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Andrews P, Vega JN, Szymkowicz SM, Newhouse P, Tyndale R, Elson D, Kang H, Siddiqi S, Tyner EB, Mather K, Gunning FM, Taylor WD. Effects of open-label transdermal nicotine antidepressant augmentation on affective symptoms and executive function in late-life depression. J Affect Disord 2024; 362:416-424. [PMID: 39009312 PMCID: PMC11373687 DOI: 10.1016/j.jad.2024.07.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 06/05/2024] [Accepted: 07/12/2024] [Indexed: 07/17/2024]
Abstract
BACKGROUND Late-life depression (LLD) is characterized by a poor response to antidepressant medications and diminished cognitive performance, particularly in executive functioning. There is currently no accepted pharmacotherapy for LLD that effectively treats both mood and cognitive symptoms. This study investigated whether transdermal nicotine augmentation of standard antidepressant medications benefitted mood and cognitive symptoms in LLD. METHODS Nonsmoking participants aged 60 years or older with unremitted LLD on stable SSRI or SNRI medications (N = 29) received transdermal nicotine patches up to a 21 mg daily dose over 12 weeks. Clinical measures assessed depression severity, secondary affective symptoms, and cognitive performance. Nicotine metabolite concentrations were obtained from blood samples. RESULTS Depression severity significantly decreased over the trial, with a 76 % response rate and 59 % remission rate. Change in depression severity was positively associated with nicotine exposure. Participants also exhibited improvement in self-reported affective symptoms (apathy, insomnia, rumination, and generalized anxiety symptoms), negativity bias, and disability. Executive function test performance significantly improved, specifically in measures of cognitive control, as did subjective cognitive performance. Adverse events were generally mild, with 75 % of the sample tolerating the maximum dose. CONCLUSION The current study extends our previous pilot open-label trial in LLD, supporting feasibility and tolerability of transdermal nicotine patches as antidepressant augmentation. Although preliminary, this open-label study supports the potential benefit of transdermal nicotine patches for both mood and cognitive symptoms of LLD. Further research, including definitive randomized, blinded trials, is warranted to confirm these findings and explore long-term risk and benefit. TRIAL REGISTRATION The study was registered with clinicaltrials.gov (NCT04433767).
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Affiliation(s)
- Patricia Andrews
- Center for Cognitive Medicine, Department of Psychiatry and Behavioral Science, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jennifer N Vega
- Center for Cognitive Medicine, Department of Psychiatry and Behavioral Science, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sarah M Szymkowicz
- Center for Cognitive Medicine, Department of Psychiatry and Behavioral Science, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Paul Newhouse
- Center for Cognitive Medicine, Department of Psychiatry and Behavioral Science, Vanderbilt University Medical Center, Nashville, TN, USA; Geriatric Research, Education, and Clinical Center, Veterans Affairs Tennessee Valley Health System, Nashville, TN, USA
| | - Rachel Tyndale
- Departments of Pharmacology, Toxicology, and Psychiatry, University of Toronto, and the Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Damian Elson
- Center for Cognitive Medicine, Department of Psychiatry and Behavioral Science, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Hakmook Kang
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sarah Siddiqi
- Center for Cognitive Medicine, Department of Psychiatry and Behavioral Science, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Elizabeth B Tyner
- Center for Cognitive Medicine, Department of Psychiatry and Behavioral Science, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kathleen Mather
- Center for Cognitive Medicine, Department of Psychiatry and Behavioral Science, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Faith M Gunning
- Weill Cornell Institute of Geriatric Psychiatry, Weill Cornell Medicine, New York, NY, USA
| | - Warren D Taylor
- Center for Cognitive Medicine, Department of Psychiatry and Behavioral Science, Vanderbilt University Medical Center, Nashville, TN, USA; Geriatric Research, Education, and Clinical Center, Veterans Affairs Tennessee Valley Health System, Nashville, TN, USA.
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Karim HT, Gerlach A, Butters MA, Krafty R, Boyd BD, Banihashemi L, Landman BA, Ajilore O, Taylor WD, Andreescu C. Brain age is not a significant predictor of relapse risk in late-life depression. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024:S2451-9022(24)00277-5. [PMID: 39349179 DOI: 10.1016/j.bpsc.2024.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 08/22/2024] [Accepted: 09/22/2024] [Indexed: 10/02/2024]
Abstract
INTRODUCTION Late-life depression (LLD) has been associated cross-sectionally with lower brain structural volumes and accelerated brain aging compared to healthy controls (HC). There are few longitudinal studies on the neurobiological predictors of recurrence in LLD. We tested a machine learning (ML) brain age model and its prospective association with LLD recurrence risk. METHODS We recruited individuals with LLD (n=102) and HC (n=43) into a multi-site 2-yr longitudinal study. Individuals with LLD were enrolled within 4 months of remission. Remitted LLD participants underwent baseline neuroimaging and longitudinal clinical follow-up. Over 2 years, 43 LLD participants relapsed (REL) and 59 stayed in remission (REM). We used a previously developed ML brain age algorithm to compute brain age at baseline and we evaluated brain age group differences (HC vs. LLD and HC vs. REM vs. REL). We conducted a Cox proportional hazards model to evaluate whether baseline brain age predicted time to relapse. RESULTS We found that brain age did not significantly differ between HC and LLD as well as HC, REM, and REL groups. Brain age did not significantly predict time to relapse. DISCUSSION In contrast to our hypothesis, we found that brain age did not differ between non-depressed controls and individuals with remitted LLD, and brain age was not associated with subsequent recurrence. This is in contrast to existing literature which has identified baseline brain age differences in late life but in line with work that shows no differences between those who do and do not relapse on gross structural measures.
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Affiliation(s)
- Helmet T Karim
- Department of Psychiatry, University of Pittsburgh; Department of Bioengineering, University of Pittsburgh.
| | | | | | - Robert Krafty
- Department of Biostatistics and Bioinformatics, Emory University
| | - Brian D Boyd
- Center for Cognitive Medicine, Department of Psychiatry and Behavioral Science, Vanderbilt University Medical Center
| | - Layla Banihashemi
- Department of Psychiatry, University of Pittsburgh; Department of Bioengineering, University of Pittsburgh
| | - Bennett A Landman
- Departments of Computer Science, Electrical Engineering, and Biomedical Engineering, Vanderbilt University; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center
| | | | - Warren D Taylor
- Center for Cognitive Medicine, Department of Psychiatry and Behavioral Science, Vanderbilt University Medical Center; Geriatric Research, Education, and Clinical Center, Veterans Affairs Tennessee Valley Health System
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Nelson JC, Gandelman JA, Mackin RS. A Systematic Review of Antidepressants and Psychotherapy Commonly Used in the Treatment of Late Life Depression for Their Effects on Cognition. Am J Geriatr Psychiatry 2024:S1064-7481(24)00443-3. [PMID: 39366871 DOI: 10.1016/j.jagp.2024.08.015] [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: 06/14/2024] [Revised: 08/25/2024] [Accepted: 08/27/2024] [Indexed: 10/06/2024]
Abstract
Cognitive dysfunction is common in late life depression (LLD) and is a major risk factor for dementia. Recent studies show limited improvement in cognition with commonly employed treatments for LLD, contradicting the notion that cognition "returns to normal" with treatment. However, findings differ with the treatments used. The aim of this study is to perform a systematic review of studies of antidepressants and psychotherapies commonly employed in LLD to determine their effects on cognition, particularly processing speed, memory, and executive function. We searched for trials of acute phase treatment, in nondemented individuals 60 years and older with unipolar nonpsychotic Major Depressive Disorder, that assessed cognitive performance with neuropsychological tests before and after treatment. We compared the magnitude of change in cognition by examining within group effect sizes. Six antidepressant trials and two psychotherapy trials (both using Problem Solving Therapy)(PST) provided relatively comparable data that allowed for quantitative comparison. Nine other antidepressant trials provided descriptive findings. Sertraline and vortioxetine had significant positive effects on processing speed and memory. Duloxetine had significant effects on memory. The most selective SRIs-citalopram and escitalopram-had minimal effects on cognition and citalopram had adverse effects in depression nonresponders. PST had modest effects on processing speed and no effect on memory. Effects of practice and improvement in depression on cognition are examined. In all but one study, cognition was a secondary outcome and various quality indicators (e.g. blinding cognitive assessment to treatment) were often not reported. As a consequence, these findings must be considered preliminary.
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Affiliation(s)
- J Craig Nelson
- Department of Psychiatry and Behavioral Sciences (JCN), Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA.
| | - Jason A Gandelman
- Department of Psychiatry (JG), Columbia University College of Physicians and Surgeons, Columbia University Medical Center, New York Presbyterian Hospital New York, NY
| | - R Scott Mackin
- Department of Psychiatry and Behavioral Sciences (RSM), University of California San Francisco, Veterans Affairs Medical Center, San Francisco, CA
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Marawi T, Zhukovsky P, Brooks H, Bowie CR, Butters MA, Fischer CE, Flint AJ, Herrmann N, Lanctôt KL, Mah L, Pollock BG, Rajji TK, Voineskos AN, Mulsant BH. Heterogeneity of Cognition in Older Adults with Remitted Major Depressive Disorder: A Latent Profile Analysis. Am J Geriatr Psychiatry 2024; 32:867-878. [PMID: 38403532 DOI: 10.1016/j.jagp.2024.01.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 01/26/2024] [Accepted: 01/27/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES To identify data-driven cognitive profiles in older adults with remitted major depressive disorder (rMDD) with or without mild cognitive impairment (MCI) and examine how the profiles differ regarding demographic, clinical, and neuroimaging measures. DESIGN Secondary cross-sectional analysis using latent profile analysis. SETTING Multisite clinical trial in Toronto, Canada. PARTICIPANTS One hundred seventy-eight participants who met DSM-5 criteria for rMDD without MCI (rMDD-MCI; n = 60) or with MCI (rMDD + MCI; n = 118). MEASUREMENTS Demographic, clinical, neuroimaging measures, and domain scores from a neuropsychological battery assessing verbal memory, visuospatial memory, processing speed, working memory, language, and executive function. RESULTS We identified three latent profiles: Profile 1 (poor cognition; n = 75, 42.1%), Profile 2 (intermediate cognition; n = 75, 42.1%), and Profile 3 (normal cognition; n = 28, 15.7%). Compared to participants with Profile 3, those with Profile 1 or 2 were older, had lower education, experienced a greater burden of medical comorbidities, and were more likely to have MCI. The profiles did not differ on the severity of residual symptoms, age of onset of rMDD, number of depressive episodes, psychotropic medication, cerebrovascular risk, ApoE4 carrier status, or family history of depression, dementia, or Alzheimer's disease. The profiles differed in cortical thickness of 15 regions, with the most prominent effects for left precentral and pars opercularis, and right inferior parietal and supramarginal. CONCLUSION Older patients with rMDD can be grouped cross-sectionally based on data-driven cognitive profiles that differ from the absence or presence of a diagnosis of MCI. Future research should determine the differential risk for dementia of these data-driven subgroups.
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Affiliation(s)
- Tulip Marawi
- Institute of Medical Science (TM, CEF, AJF, NH, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Campbell Family Mental Health Research Institute (TM, PZ, HB, CRB, BGP, TKR, ANV, BHM), Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Peter Zhukovsky
- Campbell Family Mental Health Research Institute (TM, PZ, HB, CRB, BGP, TKR, ANV, BHM), Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Heather Brooks
- Campbell Family Mental Health Research Institute (TM, PZ, HB, CRB, BGP, TKR, ANV, BHM), Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Christopher R Bowie
- Campbell Family Mental Health Research Institute (TM, PZ, HB, CRB, BGP, TKR, ANV, BHM), Centre for Addiction and Mental Health, Toronto, ON, Canada; Departments of Psychology and Psychiatry (CRB), Queen's University, Kingston, ON, Canada
| | - Meryl A Butters
- Department of Psychiatry (MAB), University of Pittsburgh, Pittsburgh, PA
| | - Corinne E Fischer
- Institute of Medical Science (TM, CEF, AJF, NH, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine (CEF, AJF, NH, KLL, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Keenan Research Centre for Biomedical Science (CEF), St. Michaels Hospital, Toronto, ON, Canada
| | - Alastair J Flint
- Institute of Medical Science (TM, CEF, AJF, NH, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine (CEF, AJF, NH, KLL, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Centre for Mental Health (AJF), University Health Network, Toronto, ON, Canada
| | - Nathan Herrmann
- Institute of Medical Science (TM, CEF, AJF, NH, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine (CEF, AJF, NH, KLL, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Department of Psychiatry (NH, KLL), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; Department of Pharmacology and Toxicology (NH, KLL), Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Krista L Lanctôt
- Department of Psychiatry, Temerty Faculty of Medicine (CEF, AJF, NH, KLL, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Department of Psychiatry (NH, KLL), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; Department of Pharmacology and Toxicology (NH, KLL), Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Linda Mah
- Institute of Medical Science (TM, CEF, AJF, NH, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine (CEF, AJF, NH, KLL, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Department of Psychiatry (LM), Baycrest Health Services, Rotman Research Institute, University of Toronto, Toronto, ON, Canada
| | - Bruce G Pollock
- Institute of Medical Science (TM, CEF, AJF, NH, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Campbell Family Mental Health Research Institute (TM, PZ, HB, CRB, BGP, TKR, ANV, BHM), Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine (CEF, AJF, NH, KLL, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada
| | - Tarek K Rajji
- Institute of Medical Science (TM, CEF, AJF, NH, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Campbell Family Mental Health Research Institute (TM, PZ, HB, CRB, BGP, TKR, ANV, BHM), Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine (CEF, AJF, NH, KLL, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Toronto Dementia Research Alliance (TKR, BHM), University of Toronto, Toronto, ON, Canada
| | - Aristotle N Voineskos
- Institute of Medical Science (TM, CEF, AJF, NH, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Campbell Family Mental Health Research Institute (TM, PZ, HB, CRB, BGP, TKR, ANV, BHM), Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine (CEF, AJF, NH, KLL, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada
| | - Benoit H Mulsant
- Institute of Medical Science (TM, CEF, AJF, NH, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Campbell Family Mental Health Research Institute (TM, PZ, HB, CRB, BGP, TKR, ANV, BHM), Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine (CEF, AJF, NH, KLL, LM, BGP, TKR, ANV, BHM), University of Toronto, Toronto, ON, Canada; Toronto Dementia Research Alliance (TKR, BHM), University of Toronto, Toronto, ON, Canada.
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Ren L, Yu J, Chen H, Luo J, Lv F, Min S. Alteration of hyperpolarization-activated cation current-mediated metaplasticity contributes to electroconvulsive shock-induced learning and memory impairment in depressed rats. Front Psychiatry 2024; 15:1365119. [PMID: 38911706 PMCID: PMC11190359 DOI: 10.3389/fpsyt.2024.1365119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 05/27/2024] [Indexed: 06/25/2024] Open
Abstract
Background Accompanied by a rapid and effective antidepressant effect, electroconvulsive shock (ECS) can also induce learning and memory impairment. Our previous research reported that metaplasticity is involved in this process. However, the mechanisms still remain unclear. This study investigated the role of I h current in the metaplastic changes and learning and memory impairment induced by ECS in depressive rats. Methods Depressive rats received ECS after modelling using chronic unpredictable. ZD7288, a type of I h current inhibitor was used to verify the effect of I h current. The sucrose preference test and Morris water maze were used for behavior testing. Changes in metaplasticity was assessed with the LTD/LTP threshold by stimulation at different frequencies. Spontaneous and evoked action potentials (APs) were measured to confirm difference of neuronal excitability. Additionally, the amplitude of I h current was analyzed. Results ECS exerts antidepressant effect, but also induce spatial learning and memory dysfunction. ECS up-regulates the LTD/LTP threshold. In rats treated with ECS, the frequency of spontaneous and evoked APs is significantly reduced. In addition, ECS induces changes in the intrinsic properties of AP, including a decrease of AP-half width and peak amplitude, and an increase in AP time to peak and post-hyperpolarization potential amplitude. In particular, ECS increases both instantaneous and steady-state I h currents. However, Inhibition of I h current with ZD7288 results in a relief of learning and memory impairment and a decrease in threshold, as well as a significant reversal of whole-cell electrophysiological changes. Conclusion ECS-induced learning and memory impairment is caused by neuronal hypoexcitability mediated metaplasticity, and upregulation of LTD/LTP threshold by an increase in I h current.
