Cells and Tissue Engineering, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing, P. R. China
| | - Lei Zhang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P. R. China.,Laboratory of Stem Cells and Tissue Engineering, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing, P. R. China
| | - Xuan Qiu
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P. R. China.,Laboratory of Stem Cells and Tissue Engineering, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing, P. R. China
| | - Yan-Min Luo
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P. R. China.,Laboratory of Stem Cells and Tissue Engineering, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing, P. R. China
| | - Qian Xiao
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P. R. China.,Laboratory of Stem Cells and Tissue Engineering, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing, P. R. China
| | - Lian Du
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P. R. China.,Laboratory of Stem Cells and Tissue Engineering, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing, P. R. China.,Department of Psychiatry, The First Affiliated Hospital, Chongqing Medical University, Chongqing, P. R. China
| | - Qian Xiao
- Department of Geriatrics, The First Affiliated Hospital, Chongqing Medical University, Chongqing, P. R. China
| | - Yong Tang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, P. R. China.,Laboratory of Stem Cells and Tissue Engineering, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing, P. R. China
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25
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Choi WH, Jung WS, Um YH, Lee CU, Park YH, Lim HK. Cerebral vascular burden on hippocampal subfields in first-onset drug-naïve subjects with late-onset depression. J Affect Disord 2017; 208:47-53. [PMID: 27744126 DOI: 10.1016/j.jad.2016.08.070] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 08/24/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Although there is substantial evidence of associations between frontal-striatal circuits and cerebral vascular burden in late-onset depression (LOD), relationships between vascular burden and hippocampal subfields are not clear. The purpose of this study was to investigate relationships between cerebral vascular burden and hippocampal subfield volume in LOD patients. METHODS Fifty subjects with LOD and 50 group-matched healthy control subjects underwent magnetic resonance imaging scanning. Hippocampal subfields volumes were measured and compared between the groups. In addition, association patterns between white matter hyperintensity (WMH) volumes, clinical measures and hippocampal subfield volumes were investigated in the LOD group. RESULTS Subjects with LOD exhibited significant hippocampal volume reductions in the total hippocampus, cornu ammonis (CA) 1 and 3 and dentate gyrus (DG) areas compared with healthy subjects. Total WMH volume was negatively correlated with left total hippocampal volume and CA1 in the LOD group. In addition, depression severity was negatively associated with left and right CA3 volumes in the LOD group. LIMITATION Our findings of distinctive relationships between WMH and hippocampal subfields demonstrate a simple correlation, but do not prove causation CONCLUSION: This study is the first to elaborate distinctive association patterns between hippocampal subfield volumes and cerebral vascular burden in LOD. These structural changes in the hippocampal CA1, CA3 and DG areas might be at the core of the underlying neurobiological mechanisms of hippocampal dysfunction in LOD. However, longitudinal studies will be needed to identify the mechanisms of these structural changes.
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Affiliation(s)
- Woo Hee Choi
- Department of Radiology, Division of Nuclear Medicine The Saint Vincent Hospital, The College of Medicine, The Catholic University of Korea, Republic of Korea
| | - Won Sang Jung
- Department of Radiology The Saint Vincent Hospital, The College of Medicine, The Catholic University of Korea, Republic of Korea
| | - Yoo Hyun Um
- Department of Psychiatry, The Saint Vincent Hospital, The College of Medicine, The Catholic University of Korea, Republic of Korea
| | - Chang Uk Lee
- Department of Psychiatry, The Seoul St. Mary's Hospital, The College of Medicine, The Catholic University of Korea, Republic of Korea
| | - Young Ha Park
- Department of Radiology, Division of Nuclear Medicine The Saint Vincent Hospital, The College of Medicine, The Catholic University of Korea, Republic of Korea
| | - Hyun Kook Lim
- Department of Psychiatry, The Saint Vincent Hospital, The College of Medicine, The Catholic University of Korea, Republic of Korea.
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26
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Aizenstein HJ, Baskys A, Boldrini M, Butters MA, Diniz BS, Jaiswal MK, Jellinger KA, Kruglov LS, Meshandin IA, Mijajlovic MD, Niklewski G, Pospos S, Raju K, Richter K, Steffens DC, Taylor WD, Tene O. Vascular depression consensus report - a critical update. BMC Med 2016; 14:161. [PMID: 27806704 PMCID: PMC5093970 DOI: 10.1186/s12916-016-0720-5] [Citation(s) in RCA: 144] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 10/14/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Vascular depression is regarded as a subtype of late-life depression characterized by a distinct clinical presentation and an association with cerebrovascular damage. Although the term is commonly used in research settings, widely accepted diagnostic criteria are lacking and vascular depression is absent from formal psychiatric manuals such as the Diagnostic and Statistical Manual of Mental Disorders, 5th edition - a fact that limits its use in clinical settings. Magnetic resonance imaging (MRI) techniques, showing a variety of cerebrovascular lesions, including extensive white matter hyperintensities, subcortical microvascular lesions, lacunes, and microinfarcts, in patients with late life depression, led to the introduction of the term "MRI-defined vascular depression". DISCUSSION This diagnosis, based on clinical and MRI findings, suggests that vascular lesions lead to depression by disruption of frontal-subcortical-limbic networks involved in mood regulation. However, despite multiple MRI approaches to shed light on the spatiotemporal structural changes associated with late life depression, the causal relationship between brain changes, related lesions, and late life depression remains controversial. While postmortem studies of elderly persons who died from suicide revealed lacunes, small vessel, and Alzheimer-related pathologies, recent autopsy data challenged the role of these lesions in the pathogenesis of vascular depression. Current data propose that the vascular depression connotation should be reserved for depressed older patients with vascular pathology and evident cerebral involvement. Based on current knowledge, the correlations between intra vitam neuroimaging findings and their postmortem validity as well as the role of peripheral markers of vascular disease in late life depression are discussed. CONCLUSION The multifold pathogenesis of vascular depression as a possible subtype of late life depression needs further elucidation. There is a need for correlative clinical, intra vitam structural and functional MRI as well as postmortem MRI and neuropathological studies in order to confirm the relationship between clinical symptomatology and changes in specific brain regions related to depression. To elucidate the causal relationship between regional vascular brain changes and vascular depression, animal models could be helpful. Current treatment options include a combination of vasoactive drugs and antidepressants, but the outcomes are still unsatisfying.