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Affiliation(s)
- Li Ren
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jian Yu
- Department of Psychiatry, Shanghai 10th People’s Hospital, Anesthesia and Brain Research Institute, Tongji University, Shanghai, China
| | - Hengsheng Chen
- Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Jie Luo
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Feng Lv
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Su Min
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Ayyash S, Davis AD, Alders GL, MacQueen G, Strother SC, Hassel S, Zamyadi M, Arnott SR, Harris JK, Lam RW, Milev R, Müller DJ, Kennedy SH, Rotzinger S, Frey BN, Minuzzi L, Hall GB. Assessing remission in major depressive disorder using a functional-structural data fusion pipeline: A CAN-BIND-1 study. IBRO Neurosci Rep 2024; 16:135-146. [PMID: 38293679 PMCID: PMC10826332 DOI: 10.1016/j.ibneur.2023.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 12/30/2023] [Indexed: 02/01/2024] Open
Abstract
Neural network-level changes underlying symptom remission in major depressive disorder (MDD) are often studied from a single perspective. Multimodal approaches to assess neuropsychiatric disorders are evolving, as they offer richer information about brain networks. A FATCAT-awFC pipeline was developed to integrate a computationally intense data fusion method with a toolbox, to produce a faster and more intuitive pipeline for combining functional connectivity with structural connectivity (denoted as anatomically weighted functional connectivity (awFC)). Ninety-three participants from the Canadian Biomarker Integration Network for Depression study (CAN-BIND-1) were included. Patients with MDD were treated with 8 weeks of escitalopram and adjunctive aripiprazole for another 8 weeks. Between-group connectivity (SC, FC, awFC) comparisons contrasted remitters (REM) with non-remitters (NREM) at baseline and 8 weeks. Additionally, a longitudinal study analysis was performed to compare connectivity changes across time for REM, from baseline to week-8. Association between cognitive variables and connectivity were also assessed. REM were distinguished from NREM by lower awFC within the default mode, frontoparietal, and ventral attention networks. Compared to REM at baseline, REM at week-8 revealed increased awFC within the dorsal attention network and decreased awFC within the frontoparietal network. A medium effect size was observed for most results. AwFC in the frontoparietal network was associated with neurocognitive index and cognitive flexibility for the NREM group at week-8. In conclusion, the FATCAT-awFC pipeline has the benefit of providing insight on the 'full picture' of connectivity changes for REMs and NREMs while making for an easy intuitive approach.
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Affiliation(s)
- Sondos Ayyash
- School of Biomedical Engineering, McMaster University, Hamilton, Ontario, Canada
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Ontario, Canada
| | - Andrew D Davis
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Rotman Research Institute, Baycrest, Toronto, Ontario, Canada
| | - Gésine L Alders
- Neuroscience Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Glenda MacQueen
- Hotchkiss Brain Institute and Mathison Centre for Mental Health Research and Education, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Stephen C Strother
- Rotman Research Institute, Baycrest, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Department of Medical Biophysics, University of Toronto, Ontario, Canada
| | - Stefanie Hassel
- Hotchkiss Brain Institute and Mathison Centre for Mental Health Research and Education, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Mojdeh Zamyadi
- Rotman Research Institute, Baycrest, Toronto, Ontario, Canada
| | | | - Jacqueline K Harris
- Department of Computer Science, University of Alberta, Edmonton, Alberta, Canada
| | - Raymond W Lam
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Roumen Milev
- Departments of Psychiatry and Psychology, Queen's University, Providence Care Hospital, Kingston, Ontario, Canada
| | - Daniel J Müller
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Sidney H Kennedy
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Mental Health, University Health Network, Toronto, Ontario, Canada
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
- Centre for Depression and Suicide Studies, and Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Susan Rotzinger
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
- Centre for Depression and Suicide Studies, and Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Benicio N Frey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Neuroscience Graduate Program, McMaster University, Hamilton, Ontario, Canada
- Mood Disorders Treatment and Research Centre and Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, Ontario, Canada
| | - Luciano Minuzzi
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Neuroscience Graduate Program, McMaster University, Hamilton, Ontario, Canada
- Mood Disorders Treatment and Research Centre and Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, Ontario, Canada
| | - Geoffrey B Hall
- School of Biomedical Engineering, McMaster University, Hamilton, Ontario, Canada
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Neuroscience Graduate Program, McMaster University, Hamilton, Ontario, Canada
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Olivera-López C, Jiménez-Genchi A, Ortega-Robles D, Valencia-Flores M, Cansino S, Salvador-Cruz J. Polysomnographic parameters associated with cognitive function in patients with major depression and insomnia. CNS Spectr 2024; 29:197-205. [PMID: 38685584 DOI: 10.1017/s1092852924000257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
OBJECTIVE To examine whether objective sleep parameters are associated with cognitive function (CF) in patients with major depressive disorder (MDD) with chronic insomnia (CI) and whether the severity of these disorders is related to CF. METHOD Thirty patients with MDD with CI attending a tertiary care institution underwent two consecutive nights of polysomnographic (PSG) recording and a battery of neuropsychological tests, which included episodic memory, sustained attention, working memory, and executive function. The severity of MDD and CI was assessed by clinical scales. We examined the relationship between PSG parameters and CF, as well as whether the severity of the disorders is related to CF. RESULTS Linear regression analysis revealed that total sleep time (TST) was positively associated with higher learning and recall of episodic memory, as well as better attention. Slow-wave sleep (SWS) showed a positive association with better working memory. Furthermore, wake after sleep onset (WASO) was negatively associated with episodic memory and lower attention. No significant relationships were found between the severity of MDD or CI with CF. CONCLUSION Both sleep duration and depth are positively associated with several aspects of CF in patients with MDD with CI. Conversely, a lack of sleep maintenance is negatively related to CF in these patients. These findings could help identify modifiable therapeutic targets to reduce CF impairment.
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Affiliation(s)
- Carlos Olivera-López
- Laboratory of Sleep Disorders, Faculty of Psychology, National Autonomous University of Mexico, Mexico City, Mexico
- Faculty of Higher Studies Zaragoza, National Autonomous University of Mexico, Mexico City, Mexico
| | - Alejandro Jiménez-Genchi
- Clinical Services Unit, Sleep Clinic, National Institute of Psychiatry "Ramón de la Fuente Muñiz", Mexico City, Mexico
| | - David Ortega-Robles
- Clinical Services Unit, Sleep Clinic, National Institute of Psychiatry "Ramón de la Fuente Muñiz", Mexico City, Mexico
| | - Matilde Valencia-Flores
- Laboratory of Sleep Disorders, Faculty of Psychology, National Autonomous University of Mexico, Mexico City, Mexico
| | - Selene Cansino
- Laboratory of NeuroCognition, Faculty of Psychology, National Autonomous University of Mexico, Mexico City, Mexico
| | - Judith Salvador-Cruz
- Faculty of Higher Studies Zaragoza, National Autonomous University of Mexico, Mexico City, Mexico
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Zeng Y, Lao J, Wu Z, Lin G, Wang Q, Yang M, Zhang S, Xu D, Zhang M, Liang S, Liu Q, Yao K, Li J, Ning Y, Zhong X. Altered resting-state brain oscillation and the associated cognitive impairments in late-life depression with different depressive severity: An EEG power spectrum and functional connectivity study. J Affect Disord 2024; 348:124-134. [PMID: 37918574 DOI: 10.1016/j.jad.2023.10.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/29/2023] [Accepted: 10/30/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE Cognitive impairments are prevalent in late-life depression (LLD). However, it remains unclear whether there are concurrent brain oscillation alterations in resting condition across varying level of depression severity. This cross-sectional study aims to investigate the characteristics of altered resting-state oscillations, including power spectrum and functional connectivity, and their association with the cognitive impairments in LLD with different depression severity. METHODS A total of 65 patients with LLD and 40 elder participants without depression were recruited. Global cognition and subtle cognitive domains were evaluated. A five-minute resting-state electroencephalography (EEG) was conducted under eyes-closed conditions. Measurements included the ln-transformed absolute power for power spectrum analysis and the weighted phase lag index (wPLI) for functional connectivity analysis. RESULTS Attentional and executive dysfunction were exhibited in Moderate-Severe LLD group. Enhanced posterior upper gamma power was observed in both LLD groups. Additionally, enhanced parietal and fronto-parietal/occipital theta connectivity were observed in Moderate-Severe LLD group, which were associated with the attentional impairment. LIMITATIONS Limitations include a small sample size, concomitant medication use, and a relatively higher proportion of females. CONCLUSIONS Current study observed aberrant brain activity patterns in LLD across different levels of depression severity, which were linked to cognitive impairments. The altered posterior brain oscillations may be trait marker of LLD. Moreover, cognitive impairments and associated connectivity alterations were exhibited in moderate-severe group, which may be a state-like marker of moderate-to severe LLD. The study deepens understanding of cognitive impairments with the associated oscillation changes, carrying implications for neuromodulation targets in LLD.
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Affiliation(s)
- Yijie Zeng
- Geriatric Neuroscience Center, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jingyi Lao
- Geriatric Neuroscience Center, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhangying Wu
- Geriatric Neuroscience Center, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Gaohong Lin
- Geriatric Neuroscience Center, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Qiang Wang
- Geriatric Neuroscience Center, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Mingfeng Yang
- Geriatric Neuroscience Center, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Si Zhang
- Geriatric Neuroscience Center, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Danyan Xu
- Geriatric Neuroscience Center, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Min Zhang
- Geriatric Neuroscience Center, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shuang Liang
- Geriatric Neuroscience Center, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Qin Liu
- Geriatric Neuroscience Center, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Kexin Yao
- Geriatric Neuroscience Center, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jiafu Li
- Geriatric Neuroscience Center, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yuping Ning
- Geriatric Neuroscience Center, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; The First School of Clinical Medicine, Southern Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China; Key Laboratory of Neurogenetics and channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou.
| | - Xiaomei Zhong
- Geriatric Neuroscience Center, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Key Laboratory of Neurogenetics and channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou.
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9
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Hu R, Li J, Lu Y, Luo H, Zhang Y, Wang X, Zhang Z, Luo Q. The effect of transcranial direct current stimulation (tDCS) on cognitive function recovery in patients with depression following electroconvulsive therapy (ECT): protocol for a randomized controlled trial. BMC Psychiatry 2024; 24:130. [PMID: 38365634 PMCID: PMC10870564 DOI: 10.1186/s12888-024-05567-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/29/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Electroconvulsive therapy (ECT) is a highly effective treatment for depressive disorder. However, the use of ECT is limited by its cognitive side effects (CSEs), and no specific intervention has been developed to address this problem. As transcranial direct current stimulation (tDCS) is a safe and useful tool for improving cognitive function, the main objective of this study was to explore the ability to use tDCS after ECT to ameliorate the cognitive side effects. METHODS 60 eligible participants will be recruited within two days after completing ECT course and randomly assigned to receive either active or sham stimulation in a blinded, parallel-design trial and continue their usual pharmacotherapy. The tDCS protocol consists of 30-min sessions at 2 mA, 5 times per week for 2 consecutive weeks, applied through 15-cm2 electrodes. An anode will be placed over the left dorsolateral prefrontal cortex (DLPFC), and a cathode will be placed over the right supraorbital cortex. Cognitive function and depressive symptoms will be assessed before the first stimulation (T0), after the final stimulation (T1), 2 weeks after the final stimulation (T2), and 4 weeks after the final stimulation (T3) using the Cambridge Neuropsychological Test Automated Battery (CANTAB). DISCUSSION We describe a novel clinical trial to explore whether the administration of tDCS after completing ECT course can accelerates recovery from the CSEs. We hypothesized that the active group would recover faster from the CSEs and be superior to the sham group. If our hypothesis is supported, the use of tDCS could benefit eligible patients who are reluctant to receive ECT and reduce the risk of self-inflicted or suicide due to delays in treatment. TRIAL REGISTRATION DETAILS The trial protocol is registered with https://www.chictr.org.cn/ under protocol registration number ChiCTR2300071147 (date of registration: 05.06.2023). Recruitment will start in November 2023.
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Affiliation(s)
- Renqin Hu
- Department of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Junyao Li
- Department of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Yulin Lu
- Department of Psychiatry, People's Hospital of Chongqing Banan District, Chongqing, China
| | - Huirong Luo
- Department of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Yinlin Zhang
- Department of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Xueqian Wang
- Department of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Zheng Zhang
- Department of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Qinghua Luo
- Department of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
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10
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Lin YJ, Huang MF, Yeh YC, Chen CS. Predicting risk of dementia among the elderly with major depressive disorder in remission: A prospective study. Int J Geriatr Psychiatry 2024; 39:e6065. [PMID: 38319233 DOI: 10.1002/gps.6065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 01/27/2024] [Indexed: 02/07/2024]
Abstract
OBJECTIVES Cognitive impairment and change are a focus of research into late-life depression. The aims of this 5-year prospective study were (1) to observe cognitive status change; (2) to investigate the rate and risk ratio of dementia or cognitive decline; and (3) to examine the cognitive domain predictors for conversion to dementia within 5 years among a clinical cohort with remitted major depressive disorder (MDD). METHODS The study cohort included 130 elderly persons with late-life remitted MDD and 100 normal controls. Comprehensive neuropsychological tests were conducted to determine cognitive domain status. Diagnoses of mild cognitive impairment (MCI) and dementia were made at baseline and at a follow-up visit at the 5-year point. In total, 98 cases and 55 normal controls completed the 5-year follow-up assessment. RESULTS Of the study cohort with late-life remitted MDD, 28.6% had MCI and 25.5% developed dementia within 5 years. Patients with late-life remitted MDD had an approximate 3 times higher risk of subsequent cognitive decline as compared with the normal controls. Information-processing speed (p = 0.009) and memory (p = 0.041) could predict subsequent progression to dementia within 5 years among patients with MDD. CONCLUSIONS This study demonstrated that compared with the general elderly population, elderly patients with depression have more significant impairment in cognitive function after 5 years. Further, we found that in depressed patients, deficits in information-processing speed and memory domains were highly suggestive of progression to dementia within 5 years.
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Affiliation(s)
- Yen-Ju Lin
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Mei-Feng Huang
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Yi-Chun Yeh
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Cheng-Sheng Chen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
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11
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Marawi T, Zhukovsky P, Rashidi-Ranjbar N, Bowie CR, Brooks H, Fischer CE, Flint AJ, Herrmann N, Mah L, Pollock BG, Rajji TK, Tartaglia MC, Voineskos AN, Mulsant BH. Brain-Cognition Associations in Older Patients With Remitted Major Depressive Disorder or Mild Cognitive Impairment: A Multivariate Analysis of Gray and White Matter Integrity. Biol Psychiatry 2023; 94:913-923. [PMID: 37271418 DOI: 10.1016/j.biopsych.2023.05.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 05/10/2023] [Accepted: 05/24/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Almost half of older patients with major depressive disorder (MDD) present with cognitive impairment, and one-third meet diagnostic criteria for mild cognitive impairment (MCI). However, mechanisms linking MDD and MCI remain unclear. We investigated multivariate associations between brain structural alterations and cognition in 3 groups of older patients at risk for dementia, remitted MDD (rMDD), MCI, and rMDD+MCI, as well as cognitively healthy nondepressed control participants. METHODS We analyzed magnetic resonance imaging data and cognitive domain scores in participants from the PACt-MD (Prevention of Alzheimer's Disease With Cognitive Remediation Plus Transcranial Direct Current Stimulation in Mild Cognitive Impairment and Depression) study. Following quality control, we measured cortical thickness and subcortical volumes of selected regions from 283 T1-weighted scans and fractional anisotropy of white matter tracts from 226 diffusion-weighted scans. We assessed brain-cognition associations using partial least squares regressions in the whole sample and in each subgroup. RESULTS In the entire sample, atrophy in the medial temporal lobe and subregions of the motor and prefrontal cortex was associated with deficits in verbal and visuospatial memory, language skills, and, to a lesser extent, processing speed (p < .0001; multivariate r = 0.30, 0.34, 0.26, and 0.18, respectively). Widespread reduced white matter integrity was associated with deficits in executive functioning, working memory, and processing speed (p = .008; multivariate r = 0.21, 0.26, 0.35, respectively). Overall, associations remained significant in the MCI and rMDD+MCI groups, but not the rMDD or healthy control groups. CONCLUSIONS We confirm findings of brain-cognition associations previously reported in MCI and extend them to rMDD+MCI, but similar associations in rMDD are not supported. Early-onset and treated MDD might not contribute to structural alterations associated with cognitive impairment.
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Affiliation(s)
- Tulip Marawi
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Peter Zhukovsky
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Neda Rashidi-Ranjbar
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Christopher R Bowie
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychology, Queen's University, Kingston, Ontario, Canada; Department of Psychiatry, Queen's University, Kingston, Ontario, Canada
| | - Heather Brooks
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Corinne E Fischer
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Alastair J Flint
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Centre for Mental Health, University Health Network, Toronto, Ontario, Canada
| | - Nathan Herrmann
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Sunnybrook Health Sciences Centre, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Linda Mah
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Baycrest Health Services, Rotman Research Institute, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Bruce G Pollock
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Tarek K Rajji
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Toronto Dementia Research Alliance, University of Toronto, Toronto, Ontario, Canada
| | - Maria Carmela Tartaglia
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
| | - Aristotle N Voineskos
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Benoit H Mulsant
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Toronto Dementia Research Alliance, University of Toronto, Toronto, Ontario, Canada.
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12
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Wu KY, Lin KJ, Chen CH, Liu CY, Wu YM, Yen TC, Hsiao IT. Atrophy, hypometabolism and implication regarding pathology in late-life major depression with suspected non-alzheimer pathophysiology (SNAP). Biomed J 2023; 46:100589. [PMID: 36914051 PMCID: PMC10749882 DOI: 10.1016/j.bj.2023.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 07/16/2022] [Accepted: 03/08/2023] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND A substantial proportion of individuals with late-life major depression could be classified as having a suspected non-Alzheimer disease pathophysiology (SNAP), as indicated by a negative test for the biomarker β-amyloid (Aβ-) but a positive test for neurodegeneration (ND+). This study investigated the clinical features, characteristic patterns of brain atrophy and hypometabolism, and implications regarding pathology in this population. METHODS Forty-six amyloid-negative patients with late-life major depressive disorder (MDD) patients, including 23 SNAP (Aβ-/ND+) and 23 Aβ-/ND- MDD subjects, and 22 Aβ-/ND-healthy control subjects were included in this study. Voxel-wise group comparisons between the SNAP MDD, Aβ-/ND- MDD and control subjects were performed, adjusting for age, gender and level of education. For exploratory comparisons, 8 Aβ+/ND- and 4 Aβ+/ND + MDD patients were included in the Supplementary Material. RESULTS The SNAP MDD patients had atrophy extending to regions outside the hippocampus, predominately in the medial temporal, dorsomedial and ventromedial prefrontal cortex; hypometabolism involving a large portion of the lateral and medial prefrontal cortex in addition to the bilateral temporal, parietal and precuneus cortex within typical Alzheimer disease regions were observed. Metabolism ratios of the inferior to the medial temporal lobe were significantly elevated in the SNAP MDD patients. We further discussed the implications with regards to underlying pathologies. CONCLUSION The present study demonstrated characteristic patterns of atrophy and hypometabolism in patients with late-life major depression with SNAP. Identifying individuals with SNAP MDD may provide insights into currently unspecified neurodegenerative processes. Future refinement of neurodegeneration biomarkers is essential in order to identify potential pathological correlates while in vivo reliable pathological biomarkers are not forthcoming.
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Affiliation(s)
- Kuan-Yi Wu
- Department of Psychiatry, Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Kun-Ju Lin
- Department of Nuclear Medicine and Center for Advanced Molecular Imaging and Translation, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Medical Imaging and Radiological Sciences and Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; Neuroscience Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Chia-Hsiang Chen
- Department of Psychiatry, Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chia-Yih Liu
- Department of Psychiatry, Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Ming Wu
- Department of Radiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Tzu-Chen Yen
- Department of Nuclear Medicine and Center for Advanced Molecular Imaging and Translation, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Medical Imaging and Radiological Sciences and Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; APRINOIA Therapeutics Inc., Taipei, Taiwan
| | - Ing-Tsung Hsiao
- Department of Nuclear Medicine and Center for Advanced Molecular Imaging and Translation, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Medical Imaging and Radiological Sciences and Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.
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13
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Yuan J, Wang Y, Liu Z. Temporal relationship between depression and cognitive decline in the elderly: a two-wave cross-lagged study in a Chinese sample. Aging Ment Health 2023; 27:2179-2186. [PMID: 37339082 DOI: 10.1080/13607863.2023.2225432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 06/04/2023] [Indexed: 06/22/2023]
Abstract
Objectives: Less information is available about the temporal relationship between depression in the elderly and cognitive decline. In the current study, we (1) evaluated the temporal association between depression and cognitive decline in older adults over a 4-year period; (2) indicated which cognitive domains have a strong temporal relationship with depression.Methods: Using data from China Family Panel Studies, we examined the relationship between depression and cognition among adults aged 65 and older with a cross-lagged design.Results: The results showed that initial depression affected subsequent cognitive function, especially immediate and delayed recall, but that cognition decline did not predict depression over time.Conclusion: The findings suggest that depression precedes cognitive decline in older adults, which is of great significance for the future research of mild cognitive impairment and dementia in the elderly.
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Affiliation(s)
- Jing Yuan
- School of Nursing, Hebei University, Baoding, China
| | - Yan Wang
- School of Nursing, Hebei University, Baoding, China
| | - Zejun Liu
- Department of Psychology, Educational College, Shanghai Normal University, Shanghai, China
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14
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Guo Y, Pai M, Xue B, Lu W. Bidirectional association between depressive symptoms and mild cognitive impairment over 20 years: Evidence from the Health and Retirement Study in the United States. J Affect Disord 2023; 338:449-458. [PMID: 37356735 DOI: 10.1016/j.jad.2023.06.046] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 05/20/2023] [Accepted: 06/20/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Research examining the association between depressive symptoms and mild cognitive impairment (MCI) has yielded conflicting results. This study aimed to examine the bidirectional association between depressive symptoms and MCI, and the extent to which this bidirectional association is moderated by gender and education. METHODS Data come from the US Health and Retirement Study over a 20-year period (older adults aged ≥50 years). Competing-risks regression is employed to examine the association between baseline high-risk depressive symptoms and subsequent MCI (N = 9317), and baseline MCI and subsequent high-risk depressive symptoms (N = 9428). Interactions of baseline exposures with gender and education are tested. RESULTS After full adjustment, baseline high-risk depressive symptoms were significantly associated with subsequent MCI (SHR = 1.20, 95%CI 1.08-1.34). Participants with baseline MCI are more likely to develop subsequent high-risk depressive symptoms than those without baseline MCI (SHR = 1.16, 95%CI 1.01-1.33). Although gender and education are risk factors for subsequent depression and MCI, neither moderates the bidirectional association. LIMITATIONS Items used to construct the composite cognitive measure are limited; selection bias due to missing data; and residual confounding. CONCLUSIONS Our study found a bidirectional association between depressive symptoms and MCI. High-risk depressive symptoms are related to a higher risk of subsequent MCI; and MCI predicts subsequent high-risk depression. Though neither gender nor education moderated the bidirectional association, public health interventions crafted to reduce the risk of depression and MCI should pivot attention to older women and those with less formal education.
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Affiliation(s)
- Yunyun Guo
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, United Kingdom; Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Manacy Pai
- Department of Sociology, Kent State University, Kent, OH, United States of America
| | - Baowen Xue
- Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Wentian Lu
- Research Department of Epidemiology and Public Health, University College London, London, United Kingdom.
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15
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Vancappel A, Dansou Y, Godin O, Haffen E, Yrondi A, Stephan F, Richieri RM, Molière F, Holtzmann J, Horn M, Allauze E, Genty JB, Bouvard A, Dorey JM, Hennion V, Camus V, Fond G, Peran B, Walter M, Anguill L, Scotto D'apolina C, Vilà E, Fredembach B, Petrucci J, Rey R, Nguon AS, Etain B, Carminati M, Courtet P, Vaiva G, Llorca PM, Leboyer M, Aouizerate B, Bennabi D, El Hage W. Evolution of Cognitive Impairments in Treatment-Resistant Depression: Results from the Longitudinal French Centers of Expertise for Treatment-Resistant Depression (FACE-DR) Cohort. Brain Sci 2023; 13:1120. [PMID: 37509050 PMCID: PMC10377578 DOI: 10.3390/brainsci13071120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/10/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023] Open
Abstract
Previous studies set out profound cognitive impairments in subjects with treatment-resistant depression (TRD). However, little is known about the course of such alterations depending on levels of improvement in those patients followed longitudinally. The main objective of this study was to describe the course of cognitive impairments in responder versus non-responder TRD patients at one-year follow-up. The second aim was to evaluate the predictive aspect of cognitive impairments to treatment resistance in patients suffering from TRD. We included 131 patients from a longitudinal cohort (FACE-DR) of the French Network of Expert TRD Centers. They undertook comprehensive sociodemographic, clinical, global functioning, and neuropsychological testing (TMT, Baddeley task, verbal fluencies, WAIS-4 subtests, D2 and RLRI-16) at baseline (V0) and one-year follow-up (V1). Most patients (n = 83; 63.36%) did not respond (47 women, 49.47 ± 12.64 years old), while one-third of patients responded (n = 48, 30 women, 54.06 ± 12.03 years old). We compared the cognitive performances of participants to average theoretical performances in the general population. In addition, we compared the cognitive performances of patients between V1 and V0 and responder versus non-responder patients at V1. We observed cognitive impairments during the episode and after a therapeutic response. Overall, each of them tended to show an increase in their cognitive scores. Improvement was more prominent in responders at V1 compared to their non-responder counterparts. They experienced a more marked improvement in code, digit span, arithmetic, similarities, and D2 tasks. Patients suffering from TRD have significant cognitive impairments that persist but alleviate after therapeutic response. Cognitive remediation should be proposed after therapeutic response to improve efficiency and increase the daily functioning.