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Affiliation(s)
- Howard J Aizenstein
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Andrius Baskys
- Memory Disorders Clinic, Riverside Psychiatric Medical Group, Riverside, CA, USA
| | - Maura Boldrini
- Department of Psychiatry, Columbia University, New York, NY, USA.,Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
| | - Meryl A Butters
- Department of Psychiatry, University of Pittsburgh Medical School, Pittsburgh, PA, USA
| | - Breno S Diniz
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Manoj Kumar Jaiswal
- Department of Psychiatry, Columbia University, New York, NY, USA.,Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - Kurt A Jellinger
- Institute of Clinical Neurobiology, Alberichgasse 5/13, Vienna, A-1150, Austria.
| | - Lev S Kruglov
- Department of Geriatric Psychiatry of the St. Petersburg Psychoneurological Research Institute named after V. M. Bekhterev, Medical Faculty of St. Petersburg University, St. Petersburg, Russia
| | - Ivan A Meshandin
- Clinical Department, Scientific and Practical Center of Psychoneurology named after V. M. Soloviev, St. Petersburg, Russia
| | - Milija D Mijajlovic
- Neurology Clinic, Clinical Center of Serbia, School of Medicine University of Belgrade, Belgrade, Serbia
| | - Guenter Niklewski
- University Clinic for Psychiatry and Psychotherapy, Paracelsus Private Medical University, Nuremberg, Germany
| | - Sarah Pospos
- Memory Disorders Clinic, Riverside Psychiatric Medical Group, Riverside, CA, USA
| | - Keerthy Raju
- Consultant in Old Age Psychiatry, Cheshire and Wirral Partnership NHS Foundation Trust, Chester, UK
| | - Kneginja Richter
- University Clinic for Psychiatry and Psychotherapy, Paracelsus Private Medical University, Nuremberg, Germany.,Faculty for Social Sciences, Technical University of Nuremberg Georg Simon Ohm, Nuremberg, Germany
| | - David C Steffens
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, USA
| | - Warren D Taylor
- Department of Psychiatry, The Center for Cognitive Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Veterans Affairs Medical Center, The Geriatric Research, Education, and Clinical Center (GRECC), Tennessee Valley Healthcare System, Nashville, TN, USA
| | - Oren Tene
- Departments of Neurology and Psychiatry, Tel Aviv Medical Center, Tel Aviv, Israel.,Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv, Israel
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27
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Chen Z, Peng W, Sun H, Kuang W, Li W, Jia Z, Gong Q. High-field magnetic resonance imaging of structural alterations in first-episode, drug-naive patients with major depressive disorder. Transl Psychiatry 2016; 6:e942. [PMID: 27824357 PMCID: PMC5314121 DOI: 10.1038/tp.2016.209] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 05/21/2016] [Accepted: 09/14/2016] [Indexed: 02/05/2023] Open
Abstract
Previous structural imaging studies have found evidence of brain morphometric changes in patients with major depressive disorder (MDD), but these studies rarely excluded compounding effects of certain important factors, such as medications and long duration of illnesses. Furthermore, the neurobiological mechanism of the macroscopic findings of structural alterations in MDD patients remains unclear. In this study, we utilized magnetization transfer imaging, a quantitative measure of the macromolecular structural integrity of brain tissue, to identify biophysical alterations, which are represented by a magnetization transfer ratio (MTR), in MDD patients. To ascertain whether MTR changes occur independent of volume loss, we also conduct voxel-based morphometry (VBM) analysis. The participants included 27 first-episode, drug-naive MDD patients and 28 healthy controls matched for age and gender. Whole-brain voxel-based analysis was used to compare MTR and gray matter volume across groups and to analyse correlations between MTR and age, symptom severity, and illness duration. The patients exhibited significantly lower MTR in the left superior parietal lobule and left middle occipital gyrus compared with healthy controls, which may be related to the attentional and cognitive dysfunction in MDD patients. The VBM analysis revealed significantly increased gray matter volume in right postcentral gyrus in MDD patients. These findings in first-episode, drug-naive MDD patients may reflect microstructural gray matter changes in the parietal and occipital cortices close to illness onset that existed before volume loss, and thus potentially provide important new insight into the early neurobiology of depression.
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Affiliation(s)
- Z Chen
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - W Peng
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - H Sun
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - W Kuang
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, China
| | - W Li
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Z Jia
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China,Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China,Department of nuclear medicine, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China. E-mail:
| | - Q Gong
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China,Department of Psychology, School of Public Administration, Sichuan University, Chengdu, China,Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital, Sichuan University, Chengdu, China. E-mail:
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Abstract
BACKGROUND Previous morphology and diffusion-imaging studies have suggested that structural changes in white matter is an important part of the pathophysiology of obsessive-compulsive disorder (OCD). However, different methodological approaches and the heterogeneity of patient samples question the validity of the findings. Materials and methods In total, 30 patients were matched for age and sex with 30 healthy controls. All participants underwent T1-weighted magnetic resonance imaging, diffusion tensor imaging and T2 fluid-attenuated inversion recovery. Voxel-based morphometry and tract-based spatial statistics were used to compare white matter volumes and diffusion tensor imaging between groups. These data were analysed correcting for the effects of multiple comparisons, age, sex, severity and duration of illness as nuisance covariates. White matter hyperintensities were manually identified. RESULTS Increase in fractional anisotropy in cerebellum was the most prominent result. A decrease in fractional anisotrophy in patients comparable with previous studies was located in forceps minor. There were no differences in the white matter morphology or in the white matter hyperintensities between patients and healthy controls. CONCLUSION Decrease in fractional anisotrophy in forceps minor and increase in cerebellum were found, and they were not due to neither white matter hyperintensities nor morphology of the white matter. Cerebellar hyperconnectivity could be an important part of OCD pathophysiology.