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Affiliation(s)
- Alexis Vancappel
- Fondation FondaMental, 94000 Créteil, France
- CHRU de Tours, UMR 1253, iBrain, Université de Tours, Inserm, 37000 Tours, France
- EE 1901 Qualipsy, Université de Tours, 37000 Tours, France
| | | | - Ophelia Godin
- Fondation FondaMental, 94000 Créteil, France
- INSERM U955, Équipe de Psychiatrie Translationnelle, Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, 94000 Créteil, France
| | - Emmanuel Haffen
- Fondation FondaMental, 94000 Créteil, France
- Department of Clinical Psychiatry, CIC-1431 INSERM, CHU de Besançon, UR481 Neurosciences and Cognition, University of Franche-Comté, 25000 Besançon, France
| | - Antoine Yrondi
- Fondation FondaMental, 94000 Créteil, France
- Service de Psychiatrie et de Psychologie Médicale de l'adulte, CHU de Toulouse, Hôpital Purpan, Université Paul Sabatier Toulouse 3, 31062 Toulouse, France
| | - Florian Stephan
- Fondation FondaMental, 94000 Créteil, France
- Service Hospitalo-Universitaire de Psychiatrie Générale et de Réhabilitation Psycho Sociale, 29200 Brest, France
| | - Raphaelle Marie Richieri
- Fondation FondaMental, 94000 Créteil, France
- Equipe Imothep, Institut Fresnel, UMR 7249, Aix-Marseille Université, CNRS, Ecole Centrale Marseille, 13284 Marseille, France
| | - Fanny Molière
- Fondation FondaMental, 94000 Créteil, France
- Department of Emergency Psychiatry and Post Acute Care, Hôpital Lapeyronie, CHU Montpellier, 34000 Montpellier, France
| | - Jérôme Holtzmann
- Fondation FondaMental, 94000 Créteil, France
- Service Hospitalo-Universitaire de Psychiatrie, CHU Grenoble Alpes, University Grenoble Alpes, 38400 Grenoble, France
| | | | | | | | - Alex Bouvard
- Fondation FondaMental, 94000 Créteil, France
- Centre de Référence Régional des Pathologies Anxieuses et de la Dépression, Centre Expert Dépression Résistante, Pôle de Psychiatrie Générale et Universitaire, CH Charles Perrens, 33076 Bordeaux, France
- Laboratoire Nutrition et Neurobiologie Intégrée (UMR INRAE 1286), Université de Bordeaux, 33076 Bordeaux, France
| | | | - Vincent Hennion
- Fondation FondaMental, 94000 Créteil, France
- INSERM UMR-S 1144 Optimisation Thérapeutique en Neurospsychopharmacologie, Département de Psychiatrie et de Médecine Addictologique, OTeN, Hôpitaux Lariboisière-Fernand Widal, GHU APHP Nord_Université Paris Cité, 75006 Paris, France
| | - Vincent Camus
- Fondation FondaMental, 94000 Créteil, France
- CHRU de Tours, UMR 1253, iBrain, Université de Tours, Inserm, 37000 Tours, France
| | - Guillaume Fond
- Fondation FondaMental, 94000 Créteil, France
- Clinical Research Unit, Academic Hospitals of Marseille (APHM), School of Medicine-La Timone Medical Campus, EA 3279, Department of Epidemiology and Health Economics, Aix-Marseille University, 13284 Marseille, France
| | - Barbara Peran
- Fondation FondaMental, 94000 Créteil, France
- Service Hospitalo-Universitaire de Psychiatrie Générale et de Réhabilitation Psycho Sociale, 29200 Brest, France
| | - Michel Walter
- Fondation FondaMental, 94000 Créteil, France
- Service Hospitalo-Universitaire de Psychiatrie Générale et de Réhabilitation Psycho Sociale, 29200 Brest, France
| | - Loic Anguill
- Fondation FondaMental, 94000 Créteil, France
- Service de Psychiatrie et de Psychologie Médicale de l'adulte, CHU de Toulouse, Hôpital Purpan, Université Paul Sabatier Toulouse 3, 31062 Toulouse, France
| | - Charlotte Scotto D'apolina
- Fondation FondaMental, 94000 Créteil, France
- Service de Psychiatrie et de Psychologie Médicale de l'adulte, CHU de Toulouse, Hôpital Purpan, Université Paul Sabatier Toulouse 3, 31062 Toulouse, France
| | - Estelle Vilà
- Fondation FondaMental, 94000 Créteil, France
- Centre de Référence Régional des Pathologies Anxieuses et de la Dépression, Centre Expert Dépression Résistante, Pôle de Psychiatrie Générale et Universitaire, CH Charles Perrens, 33076 Bordeaux, France
- Laboratoire Nutrition et Neurobiologie Intégrée (UMR INRAE 1286), Université de Bordeaux, 33076 Bordeaux, France
| | - Benjamin Fredembach
- Fondation FondaMental, 94000 Créteil, France
- Service Hospitalo-Universitaire de Psychiatrie, CHU Grenoble Alpes, University Grenoble Alpes, 38400 Grenoble, France
| | | | - Romain Rey
- Fondation FondaMental, 94000 Créteil, France
| | - Anne Sophie Nguon
- Fondation FondaMental, 94000 Créteil, France
- Service Hospitalo-Universitaire de Psychiatrie, CHU Grenoble Alpes, University Grenoble Alpes, 38400 Grenoble, France
| | - Bruno Etain
- Fondation FondaMental, 94000 Créteil, France
- INSERM UMR-S 1144 Optimisation Thérapeutique en Neurospsychopharmacologie, Département de Psychiatrie et de Médecine Addictologique, OTeN, Hôpitaux Lariboisière-Fernand Widal, GHU APHP Nord_Université Paris Cité, 75006 Paris, France
| | - Mathilde Carminati
- Fondation FondaMental, 94000 Créteil, France
- INSERM UMR-S 1144 Optimisation Thérapeutique en Neurospsychopharmacologie, Département de Psychiatrie et de Médecine Addictologique, OTeN, Hôpitaux Lariboisière-Fernand Widal, GHU APHP Nord_Université Paris Cité, 75006 Paris, France
| | - Philippe Courtet
- Fondation FondaMental, 94000 Créteil, France
- Department of Emergency Psychiatry and Post Acute Care, Hôpital Lapeyronie, CHU Montpellier, 34000 Montpellier, France
| | - Guillaume Vaiva
- Fondation FondaMental, 94000 Créteil, France
- Inserm-U1172-LilNCog-Lille Neuroscience & Cognition, Centre National de Ressources & Résilience pour les Psychotraumatismes (Cn2r Lille Paris), Université de Lille (CHU Lille), 59000 Lille, France
| | | | | | - Bruno Aouizerate
- Fondation FondaMental, 94000 Créteil, France
- Centre de Référence Régional des Pathologies Anxieuses et de la Dépression, Centre Expert Dépression Résistante, Pôle de Psychiatrie Générale et Universitaire, CH Charles Perrens, 33076 Bordeaux, France
- Laboratoire Nutrition et Neurobiologie Intégrée (UMR INRAE 1286), Université de Bordeaux, 33076 Bordeaux, France
| | - Djamila Bennabi
- Fondation FondaMental, 94000 Créteil, France
- Department of Clinical Psychiatry, CIC-1431 INSERM, CHU de Besançon, UR481 Neurosciences and Cognition, University of Franche-Comté, 25000 Besançon, France
| | - Wissam El Hage
- Fondation FondaMental, 94000 Créteil, France
- CHRU de Tours, UMR 1253, iBrain, Université de Tours, Inserm, 37000 Tours, France
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16
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Wang L, Ma Q, Sun X, Xu Z, Zhang J, Liao X, Wang X, Wei D, Chen Y, Liu B, Huang CC, Zheng Y, Wu Y, Chen T, Cheng Y, Xu X, Gong Q, Si T, Qiu S, Lin CP, Cheng J, Tang Y, Wang F, Qiu J, Xie P, Li L, He Y, Xia M, Zhang Y, Li L, Cheng J, Gong Q, Li L, Lin CP, Qiu J, Qiu S, Si T, Tang Y, Wang F, Xie P, Xu X, Xia M. Frequency-resolved connectome alterations in major depressive disorder: A multisite resting fMRI study. J Affect Disord 2023; 328:47-57. [PMID: 36781144 DOI: 10.1016/j.jad.2023.01.104] [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: 08/22/2022] [Revised: 01/24/2023] [Accepted: 01/27/2023] [Indexed: 02/13/2023]
Abstract
BACKGROUND Functional connectome studies have revealed widespread connectivity alterations in major depressive disorder (MDD). However, the low frequency bandpass filtering (0.01-0.08 Hz or 0.01-0.1 Hz) in most studies have impeded our understanding on whether and how these alterations are affected by frequency of interest. METHODS Here, we performed frequency-resolved (0.01-0.06 Hz, 0.06-0.16 Hz and 0.16-0.24 Hz) connectome analyses using a large-sample resting-state functional MRI dataset of 1002 MDD patients and 924 healthy controls from seven independent centers. RESULTS We reported significant frequency-dependent connectome alterations in MDD in left inferior parietal, inferior temporal, precentral, and fusiform cortices and bilateral precuneus. These frequency-dependent connectome alterations are mainly derived by abnormalities of medium- and long-distance connections and are brain network-dependent. Moreover, the connectome alteration of left precuneus in high frequency band (0.16-0.24 Hz) is significantly associated with illness duration. LIMITATIONS Multisite harmonization model only removed linear site effects. Neurobiological underpinning of alterations in higher frequency (0.16-0.24 Hz) should be further examined by combining fMRI data with respiration, heartbeat and blood flow recordings in future studies. CONCLUSIONS These results highlight the frequency-dependency of connectome alterations in MDD and the benefit of examining connectome alteration in MDD under a wider frequency band.
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Affiliation(s)
- Lei Wang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China; IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Qing Ma
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China; State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China; MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Xiaoyi Sun
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China; IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China; School of Systems Science, Beijing Normal University, Beijing, China
| | - Zhilei Xu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China; IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Jiaying Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China; IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Xuhong Liao
- School of Systems Science, Beijing Normal University, Beijing, China
| | - Xiaoqin Wang
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China; Department of Psychology, Southwest University, Chongqing, China
| | - Dongtao Wei
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China; Department of Psychology, Southwest University, Chongqing, China
| | - Yuan Chen
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Bangshan Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha, Hunan, China
| | - Chu-Chung Huang
- Shanghai Key Laboratory of Brain Functional Genomics (Ministry of Education), Institute of Cognitive Neuroscience, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Yanting Zheng
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yankun Wu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Taolin Chen
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Yuqi Cheng
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xiufeng Xu
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital, Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China
| | - Tianmei Si
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Shijun Qiu
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ching-Po Lin
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK; Institute of Neuroscience, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yanqing Tang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Fei Wang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jiang Qiu
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China; Department of Psychology, Southwest University, Chongqing, China
| | - Peng Xie
- Chongqing Key Laboratory of Neurobiology, Chongqing, China; Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lingjiang Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha, Hunan, China
| | - Yong He
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China; IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China; Chinese Institute for Brain Research, Beijing, China
| | | | - Mingrui Xia
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China; IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China.
| | - Yihe Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China; IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China.
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17
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Wood-Ross C, Tran T, Milanovic M, Jokic R, Milev R, Bowie CR. Neurocognition and Depressive Symptoms have Unique Pathways to Predicting Different Domains of Functioning in Major Depressive Disorder. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2023; 68:241-248. [PMID: 36411975 PMCID: PMC10037745 DOI: 10.1177/07067437221133375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Research has established the independent relationships between depressive symptoms to cognition and functioning in depression; however, little is known about the role of mediators in this relationship. We explored the role of neurocognitive abilities, depressive symptom severity, dysfunctional attitudes, and functional capacity in predicting two dimensions of daily functioning in individuals with major depressive disorder (MDD). METHODS One hundred and twenty-four participants (mean age = 46.26, SD = 12.27; 56% female) with a diagnosis of MDD were assessed on a standard neurocognitive battery, self-reported depressive symptoms, dysfunctional attitudes, and clinician-rated functional impairment. They completed a performance-based assessment of functional competence. RESULTS Confirmatory path analyses were used to model the independent and mediated effects of variables on two domains of functioning: social (relationships and social engagement) and productive (household and community activities). Cognition and depressive symptoms both predicted productive functioning, and dysfunctional attitudes mediated each of these relationships. Functional competence was a significant mediator in the relationship between neurocognition and productive functioning. Depressive symptoms and cognition were direct predictors of social functioning with no significant mediators. CONCLUSIONS There are divergent pathways to different dimensions of daily functioning in MDD. Measurement implications include the consideration of multiple levels of predicting productive activities and more direct relationships with social outcomes. Treatments that directly target depressive symptoms and cognition might not generalize to improvements in everyday functioning if additional pathways to functioning are not addressed.
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Affiliation(s)
| | - Tanya Tran
- Department of Psychology, Queen's University, Ontario, Canada
| | | | - Ruzica Jokic
- Department of Psychology, Queen's University, Ontario, Canada
- Centre for Neuroscience Studies, Queen's University, Ontario, Canada
| | - Roumen Milev
- Department of Psychology, Queen's University, Ontario, Canada
- Centre for Neuroscience Studies, Queen's University, Ontario, Canada
- Providence Care, Kingston, Ontario, Canada
| | - Christopher R Bowie
- Department of Psychology, Queen's University, Ontario, Canada
- Centre for Addictions and Mental Health, Ontario, Canada
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18
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Golas AC, Salwierz P, Rajji TK, Bowie CR, Butters MA, Fischer CE, Flint AJ, Herrmann N, Mah L, Mulsant BH, Pollock BG, Taghdiri F, Wang W, Tartaglia MC. Assessing the Role of Past Depression in Patients with Mild Cognitive Impairment, with and without Biomarkers for Alzheimer's Disease. J Alzheimers Dis 2023; 92:1219-1227. [PMID: 36911939 DOI: 10.3233/jad-221097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
Major depressive disorder (MDD) is a risk factor for Alzheimer's disease (AD). Cerebrovascular disease (CVD) is implicated in MDD and AD. Our study compared participants with AD positive and negative cerebrospinal fluid (CSF) biomarkers on neuropsychological performance, remitted MDD status, and CVD burden. Next, we compared AD-CSF biomarkers and white matter hyperintensities (WMH) burden among three groups: mild cognitive impairment (MCI) (n = 12), MCI with remitted MDD (MDD+MCI) (n = 12), and remitted MDD alone (MDD) (n = 7). Few participants (18%) with MCI+MDD exhibited AD(+) biomarkers. Nearly all participants had moderate-severe WMH. WMH may contribute to cognitive impairment or depression in MCI patients with AD(-) biomarkers.
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Affiliation(s)
- Angela C Golas
- Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Patrick Salwierz
- Centre for Addiction and Mental Health, Toronto, ON, Canada.,Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada.,Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Tarek K Rajji
- Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Toronto Dementia Research Alliance, University of Toronto, Toronto, ON, Canada
| | - Christopher R Bowie
- Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychology, Queen's University, Kingston, ON, Canada
| | - Meryl A Butters
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Corinne E Fischer
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada
| | - Alastair J Flint
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,University Health Network, Toronto, ON, Canada
| | - Nathan Herrmann
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Linda Mah
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
| | - Benoit H Mulsant
- Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Bruce G Pollock
- Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Foad Taghdiri
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
| | - Wei Wang
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - M Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada.,Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
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19
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Chen R, Lin Q, Wu J, Lin Y, Lin T, Wu W, Chen X, Wu S, Zeng G, Lin X, Wu Y, Liu N, Xiao Y, Chen H. Augmentation therapy with tandospirone citrate in vascular depression patients with mild cognitive impairment: A prospective randomized clinical trial. J Psychiatr Res 2023; 159:274-282. [PMID: 36774768 DOI: 10.1016/j.jpsychires.2022.12.023] [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: 08/03/2022] [Revised: 11/04/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022]
Abstract
Cognitive impairment is a prominent clinical manifestation of vascular depression (VaDep). The current study aimed to assess the efficacy of tandospirone citrate in VaDep cases with mild cognitive impairment (VaDep-MCI) as well as the role of plasma monoamine neurotransmitters during the treatment. In this single-blind, randomized controlled study, 116 participants were randomly assigned to the tandospirone (tandospirone citrate-escitalopram) and control (escitalopram) groups. The primary endpoints were changes in cognitive test scores from baseline to Week 8, including the Rey Auditory Verbal Learning Test (RAVLT), Semantic Verbal Fluency (SVF) test, Trail Making Test (TMT), Digital Span Test (DST) and Clock Drawing Test (CDT) scores. Generalized estimating equation models were used to examine repeated measures. The results showed that compared with the changes in the control group from baseline to Week 8, the tandospirone group showed more significant changes in SVF score at Weeks 4 (p < 0.05) and 8 (p < 0.001), and TMT (B-A) score at Week 8 (p < 0.05). RAVLT, DST and DCT scores were relatively stable in both groups during the study period. Moreover, mediation analysis showed that these results were not mediated by the alleviation of depression symptoms. Partial Spearman correlation analysis showed that only plasma 5-hydroxytryptamine (5-HT) was positively correlated with Hamilton Depression Rating Scale score after Bonferroni correction (r = 0.347, p < 0.001). Augmentation therapy with tandospirone citrate improved the executive and language functions of VaDep-MCI patients. Additionally, plasma 5-HT levels may serve as a potential biomarker of VaDep severity. These findings may provide clinical insights into the treatment of vascular depression.
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Affiliation(s)
- Ronghua Chen
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China; Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China; Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China; Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
| | - Qianwen Lin
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China; Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China; Department of Sleep Center, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China; Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China
| | - Juan Wu
- Department of Clinical Laboratory, School of Medical Technology and Engineering, Fujian Medical University, Fuzhou, China
| | - Yongsen Lin
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China; Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China; Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China; Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
| | - Ting Lin
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China; Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China; Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China; Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
| | - Weiwei Wu
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China; Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China; Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China; Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
| | - Xinyan Chen
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China; Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China
| | - Shufang Wu
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China; Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China; Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China
| | - Guiying Zeng
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China; Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China; Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China
| | - Xiaohui Lin
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China; Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China; Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China; Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
| | - Yongxi Wu
- Department of Sleep Center, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China
| | - Nan Liu
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China; Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China; Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China; Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China.
| | - Yingchun Xiao
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China; Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China; Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China; Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China.
| | - Hongbin Chen
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China; Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China; Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China; Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China.
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20
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Manning KJ, Wu R, McQuoid DR, Steffens DC, Potter GG. Reliable Cognitive Decline in Late-Life Major Depression. Arch Clin Neuropsychol 2023; 38:247-257. [PMID: 36302229 PMCID: PMC9940117 DOI: 10.1093/arclin/acac083] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Major depression in older adults increases the statistical likelihood of dementia. It is challenging to translate statistical evidence of cognitive decline at the group level into knowledge of individual cognitive outcomes. The objective of the current study is to investigate 2-year reliable cognitive change in late-life depression (LLD), which will enhance understanding of cognitive changes in LLD and provide a means to assess individual change. METHODS In a sample of non-depressed cognitively normal older adults or NDCN (n = 113), we used linear regression to predict tests of global cognition, processing speed-executive functioning, and memory administered 1 and 2 years later. Stepwise regression was used to select covariates among demographics and raw test scores (either baseline or year 1) and we cross-validated the final models using the predicted residual error sum of squares (PRESS). We then derived a z-change score from the difference between actual and predicted follow-up scores and investigated the proportion of LLD patients (n = 199) and NDCN adults who experienced reliable "decline" (a z-score < -1.645), "stability" (z-scores between + - 1.645), and "improvement" (z scores > +1.645). RESULTS A greater proportion LLD compared with NDCN experienced cognitive decline in processing speed/executive functioning and global cognition over 2 years. When compared to NDCN, a greater proportion of LLD also significantly improved on one test of processing speed over 2 years. CONCLUSIONS Older adults with LLD are at risk of meaningful cognitive decline over a relatively short period, particularly in the domain of executive functioning and processing speed. This study provides a series of reliable change equations for common neuropsychological tests that can be applied clinically.
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Affiliation(s)
- Kevin J Manning
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, USA
| | - Rong Wu
- Biostatistics Center, University of Connecticut Health Center, Farmington, CT, USA
| | - Douglas R McQuoid
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - David C Steffens
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, USA
| | - Guy G Potter
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
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21
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The Association of Adherence to the Mediterranean Diet with Depression in Older Adults Longitudinally Taking into Account Cognitive Status: Results from the HELIAD Study. Nutrients 2023; 15:nu15020359. [PMID: 36678230 PMCID: PMC9865507 DOI: 10.3390/nu15020359] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/02/2023] [Accepted: 01/08/2023] [Indexed: 01/12/2023] Open
Abstract
Although research has generally shown a negative association between depression and adherence to the Mediterranean diet (MeDi), the literature related to older adults is controversial, perhaps partially due to the fact that cognitive status has not been considered. The aim of the current work was to investigate the association between MeDi and incident depression in a representative cohort of people, taking into account their cognitive status in multiple ways. The sample was drawn from the HELIAD study, a longitudinal study including a follow-up of 3 years after the baseline assessment. In total, 879 participants without depression at baseline were included (55.4% women, mean age ± Standard Deviation: 73.3 ± 5.0 years). Depression was determined as a score in the Geriatric depression scale ≥6 and/or antidepressant medication and/or clinical diagnosis of depression. Cox proportional hazard models adjusted for age, sex and education were employed. In the basic model, adherence to the MeDi was negatively associated with depression. In the most conservative model, excluding participants with dementia and Mild Cognitive Impairment, and after controlling for the baseline Cognitive Status, each unit (range 0−55) increase in MeDi was associated with a 6.2% decrease in the risk for depression (p < 0.001). These findings indicate that MeDi is negatively associated with depression longitudinally in older adults, above and beyond cognitive status.
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Zhang Y, Shao J, Wang X, Pei C, Zhang S, Yao Z, Lu Q. Partly recovery and compensation in anterior cingulate cortex after SSRI treatment-evidence from multi-voxel pattern analysis over resting state fMRI in depression. J Affect Disord 2023; 320:404-412. [PMID: 36179779 DOI: 10.1016/j.jad.2022.09.071] [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: 11/03/2021] [Revised: 05/23/2022] [Accepted: 09/20/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Anterior cingulate cortex (ACC) plays an essential role in the pathophysiology of major depressive disorder (MDD) and its treatment. However, it's still unclear whether the effects of disease and antidepressant treatment on ACC perform diversely in neural mechanisms. METHODS Fifty-nine MDD patients completed resting-state fMRI scanning twice at baseline and after 12-week selective serotonin reuptake inhibitor (SSRI) treatment, respectively in acute state and remission state. Fifty-nine demographically matched healthy controls were enrolled. Using fractional amplitude of low-frequency fluctuation (fALFF) in ACC as features, we performed multi-voxel pattern analysis over pretreatment MDD patients vs health control (HC), and over pretreatment MDD patients vs posttreatment MDD patients. RESULTS Discriminative regions in ACC for MDD impairment and changes after antidepressants were obtained. The intersection set and difference set were calculated to form ACC subregions of recovered, unrecovered and compensative, respectively. The recovered ACC subregion mainly distributed in rostral ACC (80 %) and the other two subregions had nearly equal distribution over dorsal ACC and rostral ACC. Furthermore, only the compensative subregion had significant changed functional connectivity with cingulo-opercular control network (CON) after antidepressant treatment. LIMITATIONS The number of subjects was relatively small. The results need to be validated with larger sample sizes and multisite data. CONCLUSIONS This finding suggested that the local function of ACC was partly recovered on regulating emotion after antidepressant by detecting the common subregional targets of depression impairment and antidepressive effect. Besides, changed fALFF in the compensative ACC subregion and its connectivity with CON may partly compensate for the cognition deficits.
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Affiliation(s)
- Yujie Zhang
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing 210096, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, China
| | - Junneng Shao
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing 210096, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, China
| | - Xinyi Wang
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing 210096, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, China
| | - Cong Pei
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing 210096, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, China
| | - Shuqiang Zhang
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing 210096, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, China
| | - Zhijian Yao
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China; Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing 210093, China.
| | - Qing Lu
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing 210096, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, China.
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Relationship between chronic obstructive pulmonary disease and cognition in an aging population. J Psychosom Res 2022; 161:111000. [PMID: 35963125 DOI: 10.1016/j.jpsychores.2022.111000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 07/25/2022] [Accepted: 08/01/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Chronic obstructive pulmonary disease (COPD) is a common and severe respiratory illness. Prior research suggests that COPD may be associated with depression as well as cognitive impairment and increased risk of dementia. Many studies to date have been relatively small, have largely relied on global screening measures to identify cognitive impairment, and have not examined the potential role of comorbid depression on cognition. This cross-sectional study examined the relationship between COPD and multiple cognitive domains at two time points using data from a large longitudinal population database. METHODS Linear multivariate analyses were conducted using secondary data from the Wisconsin Longitudinal Study to determine the effect of lifetime COPD and depressive symptom severity, assessed with the Center for Epidemiological Studies Depression Scale (CESD), on multiple cognitive outcomes. RESULTS In both 2004 (n = 1608) and 2011 (n = 1743), lifetime COPD was found to be a non-significant predictor of all cognitive outcomes, while depressive symptom severity predicted significantly lower scores on the immediate recall and digit ordering tasks in 2004 and on all outcomes in 2011. Exploratory analyses in only those with lifetime COPD revealed COPD severity to be a non-significant factor for all outcomes in 2004 and 2011. CONCLUSION COPD was not significantly associated with cognition. Conversely, higher depressive symptom severity was significantly associated with poorer performance on additional cognitive tasks in 2011 compared to 2004, suggesting that depression may contribute to cognitive decline, dependent upon the context of aging.
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Zhou H, Zhong X, Chen B, Wang Q, Zhang M, Mai N, Wu Z, Huang X, Chen X, Peng Q, Ning Y. Elevated homocysteine levels, white matter abnormalities and cognitive impairment in patients with late-life depression. Front Aging Neurosci 2022; 14:931560. [PMID: 35923546 PMCID: PMC9340773 DOI: 10.3389/fnagi.2022.931560] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/30/2022] [Indexed: 11/13/2022] Open
Abstract
Background Cognitive impairment in late−life depression (LLD) is considered to be caused by neurodegenerative changes. Elevated homocysteine (Hcy) levels may be linked to cognitive abnormalities associated with LLD. The important role of white matter (WM) damage in cognitive impairment and pathogenesis in patients with LLD has been widely reported. However, no research has explored the interrelationships of these features in patients with LLD. Objective The goal of the study was to examine the interrelationship between Hcy levels, cognition, and variations in WM microstructure detected by diffusion tensor imaging (DTI) in patients with LLD. Methods We recruited 89 healthy controls (HCs) and 113 patients with LLD; then, we measured the plasma Hcy levels of participants in both groups. All individuals performed a battery of neuropsychological tests to measure cognitive ability. Seventy-four patients with LLD and 68 HCs experienced a DTI magnetic resonance imaging (MRI) scan. Results Patients with LLD showed significantly lower fractional anisotropy (FA) values in the bilateral inferior longitudinal fasciculus than those of healthy participants. Only in LLD patients was Hcy concentration inversely associated to FA values in the forceps minor. Finally, multiple regression analyses showed that an interaction between Hcy levels and FA values in the right cingulum of the cingulate cortex and right inferior longitudinal fasciculus were independent contributors to the executive function of patients with LLD. Conclusion Our results highlight the complex interplay between elevated homocysteine levels and WM abnormalities in the pathophysiology of LLD-related cognitive impairment, consistent with the neurodegeneration hypothesis.
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Affiliation(s)
- Huarong Zhou
- Center for Geriatric Neuroscience, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiaomei Zhong
- Center for Geriatric Neuroscience, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ben Chen
- Center for Geriatric Neuroscience, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Qiang Wang
- Center for Geriatric Neuroscience, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Min Zhang
- Center for Geriatric Neuroscience, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Naikeng Mai
- Department of Neurology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhangying Wu
- Center for Geriatric Neuroscience, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xingxiao Huang
- Center for Geriatric Neuroscience, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xinru Chen
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Qi Peng
- Center for Geriatric Neuroscience, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yuping Ning
- Center for Geriatric Neuroscience, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
- *Correspondence: Yuping Ning,
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Muhammad T, Skariah AE, Kumar M, Srivastava S. Socioeconomic and health-related inequalities in major depressive symptoms among older adults: a Wagstaff's decomposition analysis of data from the LASI baseline survey, 2017-2018. BMJ Open 2022; 12:e054730. [PMID: 35649601 PMCID: PMC9161106 DOI: 10.1136/bmjopen-2021-054730] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 04/28/2022] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES To find out the association between socioeconomic and health status and depression among older adults and explore the contributing factors in the socioeconomic and health-related inequalities in late-life depression. DESIGN A cross-sectional study was conducted using large representative survey data. SETTING AND PARTICIPANTS Data for this study were derived from the baseline wave of the Longitudinal Ageing Study in India conducted during 2017-2018. The effective sample size was 30 888 older adults aged 60 years and above. PRIMARY AND SECONDARY OUTCOME MEASURES The outcome variable in this study was depression among older adults. Descriptive statistics along with bivariate analysis was conducted to report the preliminary results. Multivariable binary logistic regression analysis and Wagstaff's decomposition were used to fulfil the objectives of the study. RESULTS There was a significant difference for the prevalence of depression (4.3%; p<0.05) among older adults from poor (11.2%) and non-poor categories (6.8%). The value of the Concentration Index was -0.179 which also confirms that the major depression was more concentrated among poor older adults. About 38.4% of the socioeconomic and health-related inequality was explained by the wealth quintile for major depression among older adults. Moreover, about 26.6% of the inequality in major depression was explained by psychological distress. Self-rated health (SRH), difficulty in activities of daily living (ADL) and instrumental ADL (IADL) contributed 8.7%, 3.3% and 4.8% to the inequality, respectively. Additionally, region explained about 23.1% of inequality followed by life satisfaction (11.2) and working status (9.8%) for major depression among older adults. CONCLUSIONS Findings revealed large socioeconomic and health-related inequalities in depression in older adults which were especially pronounced by poor household economy, widowhood, poor SRH, ADL and IADL difficulty, and psychological distress. In designing prevention programmes, detection and management of older adults with depression should be a high priority, especially for those who are more vulnerable.
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Affiliation(s)
- T Muhammad
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | | | - Manish Kumar
- Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Shobhit Srivastava
- Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, Maharashtra, India
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Invernizzi S, Simoes Loureiro I, Kandana Arachchige KG, Lefebvre L. Late-Life Depression, Cognitive Impairment, and Relationship with Alzheimer's Disease. Dement Geriatr Cogn Disord 2022; 50:414-424. [PMID: 34823241 DOI: 10.1159/000519453] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 09/06/2021] [Indexed: 11/19/2022] Open
Abstract
This narrative review aimed to explore the existing knowledge in order to examine the multiple forms of late-life depression (LLD) within a non-neurodegenerative or a neurodegenerative context, in particular Alzheimer's disease (AD). This review will first provide information about different pathogenic hypotheses proposed to describe LLD when it is not linked to a neurodegenerative context. Within the presentation of these syndromes, the literature reports thymic and cognitive specific features and highlights a common preponderance of cognitive impairment, and particularly executive. This review will also report data from research works that have addressed the role of depressive symptoms (DSs) in incidence of AD and mild cognitive impairment (MCI) conversion to AD. These findings support the claim that the relationship between DS (or LLD) and the cognitive decline encountered in AD can be of 2 types: (1) risk factor or (2) prodrome. They also support the hypothesis that the effect of DS on the incidence of AD can be identified between specific characteristics of these symptoms such as a very first apparition late in life, an increasing severity of DS, and a poor response to medical treatment. Finally, longitudinal and cross-sectional research will be presented, aiming to identify the predictive value of DS (or LLD) on AD incidence and/or conversion of MCI (and specifically amnestic MCI). This final section shows that specific features of LLD, such as being of early- or late-onset, can be considered as indices of AD incidence.
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Affiliation(s)
- Sandra Invernizzi
- Department of Cognitive Psychology and Neuropsychology, University of Mons, Mons, Belgium
| | | | | | - Laurent Lefebvre
- Department of Cognitive Psychology and Neuropsychology, University of Mons, Mons, Belgium
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Almdahl IS, Agartz I, Hugdahl K, Korsnes MS. Brain pathology and cognitive scores prior to onset of late-life depression. Int J Geriatr Psychiatry 2022; 37. [PMID: 35178780 DOI: 10.1002/gps.5686] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 01/26/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Understanding the biological changes that occur prior to onset of late-life depression (LLD) is key to its prevention. To investigate potential predictors of LLD, we assessed cognitive scores and neurodegenerative and vascular biomarkers in healthy older adults who later developed depression. METHODS Longitudinal data from the Alzheimer's Disease Neuroimaging Initiative of 241 cognitively unimpaired and non-depressed older adults aged 56-90 at baseline with at least 4 years of follow-up were included. Participants were classified based on whether they developed an incident depression (n = 96) or not (n = 145). Cognitive measures of memory, executive functioning, and language, and biomarkers proposed to be related to LLD: hippocampal volume, white matter hyperintensity volume (WMH), and cortical and cerebrospinal fluid (CSF) amyloid beta levels, were compared between the incident depression and the never-depressed groups at four time points: at baseline, the visit prior to onset, at onset, and after the onset of depression. RESULTS In the incident depression group, there was a mild decline in cognitive scores from baseline to the visit before depression onset compared with the never-depressed group. The cognitive differences between the groups became more marked after depression onset. Baseline cortical amyloid burden, CSF amyloid beta levels, and WMH were significant predictors of incident depression. Compared to the non-depressed group, hippocampal volume was not reduced before onset, but was reduced following depression. CONCLUSIONS Amyloid pathology and WMH can predict future development of LLD in cognitively unimpaired individuals and may be involved in precipitating vulnerability for depression in older adults.