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Meurs M, Roest AM, Groenewold NA, Franssen CFM, Westerhuis R, Kloppenburg WD, Doornbos B, Beukema L, Lindmäe H, de Groot JC, van Tol MJ, de Jonge P. Gray matter volume and white matter lesions in chronic kidney disease: exploring the association with depressive symptoms. Gen Hosp Psychiatry 2016; 40:18-24. [PMID: 27040607 DOI: 10.1016/j.genhosppsych.2016.02.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 02/09/2016] [Accepted: 02/28/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Chronic kidney disease (CKD) is associated with structural brain damage and with a high prevalence of depression. We therefore investigated structural brain alterations in both gray and white matter in CKD patients, focusing on depression-related (frontal-subcortical) regions. METHOD This cross-sectional MRI study in 24 CKD patients and 24 age- and sex-matched controls first tested whether CKD was associated with regionally lower gray matter (GM) volumes and more severe white matter lesions (WMLs). In exploratory subanalyses, we examined whether differences were more pronounced in CKD patients with depressive symptoms. RESULTS CKD patients showed lower global GM volume (P=.04) and more severe WMLs (P=.04) compared to controls. In addition, we found substantial clusters of lower GM in the bilateral orbitofrontal-cortex for CKD patients, which were however nonsignificant after proper multiple-comparison correction. In exploratory analyses for depressed CKD patients, reduced GM clusters were mainly detected within the frontal lobe. WML severity was unrelated to depression. CONCLUSION CKD was characterized by differences in brain structure. Although subthreshold, lower GM volumes were observed in depression-related brain areas and were more pronounced for depressed patients. There is a need for replication in larger and longitudinal studies to investigate whether WMLs and regional GM reductions may render CKD patients more susceptible for depression.
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Affiliation(s)
- Maaike Meurs
- University of Groningen/University Medical Center Groningen, Department of psychiatry - Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), The Netherlands.
| | - Annelieke M Roest
- University of Groningen/University Medical Center Groningen, Department of psychiatry - Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), The Netherlands.
| | - Nynke A Groenewold
- University of Groningen/University Medical Center Groningen, Department of psychiatry - Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), The Netherlands.
| | - Casper F M Franssen
- University of Groningen/University Medical Center Groningen, Department of Internal Medicine, Division of Nephrology, The Netherlands.
| | | | | | - Bennard Doornbos
- University Medical Center Groningen, department of Psychiatry, the Netherlands, GGZ Drenthe, Assen, the Netherlands.
| | - Lindy Beukema
- University of Groningen/University Medical Center Groningen, Department of psychiatry - Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), The Netherlands.
| | - Hanna Lindmäe
- University of Groningen/University Medical Center Groningen, department of Radiology, The Netherlands.
| | - Jan Cees de Groot
- University of Groningen/University Medical Center Groningen, department of Radiology, The Netherlands.
| | - Marie-José van Tol
- University of Groningen/University Medical Center Groningen, Neuroimaging Center, department of Neuroscience, section Cognitive NeuroPsychiatry, The Netherlands.
| | - Peter de Jonge
- University of Groningen/University Medical Center Groningen, Department of psychiatry - Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), The Netherlands.
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Agudelo C, Aizenstein HJ, Karp JF, Reynolds CF. Applications of magnetic resonance imaging for treatment-resistant late-life depression. DIALOGUES IN CLINICAL NEUROSCIENCE 2016. [PMID: 26246790 PMCID: PMC4518699 DOI: 10.31887/dcns.2015.17.2/cagudelo] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Late-life depression (LLD) is a growing public and global health concern with diverse clinical manifestations and etiology. This literature review summarizes neuroimaging findings associated with depression in older adults and treatment-response variability. LLD has been associated with cerebral atrophy, diminished myelin integrity, and cerebral lesions in frontostriatal-limbic regions. These associations help explain the depression-executive dysfunction syndrome observed in LLD, and support cerebrovascular burden as a pathogenic mechanism. Furthermore, this review suggests that neuroimaging determinants of treatment resistance also reflect cerebrovascular burden. Of the theoretical etiologies of LLD, cerebrovascular burden may mediate treatment resistance. This review proposes that neuroimaging has the potential for clinical translation. Controlled trials may identify neuroimaging biomarkers that may inform treatment by identifying depressed adults likely to remit with pharmacotherapy, identifying individualized therapeutic dose, and facilitating earlier treatment response measures. Neuroimaging also has the potential to similarly inform treatment response variability from treatment with aripiprazole (dopamine modulator) and buprenorphine (opiate modulator).
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Affiliation(s)
- Christian Agudelo
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Howard J Aizenstein
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Jordan F Karp
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Charles F Reynolds
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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Lai CH, Wu YT. The White Matter Microintegrity Alterations of Neocortical and Limbic Association Fibers in Major Depressive Disorder and Panic Disorder: The Comparison. Medicine (Baltimore) 2016; 95:e2982. [PMID: 26945417 PMCID: PMC4782901 DOI: 10.1097/md.0000000000002982] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The studies regarding to the comparisons between major depressive disorder (MDD) and panic disorder (PD) in the microintegrity of white matter (WM) are uncommon. Therefore, we tried to a way to classify the MDD and PD. Fifty-three patients with 1st-episode medication-naive PD, 54 healthy controls, and 53 patients with 1st-episode medication-naive MDD were enrolled in this study. The controls and patients were matched for age, gender, education, and handedness. The diffusion tensor imaging scanning was also performed. The WM microintegrity was analyzed and compared between 3 groups of participants (ANOVA analysis) with age and gender as covariates. The MDD group had lower WM microintegrity than the PD group in the left anterior thalamic radiation, left uncinate fasciculus, left inferior fronto-occipital fasciculus, and bilateral corpus callosum. The MDD group had reductions in the microintegrity when compared to controls in the bilateral superior longitudinal fasciculi, inferior longitudinal fasciculi, inferior fronto-occipital fasciculi, and corpus callosum. The PD group had lower microintegrity in bilateral superior longitudinal fasciculi and left inferior fronto-occipital fasciculus when compared to controls. The widespread pattern of microintegrity alterations in fronto-limbic WM circuit for MDD was different from restrictive pattern of alterations for PD.