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Affiliation(s)
- Ina S Almdahl
- Department of Old Age Psychiatry, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Agartz
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway.,Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Institutet, Stockholm, Sweden
| | - Kenneth Hugdahl
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.,Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Radiology, Haukeland University Hospital, Bergen, Norway
| | - Maria S Korsnes
- Department of Old Age Psychiatry, Oslo University Hospital, Oslo, Norway.,Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
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Trajectories of Concurrent Depressive Symptoms and Cognitive Function on Health Outcomes and Mortality among Older Mexican Americans. Arch Gerontol Geriatr 2022; 100:104663. [PMID: 35248914 PMCID: PMC9036192 DOI: 10.1016/j.archger.2022.104663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/15/2022] [Accepted: 02/15/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND We sought to identify distinctive concurrent trajectory classes of depressive symptoms (DS) and cognitive function (CF) in Mexican Americans aged 75+ years, and to examine whether these trajectories were associated with an increased risk of adverse outcomes. METHODS We used 4 waves of Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-EPESE) data from 2004 to 5 to 2013. Latent growth curve analysis was used to identify distinctive concurrent trajectory classes of DS and CF. Generalized linear mixed models were further used to examine the association between the concurrent trajectories and health outcomes. Cox proportional hazards regression model was used to examine the risk of mortality as a function of the concurrent trajectories. RESULTS 1,302 older adults followed-up approximately 9-years were successfully classified into 6 distinct concurrent trajectory classes of DS (low-increasing, high) and CF (high, high-declining, medium-declining). Compared to the co-occurrence of low DS and high CF trajectories, those with the high DS and declining CF trajectories were at greater risk of ADL and IADL functional limitations (1.6 - 2.9 times), more medical visits (1.3 - 1.4 times), hospital admissions (1.6 - 1.9 times), and mortality (1.7 - 2.6 times). CONCLUSIONS Differences in adverse health outcomes across concurrent trajectory classes of DS and CF suggest that differences in underlying co-occurrence and progression have important implications for public health interventions as well as development of aging social and health policies.
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Dobielska M, Bartosik NK, Zyzik KA, Kowalczyk E, Karbownik MS. Mechanisms of Cognitive Impairment in Depression. May Probiotics Help? Front Psychiatry 2022; 13:904426. [PMID: 35757204 PMCID: PMC9218185 DOI: 10.3389/fpsyt.2022.904426] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 05/16/2022] [Indexed: 12/02/2022] Open
Abstract
Depression is the major cause of disability globally. Apart from lowered mood and accompanying symptoms, it leads to cognitive impairment that altogether predicts disadvantaged social functioning. Reduced cognitive function in depression appears a bit neglected in the field of clinical and molecular psychiatry, while it is estimated to occur in two-thirds of depressed patients and persist in at least one third of remitted patients. This problem, therefore, requires elucidation at the biomolecular and system levels and calls for improvement in therapeutic approach. In this review study, we address the above-mentioned issues by discussing putative mechanisms of cognitive decline in depression: (1) increased oxidative stress and (2) inflammation, (3) disturbed hypothalamus-pituitary-adrenals axis, and (4) reduced monoamines functionality. Moreover, we acknowledge additional underpinnings of cognitive impairment in depressed elderly: (5) vascular-originated brain ischemia and (6) amyloid-beta plaque accumulation. Additionally, by reviewing molecular, pre-clinical and clinical evidence, we propose gut microbiota-targeted strategies as potential adjuvant therapeutics. The study provides a consolidated source of knowledge regarding mechanisms of cognitive impairment in depression and may path the way toward improved treatment options.
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Affiliation(s)
- Maria Dobielska
- Students' Research Club, Department of Pharmacology and Toxicology, Medical University of Łódź, Łódź, Poland
| | - Natalia Karina Bartosik
- Students' Research Club, Department of Pharmacology and Toxicology, Medical University of Łódź, Łódź, Poland
| | - Kamil A Zyzik
- Institute of Sociology, Jagiellonian University, Kraków, Poland
| | - Edward Kowalczyk
- Department of Pharmacology and Toxicology, Medical University of Łódź, Łódź, Poland
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Abstract
INTRODUCTION The syndromes of mild cognitive impairment (MCI) or mild neurocognitive disorder (MiND), often prodromal to dementia (Major Neurocognitive Disorder), are characterized by acquired clinically significant changes in one or more cognitive domains despite preserved independence. Mild impairment has significant medicolegal consequences for an affected person and their care system. We review the more common etiologies of MiND and provide a systematic review of its medicolegal implications. METHODS We conducted a systematic review of the peer-reviewed English literature on medicolegal aspects of MCI or MiND using comprehensive search terms and expanding our review to include sources cited by these reports. RESULTS Impairment of memory, executive function, social cognition, judgment, insight or abstraction can alter an individual's abilities in a variety of areas that include decision making, informed consent, designation of a surrogate decision-maker such as a health care proxy, understanding and management of financial affairs, execution of a will, or safe driving. CONCLUSION Even mild cognitive impairment can have significant behavioral consequences. Clinicians can assist care partners and persons with MCI or MiND by alerting them to the medicolegal concerns that often accompany cognitive decline. Early recognition and discussion can help a care system manage medicolegal risk more effectively and promote thoughtful advance planning.
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Affiliation(s)
- Anca Bejenaru
- Department of Psychiatry and Behavioral Health, Christiana Care, Wilmington, DE, USA
| | - James M Ellison
- Department of Psychiatry and Behavioral Health, Christiana Care, Wilmington, DE, USA.,Department of Family and Community Medicine, Christiana Care, Wilmington, DE, USA.,Department of Psychiatry & Human Behavior, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
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Roy JC, Houvenaghel JF, Duprez J, Guillery M, Drapier D, Robert G. Dynamics of cognitive action control in late-life depression during action selection. J Psychiatr Res 2021; 143:276-284. [PMID: 34530338 DOI: 10.1016/j.jpsychires.2021.09.033] [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: 01/11/2021] [Revised: 08/28/2021] [Accepted: 09/01/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Late-Life Depression (LLD) is characterized by deficits in cognitive control. We investigated the effect of LLD on a subset of cognitive control functions, the Cognitive Action Control (CAC), distinguishing on-line and adaptive control. METHODS We compared LLD subjects (n = 31) and Healthy Controls (HC, n = 31) on their performance in a Simon task. The online congruency effect and adaptive effect were compared for reaction times (RT) and accuracy rates between the groups using mixed models. We applied distributional analyses of RT to differentiate the strength of impulsive action selection and the proficiency of selective action suppression. Finally, we measured correlations between the performances on the task and clinical scores of the LLD group. RESULTS LLD had increased error rates in congruent trials compared to HC. Conversely, the adaptive CAC was equivalent between the groups. Distributional analyses showed that the fastest actions were less led by pertinent information in LLD. This phenomenon was found exclusively for congruent trials preceded by non-congruent trials. On the other hand, LLD patients, when they take time, were better than HC to suppress selectively non-relevant information. No difference was observed for adaptation to the preceding condition. No association between behavioral measurements and clinical scores were found. CONCLUSION Our results suggest that LLD participants have a specific cognitive disturbance of CAC, showing less facilitation than HC in congruent situations. We propose that this originates in a difficulty in LLD patients in disengaging their attention from conflict situations, which is consistent with a biased CAC to aversive stimuli in depression.
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Affiliation(s)
- Jean-Charles Roy
- Academic Psychiatry Department, Centre Hospitalier Guillaume Régnier, Rennes, France; Université Rennes 1, Campus Santé de Villejean, France.
| | - Jean-François Houvenaghel
- Neurology Department, Rennes University Hospital, Rennes, France; Behavior and Basal Ganglia Research Unit (EA4712), Université Rennes 1, Rennes, France
| | - Joan Duprez
- Univ Rennes, INSERM, LTSI -U1099, F-35000 Rennes, France
| | - Murielle Guillery
- Academic Psychiatry Department, Centre Hospitalier Guillaume Régnier, Rennes, France; Behavior and Basal Ganglia Research Unit (EA4712), Université Rennes 1, Rennes, France
| | - Dominique Drapier
- Academic Psychiatry Department, Centre Hospitalier Guillaume Régnier, Rennes, France; Université Rennes 1, Campus Santé de Villejean, France; Behavior and Basal Ganglia Research Unit (EA4712), Université Rennes 1, Rennes, France
| | - Gabriel Robert
- Academic Psychiatry Department, Centre Hospitalier Guillaume Régnier, Rennes, France; Université Rennes 1, Campus Santé de Villejean, France; Behavior and Basal Ganglia Research Unit (EA4712), Université Rennes 1, Rennes, France
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Dotson VM, Gradone AM, Bogoian HR, Minto LR, Taiwo Z, Salling ZN. Be Fit, Be Sharp, Be Well: The Case for Exercise as a Treatment for Cognitive Impairment in Late-life Depression. J Int Neuropsychol Soc 2021; 27:776-789. [PMID: 34154693 PMCID: PMC10436256 DOI: 10.1017/s1355617721000710] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To lay out the argument that exercise impacts neurobiological targets common to both mood and cognitive functioning, and thus more research should be conducted on its use as an alternative or adjunctive treatment for cognitive impairment in late-life depression (LLD). METHOD This narrative review summarizes the literature on cognitive impairment in LLD, describes the structural and functional brain changes and neurochemical changes that are linked to both cognitive impairment and mood disruption, and explains how exercise targets these same neurobiological changes and can thus provide an alternative or adjunctive treatment for cognitive impairment in LLD. RESULTS Cognitive impairment is common in LLD and predicts recurrence of depression, poor response to antidepressant treatment, and overall disability. Traditional depression treatment with medication, psychotherapy, or both, is not effective in fully reversing cognitive impairment for most depressed older adults. Physical exercise is an ideal treatment candidate based on evidence that it 1) is an effective treatment for depression, 2) enhances cognitive functioning in normal aging and in other patient populations, and 3) targets many of the neurobiological mechanisms that underlie mood and cognitive functioning. Results of the limited existing clinical trials of exercise for cognitive impairment in depression are mixed but overall support this contention. CONCLUSIONS Although limited, existing evidence suggests exercise may be a viable alternative or adjunctive treatment to address cognitive impairment in LLD, and thus more research in this area is warranted. Moving forward, additional research is needed in large, diverse samples to translate the growing research findings into clinical practice.
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Affiliation(s)
- Vonetta M. Dotson
- Department of Psychology, Georgia State University
- Gerontology Institute, Georgia State University
| | | | | | - Lex R. Minto
- Department of Psychology, Georgia State University
| | - Zinat Taiwo
- Department of Psychology, Georgia State University
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Smith GS, Kuwabara H, Gould NF, Nassery N, Savonenko A, Joo JH, Bigos KL, Kraut M, Brasic J, Holt DP, Hall AW, Mathews WB, Dannals RF, Nandi A, Workman CI. Molecular imaging of the serotonin transporter availability and occupancy by antidepressant treatment in late-life depression. Neuropharmacology 2021; 194:108447. [PMID: 33450276 PMCID: PMC8716112 DOI: 10.1016/j.neuropharm.2021.108447] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 12/04/2020] [Accepted: 12/30/2020] [Indexed: 12/17/2022]
Abstract
Patients with late-life depression (LLD) have a more variable response to pharmacotherapy relative to patients with mid-life depression. Degeneration of the serotonergic system and lower occupancy of the initial target for antidepressant medications, the serotonin transporter (5-HTT), may contribute to variability in treatment response. The focus of this study was to test the hypotheses that lower cortical and limbic serotonin transporter (5-HTT) availability in LLD patients relative to controls and less 5-HTT occupancy by antidepressant medications would be associated with less improvement in mood and cognition with treatment in LLD patients. Twenty LLD patients meeting DSM-IV criteria for a current major depressive episode and 20 non-depressed controls underwent clinical and neuropsychological assessments, magnetic resonance imaging to measure gray matter volumes and high-resolution positron emission tomography (PET) scanning to measure 5-HTT before and after 10-12 weeks of treatment with Citalopram or Sertraline (patients only). Prior to treatment, 5-HTT was lower in LLD patients relative to controls in mainly temporal cortical and limbic (amygdala and hippocampus) regions. Gray matter volumes were not significantly different between groups. 5-HTT occupancy was detected throughout cortical, striatal, thalamic and limbic regions. The magnitude of regional 5-HTT occupancy by antidepressants was 70% or greater across cortical and sub-cortical regions, consistent with the magnitude of 5-HTT occupancy observed in mid-life depressed patients. Greater regional 5-HTT occupancy correlated with greater improvement in depressive symptoms and visual-spatial memory performance. These data support the hypothesis that serotonin degeneration and variability in 5-HTT occupancy may contribute to heterogeneity in treatment response in LLD patients.
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Affiliation(s)
- Gwenn S Smith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Division of Nuclear Medicine and Molecular Imaging, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Hiroto Kuwabara
- Division of Nuclear Medicine and Molecular Imaging, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Neda F Gould
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Najilla Nassery
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alena Savonenko
- Department of Pathology (Neuropathology), Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jin Hui Joo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kristin L Bigos
- Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michael Kraut
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - James Brasic
- Division of Nuclear Medicine and Molecular Imaging, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Daniel P Holt
- Division of Nuclear Medicine and Molecular Imaging, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Andrew W Hall
- Division of Nuclear Medicine and Molecular Imaging, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - William B Mathews
- Division of Nuclear Medicine and Molecular Imaging, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Robert F Dannals
- Division of Nuclear Medicine and Molecular Imaging, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ayon Nandi
- Division of Nuclear Medicine and Molecular Imaging, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Clifford I Workman
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Wang SM, Han KD, Kim NY, Um YH, Kang DW, Na HR, Lee CU, Lim HK. Late-life depression, subjective cognitive decline, and their additive risk in incidence of dementia: A nationwide longitudinal study. PLoS One 2021; 16:e0254639. [PMID: 34260630 PMCID: PMC8279395 DOI: 10.1371/journal.pone.0254639] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 07/01/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Late-life depression and subjective cognitive decline (SCD) are significant risk factors for dementia. However, studies with a large sample size are needed to clarify their independent and combined risks for subsequent dementia. METHODS This nationwide population-based cohort study included all individuals aged 66 years who participated in the National Screening Program between 2009 and 2013 (N = 939,099). Subjects were followed from the day they underwent screening to the diagnosis of dementia, death, or the last follow-up day (December 31, 2017). RESULTS Depressive symptom presentation, recent depressive disorder, and SCD independently increased dementia incidence with adjusted hazard ratio (aHR) of 1.286 (95% CI:1.255-1.318), 1.697 (95% CI:1.621-1.776), and 1.748 (95% CI: 689-1.808) respectively. Subjects having both SCD and depression had a higher risk (aHR = 2.466, 95% CI:2.383-2.551) of dementia than having depression (aHR = 1.402, 95% CI:1.364-1.441) or SCD (aHR = 1.748, 95% CI:1.689-1.808) alone. CONCLUSIONS Depressive symptoms, depressive disorder, and SCD are independent risk factors for dementia. Co-occurring depression and SCD have an additive effect on the risk of dementia; thus, early intervention and close follow up are necessary for patients with co-occurring SCD and depression.