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Affiliation(s)
- Chien-Han Lai
- From the Department of Psychiatry, Cheng Hsin General Hospital, Taipei City (C-HL); Department of Biomedical Imaging and Radiological Sciences (C-HL, Y-TW); Brain Research Center (Y-TW); and Institute of Biophotonics, National Yang-Ming University (C-HL, Y-TW), Taipei, Taiwan, ROC
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Gade A, Kristoffersen M, Kessing LV. Neuroticism in Remitted Major Depression: Elevated with Early Onset but Not Late Onset of Depression. Psychopathology 2015; 48:400-7. [PMID: 26555606 DOI: 10.1159/000440813] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 09/01/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND The personality trait of neuroticism is strongly related to depression, but depression is etiologically heterogeneous. Late-onset depression (LOD) may be more closely related to vascular factors, and previous studies of neuroticism in LOD versus early-onset depression (EOD) have not been consistent. METHOD We examined neuroticism, extraversion and perceived stress in 88 fully remitted depressed patients with a mean age of 60 years and with a history of hospitalization for major depressive disorder. Patients were divided into those with onset after and those with onset before 50 years of age (LOD and EOD, respectively), and the two groups were compared both with each other and with matched control groups of healthy subjects. RESULTS EOD patients showed increased levels of neuroticism in comparison with both LOD and matched controls, who did not differ. The association between age of onset and neuroticism was confirmed in analyses based on age of depression onset as a continuous variable. CONCLUSION Neuroticism may be an etiological factor in EOD but not or less so in LOD. This finding contributes to the growing evidence for etiological differences between early- and late-onset late-life depression.
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Affiliation(s)
- Anders Gade
- Department of Psychology, Copenhagen University, Copenhagen, Denmark
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33
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Kirton JW, Resnick SM, Davatzikos C, Kraut MA, Dotson VM. Depressive symptoms, symptom dimensions, and white matter lesion volume in older adults: a longitudinal study. Am J Geriatr Psychiatry 2014; 22:1469-77. [PMID: 24211028 PMCID: PMC3984387 DOI: 10.1016/j.jagp.2013.10.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 09/18/2013] [Accepted: 10/07/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVE White matter lesions (WMLs) are associated with depressive symptoms in older adults. However, it is not clear whether different symptom dimensions of depression have distinct associations with WMLs. The authors assessed the longitudinal relationships of the Center for Epidemiologic Studies Depression Scale (CES-D) total score and subscale scores with WML volume in the Baltimore Longitudinal Study of Aging. METHODS Using a prospective observational design, the authors examined WML volume and depressive symptoms at 1- to 2-year intervals for up to 9 years in 116 dementia-free participants (mean age: 68.78 ± 7.68). At each visit, depressive symptoms were measured with the CES-D and WML volumes were quantified from structural magnetic resonance imaging scans. RESULTS Higher CES-D full-scale scores were associated with greater WML volume and with a faster rate of volume increases over time in women, especially at older ages. Higher depressed mood and somatic symptoms subscale scores were associated with greater increases in WML volume over time at older ages. In men, depressed mood and somatic symptoms were associated with larger WML volume at baseline. CONCLUSION Findings confirm an association between WMLs and depressive symptoms and suggest that depressed mood and somatic symptoms may be stronger predictors of depression-related brain changes than lack of well-being. Age and sex may moderate the relationships between depressive symptoms and WMLs. Understanding particular symptom dimensions of depressive symptoms has implications for treatment and may lead to targeted interventions and more precise knowledge of mechanisms underlying depression.
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Affiliation(s)
- Joshua W Kirton
- Department of Clinical & Health Psychology, University of Florida, Gainesville, FL
| | - Susan M Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD
| | - Christos Davatzikos
- Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Michael A Kraut
- Department of Radiology, Johns Hopkins Medical Institutions, Baltimore, MD
| | - Vonetta M Dotson
- Department of Clinical & Health Psychology, University of Florida, Gainesville, FL.
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Fujishima M, Maikusa N, Nakamura K, Nakatsuka M, Matsuda H, Meguro K. Mild cognitive impairment, poor episodic memory, and late-life depression are associated with cerebral cortical thinning and increased white matter hyperintensities. Front Aging Neurosci 2014; 6:306. [PMID: 25426066 PMCID: PMC4224123 DOI: 10.3389/fnagi.2014.00306] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 10/20/2014] [Indexed: 12/22/2022] Open
Abstract
In various independent studies to date, cerebral cortical thickness and white matter hyperintensity (WMH) volume have been associated with episodic memory, depression, and mild cognitive impairment (MCI). The aim of this study was to uncover variations in cortical thickness and WMH volume in association with episodic memory, depressive state, and the presence of MCI simultaneously in a single study population. The participants were 186 individuals with MCI (clinical dementia rating [CDR] of 0.5) and 136 healthy elderly controls (HCs; CDR of 0) drawn from two community-based cohort studies in northern Japan. We computed cerebral cortical thickness and WMH volume by using MR scans and statistically analyzed differences in these indices between HCs and MCI participants. We also assessed the associations of these indices with memory performance and depressive state in participants with MCI. Compared with HCs, MCI participants exhibited thinner cortices in the temporal and inferior parietal lobes and greater WMH volumes in the corona radiata and semioval center. In MCI participants, poor episodic memory was associated with thinner cortices in the left entorhinal region and increased WMH volume in the posterior periventricular regions. Compared with non-depressed MCI participants, depressed MCI participants showed reduced cortical thickness in the anterior medial temporal lobe and gyrus adjacent to the amygdala bilaterally, as well as greater WMH volume as a percentage of the total intracranial volume (WMHr). A higher WMHr was associated with cortical thinning in the frontal, temporal, and parietal regions in MCI participants. These results demonstrate that episodic memory and depression are associated with both cortical thickness and WMH volume in MCI participants. Additional longitudinal studies are needed to clarify the dynamic associations and interactions among these indices.