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Affiliation(s)
- Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyung-do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Nak-Young Kim
- Department of Psychiatry, Geyo Hospital, Uiwang, Korea
| | - Yoo Hyun Um
- Department of Psychiatry, St. Vincent Hospital, Suwon, Korea
- College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong-Woo Kang
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hae-Ran Na
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chang-Uk Lee
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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McClintock SM, Minto L, Denney DA, Bailey KC, Cullum CM, Dotson VM. Clinical Neuropsychological Evaluation in Older Adults With Major Depressive Disorder. Curr Psychiatry Rep 2021; 23:55. [PMID: 34255167 PMCID: PMC8764751 DOI: 10.1007/s11920-021-01267-3] [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] [Accepted: 05/25/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE OF THE REVIEW Older adults with major depressive disorder are particularly vulnerable to MDD-associated adverse cognitive effects including slowed processing speed, decreased attention, and executive dysfunction. The purpose of this review is to describe the approach to a clinical neuropsychological evaluation in older adults with MDD. Specifically, this review compares and contrasts neurocognitive screening and clinical neuropsychological evaluation procedures and details the multiple components of the clinical neuropsychological evaluation. RECENT FINDINGS Research has shown that neurocognitive screening serves a useful purpose to provide an acute and rapid assessment of global cognitive function; however, it has limited sensitivity and specificity. The clinical neuropsychological evaluation process is multifaceted and encompasses a review of available medical records, neurobehavioral status and diagnostic interview, comprehensive cognitive and clinical assessment, examination of inclusion and diversity factors as well as symptom and performance validity, and therapeutic feedback. As such, the evaluation provides invaluable information on multiple cognitive functions, establishes brain and behavior relationships, clarifies neuropsychiatric diagnoses, and can inform the etiology of cognitive impairment. Clinical neuropsychological evaluation plays a unique and critical role in integrated healthcare for older adults with MDD. Indeed, the evaluation can serve as a nexus to synthesize information across healthcare providers in order to maximize measurement-based care that can optimize personalized medicine and overall health outcomes.
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Affiliation(s)
- Shawn M McClintock
- Division of Psychology, Department of Psychiatry, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-8898, USA.
- Division of Brain Stimulation and Neurophysiology, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
| | - Lex Minto
- Georgia State University, Atlanta, GA, USA
| | - David A Denney
- Division of Psychology, Department of Psychiatry, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-8898, USA
| | - K Chase Bailey
- Division of Psychology, Department of Psychiatry, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-8898, USA
| | - C Munro Cullum
- Division of Psychology, Department of Psychiatry, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-8898, USA
| | - Vonetta M Dotson
- Department of Psychology, Georgia State University, P.O. Box 5010, Atlanta, GA, 30302-5010, USA
- Gerontology Institute, Georgia State University, Atlanta, GA, USA
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Muhammad T, Meher T. Association of late-life depression with cognitive impairment: evidence from a cross-sectional study among older adults in India. BMC Geriatr 2021; 21:364. [PMID: 34130632 PMCID: PMC8204463 DOI: 10.1186/s12877-021-02314-7] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 06/02/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Late-life depression (LLD) is considered as a prodrome to dementia and plays a major role in the development of long-term cognitive disabilities. We aimed to estimate the prevalence and correlates of LLD and cognitive impairment and to explore their associations among older adults in India. METHODS Data for this study was derived from the Longitudinal Ageing Study in India (LASI) Wave 1 (2017-18). The total sample included 31,464 (15,098 male and 16,366 female) older individuals aged 60 years and above. Cognitive impairment measured from various domains derived from the cognitive module of the Health and Retirement Study (HRS), and major depression measured by the CIDI-SF (Composite International Diagnostic Interview- Short Form) were the outcome variables. Descriptive, bivariate, and multivariable analyses were performed to fulfill the objectives of the study. RESULTS The overall prevalence of LLD and cognitive impairment for the current sample was 8.7% and 13.7 % respectively. Among older individuals who have rated their health status as poor were 2.59 times more likely to suffer from LLD [OR: 2.59, CI: 2.24-2.99] as compared to their counterparts. The older adults who had difficulty in activities of daily living (ADL) and instrumental activities of daily living (IADL) were 74% and 69 % more likely to suffer from LLD. Similarly, older adults who were depressed had higher odds of cognitive impairment [OR: 1.22, CI: 1.01-1.48] compared to their counterparts. Also, older adults who were depressed and belonged to rural areas were 2.58 times [AOR: 2.58, CI: 1.95-3.41] more likely to be cognitively impaired than those who were not depressed and resided in urban areas. CONCLUSIONS Depression is linked to an increased risk of cognitive decline and dementia; therefore, failing to diagnose and treat LLD in later life may have significant health implications. Moreover, treatment under the care of a cognitive neurologist or geriatric psychiatrist is recommended for people with LLD and cognitive disability due to both the disorders' complex existence.
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Affiliation(s)
- T. Muhammad
- International Institute for Population Sciences, 400088 Mumbai, Maharashtra India
| | - Trupti Meher
- International Institute for Population Sciences, 400088 Mumbai, Maharashtra India
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Smith GS, Kuwabara H, Nandi A, Gould NF, Nassery N, Savonenko A, Joo JH, Kraut M, Brasic J, Holt DP, Hall AW, Mathews WB, Dannals RF, Avramopoulos D, Workman CI. Molecular imaging of beta-amyloid deposition in late-life depression. Neurobiol Aging 2021; 101:85-93. [PMID: 33592548 PMCID: PMC8730327 DOI: 10.1016/j.neurobiolaging.2021.01.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 12/16/2020] [Accepted: 01/06/2021] [Indexed: 12/11/2022]
Abstract
Late-life depression (LLD) is associated with an increased risk of all-cause dementia and may involve Alzheimer's disease pathology. Twenty-one LLD patients who met the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria for a current major depressive episode and 21 healthy controls underwent clinical and neuropsychological assessments, magnetic resonance imaging to measure gray matter volumes, and high-resolution positron emission tomography to measure beta-amyloid (Aβ) deposition. Clinical and neuropsychological assessments were repeated after 10-12 weeks of Citalopram or Sertraline treatment (LLD patients only). LLD patients did not differ from healthy controls in baseline neuropsychological function, although patients improved in both depressive symptoms and visual-spatial memory during treatment. Greater Aβ in the left parietal cortex was observed in LLD patients compared with controls. Greater Aβ was correlated with greater depressive symptoms and poorer visual-spatial memory, but not with improvement with treatment. The study of LLD patients with prospective measurements of mood and cognitive responses to antidepressant treatment is an opportunity to understand early neurobiological mechanisms underlying the association between depression and subsequent cognitive decline.
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Affiliation(s)
- Gwenn S Smith
- Division of Geriatric Psychiatry and Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Division of Nuclear Medicine and Molecular Imaging.
| | | | - Ayon Nandi
- Division of Nuclear Medicine and Molecular Imaging
| | - Neda F Gould
- Division of Geriatric Psychiatry and Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Najilla Nassery
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alena Savonenko
- Department of Pathology (Neuropathology), Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jin Hui Joo
- Division of Geriatric Psychiatry and Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michael Kraut
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - James Brasic
- Division of Nuclear Medicine and Molecular Imaging
| | | | | | | | | | - Dimitrios Avramopoulos
- Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Clifford I Workman
- Division of Geriatric Psychiatry and Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Diniz BS, Vieira EM, Mendes‐Silva AP, Bowie CR, Butters MA, Fischer CE, Flint A, Herrmann N, Kennedy J, Lanctôt KL, Mah L, Pollock BG, Mulsant BH, Rajji TK. Mild cognitive impairment and major depressive disorder are associated with molecular senescence abnormalities in older adults. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2021; 7:e12129. [PMID: 33816758 PMCID: PMC8012242 DOI: 10.1002/trc2.12129] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/10/2020] [Accepted: 11/25/2020] [Indexed: 11/08/2022]
Abstract
INTRODUCTION The biological mechanisms linking mild cognitive impairment (MCI) and major depressive disorder are not well understood. We investigated whether molecular senescence changes in older adults are associated with a history of major depressive disorder (MDD) or MCI. METHODS We included 371 participants: 167 with MCI; 62 cognitively normal with a history of MDD; 97 with MDD+MCI; and 45 cognitively unimpaired (CU) without a history of MDD. The candidate Senescence-Associated Secretory Phenotype (SASP) biomarkers were measured in the plasma using a customized LUMINEX assay. RESULTS The MDD+MCI group had a higher SASP index than the other groups (P < .001). A higher SASP index was significantly associated with worse global cognitive performance, executive dysfunction, slower processing speed, and episodic memory deficits. DISCUSSION Our study suggests that increased molecular changes are associated with cognitive impairment in older adults with MDD and indicate that accelerated biological aging is an underlying feature of MDD.
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Affiliation(s)
- Breno S. Diniz
- Platform for Peripheral Biomarkers DiscoveryCentre for Addiction and Mental Health (CAMH)Campbell Family Mental Health Research InstituteTorontoOntarioCanada
- Adult Neurodevelopment and Geriatric Psychiatry DivisionCentre for Addiction and Mental Health (CAMH)TorontoOntarioCanada
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
| | - Erica M. Vieira
- Platform for Peripheral Biomarkers DiscoveryCentre for Addiction and Mental Health (CAMH)Campbell Family Mental Health Research InstituteTorontoOntarioCanada
| | - Ana Paula Mendes‐Silva
- Platform for Peripheral Biomarkers DiscoveryCentre for Addiction and Mental Health (CAMH)Campbell Family Mental Health Research InstituteTorontoOntarioCanada
| | - Christopher R. Bowie
- Adult Neurodevelopment and Geriatric Psychiatry DivisionCentre for Addiction and Mental Health (CAMH)TorontoOntarioCanada
- Department of PsychologyQueen's UniversityKingstonOntarioCanada
| | - Meryl A. Butters
- Department of PsychiatryUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Corinne E. Fischer
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
- Keenan Research Centre for Biomedical ResearchSt. Michael's HospitalLi Ka Shing Knowledge InstituteTorontoOntarioCanada
| | - Alastair Flint
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
- Centre for Mental HealthUniversity Health NetworkTorontoOntarioCanada
| | - Nathan Herrmann
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
- Sunnybrook Health Sciences CentreTorontoOntarioCanada
| | - James Kennedy
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
- Centre for Addiction and Mental Health (CAMH)TorontoOntarioCanada
| | - Krista L. Lanctôt
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
- Sunnybrook Health Sciences CentreTorontoOntarioCanada
| | - Linda Mah
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
- Baycrest Health Sciences CentreRotman Research InstituteTorontoOntarioCanada
| | - Bruce G. Pollock
- Adult Neurodevelopment and Geriatric Psychiatry DivisionCentre for Addiction and Mental Health (CAMH)TorontoOntarioCanada
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
| | - Benoit H. Mulsant
- Adult Neurodevelopment and Geriatric Psychiatry DivisionCentre for Addiction and Mental Health (CAMH)TorontoOntarioCanada
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
| | - Tarek K. Rajji
- Adult Neurodevelopment and Geriatric Psychiatry DivisionCentre for Addiction and Mental Health (CAMH)TorontoOntarioCanada
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
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Late-life depression and increased risk of dementia: a longitudinal cohort study. Transl Psychiatry 2021; 11:147. [PMID: 33654078 PMCID: PMC7925518 DOI: 10.1038/s41398-021-01269-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 12/06/2020] [Accepted: 12/16/2020] [Indexed: 01/26/2023] Open
Abstract
Late-life depression (LLD) is associated with an increased risk of developing dementia; however, it is not known whether individuals with a history of LLD exhibit a more rapid rate of cognitive decline. We aimed to determine whether those with LLD experienced faster cognitive decline compared with never-depressed control (NDC) participants from the community and whether stratification of LLD into early-onset depression (EOD) and late-onset depression (LOD) subtypes revealed differing rates and domain-specific expression of cognitive decline. We conducted a prospective, longitudinal study where 185 participants with LLD (remitted) and 114 NDC were followed for 5 years on average. EOD was defined as having first lifetime depressive episode at <60years and LOD at ≥60years. Every year, participants underwent comprehensive neuropsychological assessment. Composite scores for each cognitive domain were calculated through averaging standardized scores across tests. LLD compared to NDC demonstrated significant baseline impairment but did not decline more rapidly. EOD were significantly impaired in attention/processing speed and global cognitive function at baseline but did not experience more rapid decline as compared to NDC. Those with LOD compared to both NDC and EOD performed worse in all domains at baseline and experienced more rapid decline in verbal skills and delayed memory ability. Our findings suggest that baseline impairment may lower the threshold for those with LLD to develop dementia. EOD and LOD may represent distinct phenotypes of cognitive impairment with differing neural substrates. LOD may represent a distinct phenotype with a more rapid decline in verbal skills and delayed memory.
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Siddarth P, Funes CM, Laird KT, Ercoli L, Lavretsky H. Predictors of Cognitive Improvement Following Treatment for Late-Life Depression. J Geriatr Psychiatry Neurol 2021; 34:162-168. [PMID: 32208884 DOI: 10.1177/0891988720915515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Cognitive impairment is frequently comorbid with late-life depression (LLD) and often persists despite remission of mood symptoms with antidepressant treatment. Increasing understanding of factors that predict improvement of cognitive symptoms in LLD is useful to inform treatment recommendations. METHODS We used data from 2 randomized clinical trials of geriatric depression to examine the relationships between sociodemographic factors (resilience, quality of life) and clinical factors (age of depression onset, severity of depression, apathy) with subsequent cognitive outcomes. One hundred sixty-five older adults with major depression who had completed one of 2 clinical trials were included: (1) methylphenidate plus placebo, citalopram plus placebo, and citalopram plus methylphenidate or (2) citalopram combined with Tai Chi or health education. A comprehensive neuropsychiatric battery was administered; 2 measures of cognitive improvement were examined, one defined as an increase in general cognitive performance score of at least 1 standard deviation and the other 0.5 standard deviation pre-post treatment. RESULTS At posttreatment, 59% of participants had remitted, but less than a third of those who remitted showed cognitive improvement (29%). Cognitive improvement was observed in 18% of nonremitters. Lower baseline depression severity, greater social functioning, and depression onset prior to 60 years of age were significantly associated with cognitive improvement. None of the other measures, including baseline apathy, resilience, and depression remission status, were significantly associated with cognitive improvement. CONCLUSIONS Lower severity of depression, earlier onset, and greater social functioning may predict improvement in cognitive functioning with treatment for depression in LLD.
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Affiliation(s)
- Prabha Siddarth
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at 8783UCLA, Los Angeles, CA, USA
| | - Cynthia M Funes
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at 8783UCLA, Los Angeles, CA, USA.,Neuroscience Institute, Banner University Medical Center Phoenix, University of Arizona College of Medicine, Phoenix, AZ, USA
| | - Kelsey T Laird
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at 8783UCLA, Los Angeles, CA, USA
| | - Linda Ercoli
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at 8783UCLA, Los Angeles, CA, USA
| | - Helen Lavretsky
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at 8783UCLA, Los Angeles, CA, USA
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Hyung WSW, Kang J, Kim J, Lee S, Youn H, Ham BJ, Han C, Suh S, Han CE, Jeong HG. Cerebral amyloid accumulation is associated with distinct structural and functional alterations in the brain of depressed elders with mild cognitive impairment. J Affect Disord 2021; 281:459-466. [PMID: 33360748 DOI: 10.1016/j.jad.2020.12.049] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 12/03/2020] [Accepted: 12/11/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Elderly patients with late-life depression (LLD) often report mild cognitive impairment (MCI), so Alzheimer's disease (AD) is hard to identify in these patients. We aimed to identify the structural and functional differences between prodromal AD and LLD-related MCI. METHODS We performed voxel-based morphometry and functional connectivity (FC) analyses in elderly patients with both LLD and MCI to compare alterations between those with cerebral amyloidopathy and those without. We subdivided patients into subthreshold depression (STD) and major depressive disorder (MDD) groups. Using florbetaben positron emission tomography (PET), we compared volume and connectivity between healthy controls and four STD and MDD groups with or without amyloid deposition(A): STD-MCI-A(+), MDD-MCI-A(+), STD-MCI-A(-), and MDD-MCI-A(-). RESULTS Subjects with MDD or amyloid deposition showed greater volume reduction in the left middle temporal gyrus. MDD groups had lower FC than STD groups in the frontal, cortical, and limbic areas. The STD-MCI-A(+) group showed greater FC reduction than the MDD-MCI-A(-) and STD-MCI-A(-) groups, particularly in the hippocampus, parahippocampus, and frontal and temporal cortices. The functional differences associated with amyloid plaques were more evident in the STD group than in the MDD group. LIMITATIONS Limitations include disproportional sex ratios, inability to determine the longitudinal effects of amyloidopathy in large populations. CONCLUSIONS Regional gray matter loss and alterations in brain networks may reflect impairments caused by amyloid deposition and depression. Such changes may facilitate the detection of prodromal AD in elderly patients with both depression and cognitive dysfunction, allowing earlier intervention and more appropriate treatment.