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Affiliation(s)
- Motonobu Fujishima
- Department of Nuclear Medicine, Saitama Medical University International Medical Center Hidaka, Japan ; Integrative Brain Imaging Center, National Center of Neurology and Psychiatry (NCNP), Kodaira Tokyo, Japan
| | - Norihide Maikusa
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry (NCNP), Kodaira Tokyo, Japan
| | - Kei Nakamura
- Division of Geriatric Behavioral Neurology, Cyclotron and Radioisotope Center, Tohoku University Sendai, Japan
| | - Masahiro Nakatsuka
- Division of Geriatric Behavioral Neurology, Cyclotron and Radioisotope Center, Tohoku University Sendai, Japan
| | - Hiroshi Matsuda
- Department of Nuclear Medicine, Saitama Medical University International Medical Center Hidaka, Japan ; Integrative Brain Imaging Center, National Center of Neurology and Psychiatry (NCNP), Kodaira Tokyo, Japan
| | - Kenichi Meguro
- Division of Geriatric Behavioral Neurology, Cyclotron and Radioisotope Center, Tohoku University Sendai, Japan
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Lai CH, Wu YT. Alterations in white matter micro-integrity of the superior longitudinal fasciculus and anterior thalamic radiation of young adult patients with depression. Psychol Med 2014; 44:2825-2832. [PMID: 25065445 DOI: 10.1017/s0033291714000440] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND This study surveyed the characteristics of white matter (WM) micro-integrity in patients who were diagnosed with major depressive disorder (MDD) without co-morbidities. METHOD A total of 44 patients with MDD and 27 normal controls were enrolled in our study. Diffusion tensor imaging images of patients and controls were pre-processed and analysed to estimate differences in WM micro-integrity between patients and controls by performing comparisons of the values obtained from fractional anisotropy (FA). FA outputs of patients and controls were compared by a non-parametric permutation-based method with global brain volume, age and gender as covariates. In addition, the between-group differences of radial diffusivity (RD) and axial diffusivity (AD) were assessed to explain the alterations in FA values. Correlations between clinical variables (such as depression severity, anxiety severity, illness duration) and FA values were also estimated in each group and across both groups. RESULTS The patients with MDD had significantly lower FA values than the controls, for the left superior longitudinal fasciculus (SLF) and the right anterior thalamic radiation (ATR). The reductions in FA values occurred in combination with elevated RD values in the bilateral SLF and decreased AD values in the bilateral ATR. FA values were negatively correlated with depression severity in the SLF and with illness duration in the right SLF and ATR. CONCLUSIONS MDD patients had significant alterations in the WM micro-integrity of the left SLF and the right ATR.
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Affiliation(s)
- C H Lai
- Department of Psychiatry,Cheng Hsin General Hospital,Taipei City,Taiwan, ROC
| | - Y T Wu
- Department of Biomedical Imaging and Radiological Sciences,National Yang-Ming University,Taipei,Taiwan, ROC
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Wang L, Leonards CO, Sterzer P, Ebinger M. White matter lesions and depression: a systematic review and meta-analysis. J Psychiatr Res 2014; 56:56-64. [PMID: 24948437 DOI: 10.1016/j.jpsychires.2014.05.005] [Citation(s) in RCA: 103] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 03/13/2014] [Accepted: 05/09/2014] [Indexed: 10/25/2022]
Abstract
We sought to determine if an association exists between overall, deep, and periventricular white matter hyperintensities and depression. We searched PubMed (Medline) and Scopus (Embase) from April-October 2012 using the MeSH terms: "White matter lesions" OR "white matter disease" OR "Cerebrovascular Disease" OR "Leukoencephalopathies" AND "Depressive Disorder" AND "magnetic resonance imaging," and "Depression" AND "leukoaraiosis." No language limits were implemented. Hand searching was performed of all included studies and relevant review articles. 913 PubMed and 188 Scopus citations were identified. Relevant, human, non-overlapping magnetic resonance imaging studies were eligible for inclusion if they reported generic data. We extracted the most adjusted odds ratios reported generated from comparing depression across severe (determined either volumetrically or visually) and mild/no white matter lesion groups. 19 reports were included. Cross-sectional subgroup analyses showed that deep white matter hyperintensities significantly associated with depression (N = 2261, odds ratio 1.02, 95% confidence interval 1.00-1.04, p = 0.02), whereas periventricular (N = 3813, odds ratio 1.08, 95% confidence interval 0.99-1.17, p = 0.07) and overall did not (N = 5876, odds ratio 1.12, 95% confidence interval 0.96-1.30, p = 0.14). Overall longitudinal analysis revealed a pooled odds ratio of 1.12 (N = 2015; 95% confidence interval 0.97-1.29; p = 0.13; Q = 7.19, p = 0.07; I2 = 58.3%). Longitudinal subgroup analyses revealed that overall white matter hyperintensities (N = 1882, odds ratio 1.22, 95% confidence interval, 1.06-1.4, p < 0.01) significantly associated with depression but deep did not (N = 660, odds ratio 2.02, 95% confidence interval, 0.56-7.22, p = 0.281). No significant heterogeneity was present in subgroup analyses. In conclusion, we found a significant, but weak association between white matter hyperintensities and depression.
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Affiliation(s)
- Li Wang
- International Graduate Program Medical Neurosciences, Charité - Universitätsmedizin, Berlin, Germany
| | - Christopher O Leonards
- Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin, Berlin, Germany.
| | - Philipp Sterzer
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin, Berlin, Germany
| | - Martin Ebinger
- Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin, Berlin, Germany; Klinik und Poliklinik für Neurologie, Charité - Universitätsmedizin, Berlin, Germany
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Sundseth J, Sundseth A, Thommessen B, Johnsen LG, Altmann M, Sorteberg W, Lindegaard KF, Berg-Johnsen J. Long-Term Outcome and Quality of Life After Craniectomy in Speech-Dominant Swollen Middle Cerebral Artery Infarction. Neurocrit Care 2014; 22:6-14. [DOI: 10.1007/s12028-014-0056-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Depression in the elderly: brain correlates, neuropsychological findings, and role of vascular lesion load. Curr Opin Neurol 2014; 26:656-61. [PMID: 24184971 DOI: 10.1097/wco.0000000000000028] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Late-life depression (LLD) presents in older adults as a heterogeneous mood disorder. Because of the diverse outcomes and symptomatology of LLD, several theories, especially the vascular depression hypothesis, have been proposed to identify its cause. This review outlines the features of LLD and explores the recent advances in characterizing this disorder through studies of brain functioning and cognition, with an emphasis on how vascular changes may mediate this disorder. RECENT FINDINGS LLD is associated with brain changes, including atrophy of hippocampus, independent of other neurodegenerative states. White matter lesions (WMLs) are frequently found in patients with LLD. Functional imaging has revealed both distinct characteristics of LLD and overlap of some cognitive symptoms with other dementias. Executive dysfunction and impaired processing speeds are at the core of the cognitive deficits in LLD and are associated with the development of WMLs in specific fiber tracts in the brain. SUMMARY LLD is associated with brain changes in both gray matter and white matter, including cerebrovascular changes, atrophy, and loss of myelin integrity. These brain changes are associated with age of onset of depression, as well as cumulative life-time depression burden, and can explain the increased dementia risk associated with LLD.
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Cingulum bundle white matter lesions influence antidepressant response in late-life depression: a pilot study. J Affect Disord 2014; 162:8-11. [PMID: 24766997 PMCID: PMC4030539 DOI: 10.1016/j.jad.2014.03.031] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Revised: 03/12/2014] [Accepted: 03/14/2014] [Indexed: 11/23/2022]
Abstract
BACKGROUND Late-life depression is associated with white matter hyperintense lesions (WMLs) occurring in specific fiber tracts. In this study, we sought to determine if greater WML severity in the cingulum bundle or uncinate fasciculus was associated with poor short-term antidepressant response. METHODS Eleven depressed elders completed a baseline cranial 3T MRI and received antidepressant treatment following a medication algorithm. MRIs were analyzed to measure the fraction of each fiber tract׳s volume occupied by WMLs. Statistical analyses examined the effect of dichotomized fiber tract WML severity on three- and six-month depression severity after controlling for age and baseline depression severity. RESULTS Greater WML severity in the left hemispheric cingulum bundle adjacent to the hippocampus was associated with greater post-treatment depression severity at three- (F1,7=6.42, p=0.0390) and six-month assessments (F1,5=9.62, p=0.0268). Other fiber tract WML measures were not significantly associated with outcomes. LIMITATIONS The study had a small sample size and analyses were limited to only a priori fiber tracts. CONCLUSIONS This pilot study supports the hypothesis that focal damage to the cingulum bundle may contribute to poor short-term antidepressant response. These findings warrant further investigation with a larger, more definitive study.
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O'Neill D, Macsweeney CA, Cornell IA, Moss H. Stravinsky syndrome: giving a voice to chronic stroke disease. QJM 2014; 107:489-93. [PMID: 24652653 DOI: 10.1093/qjmed/hcu059] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D O'Neill
- From the Centre for Ageing, Neuroscience and the Humanities, Trinity College Dublin, Tallaght Hospital, Dublin and National Centre for Arts and Health, Tallaght Hospital, Dublin, Ireland
| | - C A Macsweeney
- From the Centre for Ageing, Neuroscience and the Humanities, Trinity College Dublin, Tallaght Hospital, Dublin and National Centre for Arts and Health, Tallaght Hospital, Dublin, Ireland
| | - I A Cornell
- From the Centre for Ageing, Neuroscience and the Humanities, Trinity College Dublin, Tallaght Hospital, Dublin and National Centre for Arts and Health, Tallaght Hospital, Dublin, Ireland
| | - H Moss
- From the Centre for Ageing, Neuroscience and the Humanities, Trinity College Dublin, Tallaght Hospital, Dublin and National Centre for Arts and Health, Tallaght Hospital, Dublin, Ireland
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Wu RH, Feng C, Xu Y, Hua T, Liu XY, Fang M. Late-onset depression in the absence of stroke: associated with silent brain infarctions, microbleeds and lesion locations. Int J Med Sci 2014; 11:587-92. [PMID: 24782647 PMCID: PMC4003543 DOI: 10.7150/ijms.8025] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 03/25/2014] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Late-onset depression (LOD) is a frequent mood disorder among elderly. Previous studies have proved that LOD is associated with cerebral silent lesions especially white matter lesions (WML) and yielded the "vascular depression" hypothesis to explain the pathogenesis of LOD. However, there were relatively few studies about the association between silent brain infarctions (SBIs), microbleeds (MBs) and the prevalence of LOD. In this study we sought to evaluate the presence, accumulation and locations of SBIs and MBs, and explore the possible association between them and LOD. METHODS 65 patients of LOD diagnosed according to DSM-IV and 270 subjects of control group were enrolled and scanned by MRI to analyze the presence, numbers and locations of SBIs and MBs. Clinical and radiological characteristics were compared between LOD patients and control group. Logistic regression models were constructed to identify the independent risk factors for LOD. RESULTS LOD patients had higher prevalence and numbers of both SBIs and MBs. SBIs and MBs in the left hemisphere, SBIs in basal ganglia and lobar MBs were all independent risk factors for LOD. CONCLUSION The presence of both SBIs and MBs were associated with a higher rate LOD. Lesions in some specific locations might be critical for the presence of LOD.
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Affiliation(s)
- Ri-Han Wu
- 1. Department of Neurology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, China
| | - Chao Feng
- 1. Department of Neurology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, China
- 2. Yiwu Affiliated Hospital of Zhejiang University, School of Medicine, Zhejiang, China
| | - Yu Xu
- 3. Department of Radiology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, China
| | - Ting Hua
- 3. Department of Radiology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, China
| | - Xue-Yuan Liu
- 1. Department of Neurology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, China
| | - Min Fang
- 1. Department of Neurology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, China
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Dalby RB, Elfving B, Poulsen PHP, Foldager L, Frandsen J, Videbech P, Rosenberg R. Plasma brain-derived neurotrophic factor and prefrontal white matter integrity in late-onset depression and normal aging. Acta Psychiatr Scand 2013; 128:387-96. [PMID: 23350796 DOI: 10.1111/acps.12085] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/20/2012] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To explore the relationship between brain-derived neurotrophic factor (BDNF) and vascular endothelial growth factor (VEGF), cerebral deep white matter lesions (DWMLs), and measures of white matter integrity in patients with late-onset depression, with respect to vascular risk factors. METHOD We examined 22 patients with late-onset depression and 22 matched controls. Quantification of plasma BDNF and VEGF levels were performed with enzyme-linked immunosorbent assay (ELISA) kits. Measures of white matter integrity comprised apparent diffusion coefficient (ADC) and fractional anisotropy (FA), obtained by diffusion tensor imaging (DTI). Effects of DWMLs, FA, ADC, and vascular risk factors on BDNF and VEGF were assessed using multiple linear regression. RESULTS The BDNF and VEGF levels did not differ significantly between groups. With pooled data for patients and controls, the BDNF level was positively associated with both number (t = 2.14, P = 0.039) and volume (t = 2.04, P = 0.048) of prefrontal DWMLs and negatively associated with FA in prefrontal normal-appearing white matter (t = -2.40, P = 0.02), adjusted for age and gender. Smoking and hypercholesterolemia was positively associated with the BDNF (t = 2.36, P = 0.023) and VEGF levels (t = 2.28, P = 0.028), respectively. CONCLUSION Our results suggest a role for BDNF in the complex pathophysiologic mechanisms underlying DWMLs in both normal aging and late-onset depression.
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Affiliation(s)
- R B Dalby
- Centre for Psychiatric Research, Aarhus University Hospital, Risskov, Denmark; MINDLab, Aarhus University, Aarhus, Denmark
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Taylor WD, Aizenstein HJ, Alexopoulos GS. The vascular depression hypothesis: mechanisms linking vascular disease with depression. Mol Psychiatry 2013; 18:963-74. [PMID: 23439482 PMCID: PMC3674224 DOI: 10.1038/mp.2013.20] [Citation(s) in RCA: 551] [Impact Index Per Article: 50.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 01/09/2013] [Accepted: 01/18/2013] [Indexed: 02/07/2023]
Abstract
The 'Vascular Depression' hypothesis posits that cerebrovascular disease may predispose, precipitate or perpetuate some geriatric depressive syndromes. This hypothesis stimulated much research that has improved our understanding of the complex relationships between late-life depression (LLD), vascular risk factors, and cognition. Succinctly, there are well-established relationships between LLD, vascular risk factors and cerebral hyperintensities, the radiological hallmark of vascular depression. Cognitive dysfunction is common in LLD, particularly executive dysfunction, a finding predictive of poor antidepressant response. Over time, progression of hyperintensities and cognitive deficits predicts a poor course of depression and may reflect underlying worsening of vascular disease. This work laid the foundation for examining the mechanisms by which vascular disease influences brain circuits and influences the development and course of depression. We review data testing the vascular depression hypothesis with a focus on identifying potential underlying vascular mechanisms. We propose a disconnection hypothesis, wherein focal vascular damage and white matter lesion location is a crucial factor, influencing neural connectivity that contributes to clinical symptomatology. We also propose inflammatory and hypoperfusion hypotheses, concepts that link underlying vascular processes with adverse effects on brain function that influence the development of depression. Testing such hypotheses will not only inform the relationship between vascular disease and depression, but also provide guidance on the potential repurposing of pharmacological agents that may improve LLD outcomes.
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Affiliation(s)
- W D Taylor
- Center for Cognitive Medicine, Department of Psychiatry, Vanderbilt University, Nashville, TN 37212, USA.
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Abstract
Neuroimaging, both structural and functional, serve as useful adjuncts to clinical assessment, and can provide objective, reliable means of assessing disease presence and process in the aging population. In the following review we briefly explain current imaging methodologies. Then, we analyze recent developments in developing neuroimaging biomarkers for two highly prevalent disorders in the elderly population- Alzheimer's disease (AD) and late-life depression (LLD). In AD, efforts are focused on early diagnosis through in vivo visualization of disease pathophysiology. In LLD, recent imaging evidence supports the role of white matter ischemic changes in the pathogenesis of depression in the elderly, the "vascular hypothesis." Finally, we discuss potential roles for neuroimaging biomarkers in geriatric psychiatry in the future.
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Affiliation(s)
- Abhisek C Khandai
- University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
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Valkanova V, Ebmeier KP. Vascular risk factors and depression in later life: a systematic review and meta-analysis. Biol Psychiatry 2013; 73:406-13. [PMID: 23237315 DOI: 10.1016/j.biopsych.2012.10.028] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Revised: 10/22/2012] [Accepted: 10/31/2012] [Indexed: 02/07/2023]
Abstract
Reports of the association between cardiovascular risk factors and depression in later life are inconsistent; to establish the nature of their association seems important for prevention and treatment of late-life depression. We searched MEDLINE, EMBASE, and PsycINFO for relevant cohort or case control studies over the last 22 years; 1097 were retrieved; 26 met inclusion criteria. Separate meta-analyses were performed for Risk Factor Composite Scores (RFCS) combining different subsets of risk factors, Framingham Stroke Risk Score, and single factors. We found a positive association (odds ratio [OR]: 1.49; 95% confidence interval [CI]: 1.27-1.75) between RFCS and late-life depression. There was no association between Framingham Stroke Risk Score (OR: 1.25; 95% CI: .99-1.57), hypertension (OR: 1.14; 95% CI: .94-1.40), or dyslipidemia (OR: 1.08; 95% CI: .91-1.28) and late-life depression. The association with smoking was weak (OR: 1.35; 95% CI: 1.00-1.81), whereas positive associations were found with diabetes (OR: 1.51; 95% CI: 1.30-1.76), cardiovascular disease (OR: 1.76; 95% CI: 1.52-2.04), and stroke (OR: 2.11; 95% CI: 1.61-2.77). Moderate to high heterogeneity was found in the results for RFCS, smoking, hypertension, dyslipidemia, and stroke, whereas publication bias was detected for RFCS and diabetes. We therefore found convincing evidence of a strong relationship between key diseases and depression (cardiovascular disease, diabetes, and stroke) and between composite vascular risk and depression but not between some vascular risk factors (hypertension, smoking, dyslipidemia) and depression. More evidence is needed to be accumulated from large longitudinal epidemiological studies, particularly if complemented by neuroimaging.
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Affiliation(s)
- Vyara Valkanova
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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Jellinger KA. Organic bases of late-life depression: a critical update. J Neural Transm (Vienna) 2013; 120:1109-25. [PMID: 23355089 DOI: 10.1007/s00702-012-0945-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Accepted: 11/30/2012] [Indexed: 02/07/2023]
Abstract
Late-life depression (LLD) is frequently associated with cognitive impairment and increases the risk of subsequent dementia. Cerebrovascular disease, deep white matter lesions, Alzheimer disease (AD) and dementia with Lewy bodies (DLB) have all been hypothesized to contribute to this increased risk, and a host of studies have looked at the interplay between cerebrovascular disease and LLD. This has resulted in new concepts of LLD, such as "vascular depression", but despite multiple magnetic resonance imaging (MRI) studies in this field, the relationship between structural changes in human brain and LLD is still controversial. While pathological findings of suicide in some elderly persons revealed multiple lacunes, small vessel cerebrovascular disease, AD-related lesions or multiple neurodegenerative pathologies, recent autopsy data challenged the role of subcortical lacunes and white matter lesions as major morphological substrates of depressive symptoms as well as poorer executive function and memory. Several neuropathological studies, including a personal clinico-pathological study in a small cohort of elderly persons with LLD and age-matched controls confirmed that lacunes, periventricular and deep white matter demyelination as well as AD-related lesions are usually unrelated to the occurrence of LLD. In the same line, neuropathological data show that early-onset depression is not associated with an acceleration of age-related neurodegenerative changes. Very recent data on the critical role of glia-modulating neuronal dysfunction and degeneration in depression are discussed.
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Affiliation(s)
- Kurt A Jellinger
- Institute of Clinical Neurobiology, Kenyongasse 18, 1070 Vienna, Austria.
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Dotson VM, Zonderman AB, Kraut MA, Resnick SM. Temporal relationships between depressive symptoms and white matter hyperintensities in older men and women. Int J Geriatr Psychiatry 2013; 28:66-74. [PMID: 22415749 PMCID: PMC3851322 DOI: 10.1002/gps.3791] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2011] [Accepted: 01/24/2011] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Associations between vascular disease and depression in late life, including increased white matter hyperintensities (WMHs), have been reported. Whether depression is an etiology or a consequence of vascular disease is still unknown. We investigated the temporal relationship between depressive symptoms and WMHs in older men and women. METHODS We utilized data from 90 dementia-free older adults (39 women, 51 men), 57 years of age and older at baseline, from the neuroimaging substudy of the Baltimore Longitudinal Study of Aging. Participants were followed for up to 8 years. Ratings of white matter disease burden were available for the first, last, and at least one interim visit, and participants completed the Center for Epidemiologic Studies Depression Scale (CES-D) annually. Statistical models, performed separately in men and women, examined whether depressive symptoms predicted subsequent WMH ratings or WMHs predicted subsequent depressive symptoms. RESULTS The total CES-D score was not associated with WMHs in men or women. In men, the CES-D depressed mood subscale predicted accelerating longitudinal increases in WMHs at older ages, but WMHs did not predict subsequent depressive symptoms. In women, there were no significant associations between the CES-D depressed mood subscale and WMHs. CONCLUSIONS White matter disease may be a consequence of depressed mood in men but not in women. Intervention strategies for depression may slow the progression of white matter disease in older men. These results add to previous findings documenting sex differences in the correlates of depressive disorders in late life.
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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, USA.
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Åberg MAI, Waern M, Nyberg J, Pedersen NL, Bergh Y, Åberg ND, Nilsson M, Kuhn HG, Torén K. Cardiovascular fitness in males at age 18 and risk of serious depression in adulthood: Swedish prospective population-based study. Br J Psychiatry 2012; 201:352-9. [PMID: 22700083 DOI: 10.1192/bjp.bp.111.103416] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Studies suggest a role for cardiovascular fitness in the prevention of affective disorders. AIMS To determine whether cardiovascular fitness at age 18 is associated with future risk of serious affective illness. METHOD Population-based Swedish cohort study of male conscripts (n = 1 117 292) born in 1950-1987 with no history of mental illness who were followed for 3-40 years. Data on cardiovascular fitness at conscription were linked with national hospital registers to calculate future risk of depression (requiring in-patient care) and bipolar disorder. RESULTS In fully adjusted models low cardiovascular fitness was associated with increased risk for serious depression (hazard ratios (HR) = 1.96, 95%, CI 1.71-2.23). No such association could be shown for bipolar disorder (HR = 1.11, 95% CI 0.84-1.47). CONCLUSIONS Lower cardiovascular fitness at age 18 was associated with increased risk of serious depression in adulthood. These results strengthen the theory of a cardiovascular contribution to the aetiology of depression.
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Affiliation(s)
- Maria A I Åberg
- Center for Brain Repair and Rehabilitation, Institute for Neuroscience and Physiology and Department of Primary Health Care, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Neuropathological substrates and structural changes in late-life depression: the impact of vascular burden. Acta Neuropathol 2012; 124:453-64. [PMID: 22836715 DOI: 10.1007/s00401-012-1021-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Revised: 07/13/2012] [Accepted: 07/17/2012] [Indexed: 01/01/2023]
Abstract
A first episode of depression after 65 years of age has long been associated with both severe macrovascular and small microvascular pathology. Among the three more frequent forms of depression in old age, post-stroke depression has been associated with an abrupt damage of cortical circuits involved in monoamine production and mood regulation. Late-onset depression (LOD) in the absence of stroke has been related to lacunes and white matter lesions that invade both the neocortex and subcortical nuclei. Recurrent late-life depression is thought to induce neuronal loss in the hippocampal formation and white matter lesions that affect limbic pathways. Despite an impressive number of magnetic resonance imaging (MRI) studies in this field, the presence of a causal relationship between structural changes in the human brain and LOD is still controversial. The present article provides a critical overview of the contribution of neuropathology in post-stroke, late-onset, and late-life recurrent depression. Recent autopsy findings challenge the role of stroke location in the occurrence of post-stroke depression by pointing to the deleterious effect of subcortical lacunes. Despite the lines of evidences supporting the association between MRI-assessed white matter changes and mood dysregulation, lacunes, periventricular and deep white matter demyelination are all unrelated to the occurrence of LOD. In the same line, neuropathological data show that early-onset depression is not associated with an acceleration of aging-related neurodegenerative changes in the human brain. However, they also provide data in favor of the neurotoxic theory of depression by showing that neuronal loss occurs in the hippocampus of chronically depressed patients. These three paradigms are discussed in the light of the complex relationships between psychosocial determinants and biological vulnerability in affective disorders.
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