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Affiliation(s)
- Won Seok William Hyung
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - June Kang
- Department of Brain and Cognitive Engineering, Korea University, Seoul, Republic of Korea
| | - Junhyung Kim
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Suji Lee
- Department of Biomedical Sciences, Korea University Graduate School, Seoul, Republic of Korea
| | - HyunChul Youn
- Department of Psychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Byung-Joo Ham
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Changsu Han
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Sangil Suh
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Cheol E Han
- Department of Electronics and Information Engineering, Korea University, Sejong, Republic of Korea
| | - Hyun-Ghang Jeong
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea; Department of Biomedical Sciences, Korea University Graduate School, Seoul, Republic of Korea.
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Obbels J, Vansteelandt K, Bouckaert F, Dols A, Stek M, Verwijk E, Sienaert P. Neurocognitive functioning after electroconvulsive therapy in late-life depression: A 4-year prospective study. Acta Psychiatr Scand 2021; 143:141-150. [PMID: 33150605 DOI: 10.1111/acps.13252] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/15/2020] [Accepted: 10/22/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Despite the proven efficacy and safety of ECT, there is still concern about the possible cognitive side effects of ECT in older patients. In this study, we aimed to characterize the long-term cognitive effects of ECT in patients with late-life depression (LLD) from before the start until 4 years after the index ECT course. METHODS Fourty one patients aged 55 years and older with a unipolar depression, referred for ECT, were included. The neuropsychological test battery was assessed prior to ECT, 6 months, 1 year, 2 years, 3 years, and 4 years after the last ECT session. RESULTS We did not find any statistically significant cognitive changes from before the start to 4 years after ending the ECT course. Although we could not detect cognitive changes at group level, we found clinically important differences on an individual level. CONCLUSION Cognitive performance in patients with LLD runs a stable course from before the start of ECT until 4 years after the index course. At an individual level, however, both cognitive decline and improvement can be witnessed. Older patients can tolerate ECT and most of them will not experience long-term cognitive side effects.
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Affiliation(s)
- Jasmien Obbels
- Academic Center for ECT and Neuromodulation (AcCENT, University Psychiatric Center KU Leuven, KU Leuven - University of Leuven, Kortenberg, Belgium
| | - Kristof Vansteelandt
- Academic Center for ECT and Neuromodulation (AcCENT, University Psychiatric Center KU Leuven, KU Leuven - University of Leuven, Kortenberg, Belgium
| | - Filip Bouckaert
- Old-age Psychiatry, University Psychiatric Center KU Leuven, KU Leuven - University of Leuven, Kortenberg, Belgium
| | - Annemiek Dols
- Department of Old Age Psychiatry, Amsterdam Public Health Research Institute, Amsterdam Neuroscience, GGZ inGeest/Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
| | - Max Stek
- Department of Old Age Psychiatry, Amsterdam Public Health Research Institute, Amsterdam Neuroscience, GGZ inGeest/Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
| | - Esmée Verwijk
- Department of Medical Psychology, Neuropsychology Department, Academic Medical Center, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Psychology, Brain & Cognition, University of Amsterdam, Amsterdam, The Netherlands.,ECT Department, Parnassia Psychiatric Institute, The Hague, The Netherlands
| | - Pascal Sienaert
- Academic Center for ECT and Neuromodulation (AcCENT, University Psychiatric Center KU Leuven, KU Leuven - University of Leuven, Kortenberg, Belgium
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Zhang M, Chen B, Zhong X, Zhou H, Wang Q, Mai N, Wu Z, Chen X, Peng Q, Zhang S, Yang M, Lin G, Ning Y. Neuropsychiatric Symptoms Exacerbate the Cognitive Impairments in Patients With Late-Life Depression. Front Psychiatry 2021; 12:757003. [PMID: 34867543 PMCID: PMC8639522 DOI: 10.3389/fpsyt.2021.757003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/21/2021] [Indexed: 12/27/2022] Open
Abstract
Background: Neuropsychiatric symptoms (NPS) and cognitive impairments are both common in patients with late-life depression (LLD). However, the relationship between NPS and cognitive functions in LLD patients remains unclear. The current study aims to explore the effects of NPS on cognitive impairments in LLD patients. Methods: Two hundred and sixty-two LLD patients and 141 normal controls (NC) were recruited. Exploratory factor analysis was used to extract factors from the Neuropsychiatric Inventory (NPI). Correlation, mediation, and moderation analyses were used to explore whether NPS exacerbated the cognitive impairments in LLD and whether NPS exhibited different effects on cognitive impairments in acute-state LLD (aLLD) and recovery-state LLD (rLLD). Results: Three main factors were extracted from the NPI, including emotional, behavioral, and psychotic factors. The patients with LLD exhibited worse cognition and higher NPI scores, and the scores of NPI-total and three extracted factors were negatively associated with cognitive scores. The mediation analyses exhibited that NPI-total and behavioral factor scores increase the difference in cognition scores between LLD and NC groups. The mediation analyses exhibited that behavioral factor score played a greater effect on impairing MMSE in the rLLD group than in the aLLD group. Additionally, behavioral factor score was in a trend to be negatively associated with Mini-Mental State Examination (MMSE) score changes at a one-year follow-up (p = 0.051). Conclusions: NPS, especially behavioral symptoms, exacerbate cognitive impairments in LLD and may contribute to residual cognitive impairment in rLLD patients. Early intervention for behavioral symptoms in LLD patients may be beneficial to their long-term clinical prognosis.
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Affiliation(s)
- Min Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ben Chen
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiaomei Zhong
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Huarong Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Qiang Wang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Naikeng Mai
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhangying Wu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xinru Chen
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Qi Peng
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Si Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Minfeng Yang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Gaohong Lin
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yuping Ning
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.,The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
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44
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Rhodes E, Insel PS, Butters MA, Morin R, Bickford D, Tosun D, Gessert D, Rosen HJ, Aisen P, Raman R, Landau S, Saykin A, Toga A, Jack CR, Weiner MW, Nelson C, Mackin RS. The Impact of Amyloid Burden and APOE on Rates of Cognitive Impairment in Late Life Depression. J Alzheimers Dis 2021; 80:991-1002. [PMID: 33682706 PMCID: PMC8935860 DOI: 10.3233/jad-201089] [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] [Indexed: 10/22/2022]
Abstract
BACKGROUND Cognitive impairment (CI) is a key feature of late life depression (LLD), but the contribution of underlying neurodegenerative pathology remains unclear. OBJECTIVE To evaluate cognitive dysfunction in LLD relative to a sample of nondepressed (ND) older adults with matched levels of memory impairment and amyloid-β (Aβ) burden. METHODS Participants included 120 LLD and 240 ND older adults matched on age, education, sex, Mini-Mental State Exam, mild cognitive impairment diagnosis, and PET Aβ burden. RESULTS LLD showed higher rates of impairment relative to ND with 54.6% of the LLD sample demonstrating impairment in at least one cognitive domain compared to 42.9% of controls (H = 7.13, p = 0.008). LLD had poorer performance and higher rates of impairment on Rey Auditory Verbal Learning Test learning and memory compared to controls. In the overall sample, Aβ positivity was associated with worse performance on Logical Memory I (p = 0.044), Logical Memory II (p = 0.011), and Trail Making Test -B (p = 0.032), and APOEɛ4 genotype was associated with worse performance on Logical Memory I (p = 0.022); these relationships did not differ between LLD and ND. CONCLUSION LLD showed higher rates of CI driven by focal deficits in verbal learning and memory. Alzheimer's disease (AD) biomarkers were associated with worse performance on timed set-shifting and story learning and memory, and these relationships were not impacted by depression status. These findings suggest that AD may account for a portion of previously reported multi-domain CI in LLD and highlight the potential for AD to confound studies of cognition in LLD.
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Affiliation(s)
- Emma Rhodes
- Mental Illness Research Education and Clinical Centers, Veterans Administration Medical Center, San Francisco, CA, USA
| | - Philip S. Insel
- Department of Psychiatry, University of California, San Francisco, CA, USA
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden
| | - Meryl A. Butters
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Ruth Morin
- Mental Illness Research Education and Clinical Centers, Veterans Administration Medical Center, San Francisco, CA, USA
| | - David Bickford
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Duygu Tosun
- Veterans Administration Medical Center, San Francisco, CA, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Devon Gessert
- University of Southern California, Los Angeles, CA, USA
| | - Howie J. Rosen
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Paul Aisen
- University of Southern California, Los Angeles, CA, USA
- Alzheimer’s Therapeutic Research Institute, Keck School of Medicine, University of Southern California, San Dieeo, CA, USA
| | - Rema Raman
- University of Southern California, Los Angeles, CA, USA
- Alzheimer’s Therapeutic Research Institute, Keck School of Medicine, University of Southern California, San Dieeo, CA, USA
| | - Susan Landau
- Helen Wills Neuroscience Institute, University of California, Berkeley, CA, USA
| | - Andrew Saykin
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Arthur Toga
- Laboratory of Neuro Imaging, Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Michael W. Weiner
- Department of Psychiatry, University of California, San Francisco, CA, USA
- Veterans Administration Medical Center, San Francisco, CA, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Craig Nelson
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - R. Scott Mackin
- Department of Psychiatry, University of California, San Francisco, CA, USA
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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45
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Interactive effects of elevated homocysteine and late-life depression on cognitive impairment. J Affect Disord 2020; 277:212-217. [PMID: 32829197 DOI: 10.1016/j.jad.2020.08.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 06/02/2020] [Accepted: 08/10/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Both an elevated homocysteine (Hcy) level and depression are risk factors for cognitive impairment in the general population, but no study has analyzed whether the coexistence of an elevated Hcy level and late-life depression (LLD) is associated with worse cognitive performance. OBJECTIVE We aimed to investigate the relationship between Hcy levels and cognitive function in individuals with LLD and whether the coexistence of an elevated Hcy level and LLD is associated with worse cognitive performance. METHODS A total of 113 LLD patients and 89 normal controls underwent a standardized clinical interview and comprehensive neuropsychological assessment battery. Plasma concentrations of Hcy were detected. Factorial analyses were performed to examine the impact of the coexistence of an elevated Hcy level and LLD on cognitive performance. RESULTS Plasma Hcy levels in patients with LLD were significantly higher than that in normal controls. Only for LLD patients, Hcy level was negatively correlated with global cognition, executive function, attention, and visual space. The factorial analysis showed that there was a significant interactive effect of Hcy level (normal and elevated levels) and LLD (with and without LLD) on global cognition. In post hoc comparisons, the elderly individuals with both elevated Hcy levels and LLD tended to have the worst global cognitive function compared with those with LLD or elevated Hcy levels alone. CONCLUSIONS The coexistence of an elevated Hcy level and LLD was associated with worse cognitive performance. Early intervention should be initiated to protect cognition in LLD patients with elevated Hcy levels.
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Trammell TS, Henderson NL, Madkour HS, Stanwood GD, Graham DL. GLP-1R activation alters performance in cognitive tasks in a sex-dependent manner. Neurol Sci 2020; 42:2911-2919. [PMID: 33222103 DOI: 10.1007/s10072-020-04910-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 11/15/2020] [Indexed: 01/22/2023]
Abstract
RATIONALE The activation of the glucagon-like peptide-1 receptor (GLP-1R) has been purported to have antidepressant-like and cognitive-enhancing effects. Many people suffering from major depressive disorder (MDD) also experience deficits in cognition. While currently approved antidepressant pharmacotherapies can alleviate the mood symptoms in some patients, they do not treat the cognitive ones. OBJECTIVES We tested whether systemic administration of a GLP-1R agonist would alter location discrimination, a cognitive task that is diminished in humans with MDD. METHODS Male and female laboratory mice (6-8 weeks old, N = 6-14/sex) were trained in a touchscreen operant task of location discrimination. Upon reaching baseline criterion, mice were administered vehicle or a GLP-1R agonist, Exendin-4, systemically prior to testing in probe trials of varying difficulty. RESULTS Following GLP-1R activation, males showed modest yet non-significant performance in the location discrimination task. Females, however, showed enhanced performance during the most difficult probe tests following Exendin-4 administration. CONCLUSIONS GLP-1R activation appears to enhance overall performance in the location discrimination task and does so in a sex- and difficulty-dependent manner. These preliminary yet impactful data indicate that GLP-1R agonists may be useful as an adjunctive pharmacotherapy to treat cognitive deficits associated with MDD and/or multiple neurological disorders.
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Affiliation(s)
- Taylor S Trammell
- Department of Biomedical Sciences and Center for Brain Repair, Florida State University College of Medicine, Tallahassee, FL, 32306, USA
| | - Natalie L Henderson
- Department of Biomedical Sciences and Center for Brain Repair, Florida State University College of Medicine, Tallahassee, FL, 32306, USA
| | - Haley S Madkour
- Department of Biomedical Sciences and Center for Brain Repair, Florida State University College of Medicine, Tallahassee, FL, 32306, USA
| | - Gregg D Stanwood
- Department of Biomedical Sciences and Center for Brain Repair, Florida State University College of Medicine, Tallahassee, FL, 32306, USA
| | - Devon L Graham
- Department of Biomedical Sciences and Center for Brain Repair, Florida State University College of Medicine, Tallahassee, FL, 32306, USA.
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47
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Koskinen MK, van Mourik Y, Smit AB, Riga D, Spijker S. From stress to depression: development of extracellular matrix-dependent cognitive impairment following social stress. Sci Rep 2020; 10:17308. [PMID: 33057053 PMCID: PMC7560730 DOI: 10.1038/s41598-020-73173-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 09/04/2020] [Indexed: 12/13/2022] Open
Abstract
Stress can predispose to depressive episodes, yet the molecular mechanisms regulating the transition from the initial stress response to a persistent pathological depressive state remain poorly understood. We profiled the development of an enduring depressive-like state by assessing affective behavior and hippocampal function during the 2 months following social-defeat stress. We measured remodeling of hippocampal extracellular matrix (ECM) during this period, as we recently identified ECM changes to mediate cognitive impairment during the sustained depressive-like state. Affective disturbance and cognitive impairments develop disparately after social stress, with gradual appearance of affective deficits. In contrast, spatial memory was impaired both early after stress and during the late-emerging chronic depressive-like state, while intact in-between. Similarly, we observed a biphasic regulation of the hippocampal ECM coinciding with hippocampus-dependent memory deficits. Together our data (1) reveal a dichotomy between affective and cognitive impairments similar to that observed in patients, (2) indicate different molecular processes taking place during early stress and the chronic depressive-like state, and (3) support a role of the ECM in mediating long-lasting effects on memory. From a translational point of view, it is important to prioritize on temporal phenotypic aspects in animal models to elucidate the underlying mechanisms of depression.
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Affiliation(s)
- Maija-Kreetta Koskinen
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit, Amsterdam, The Netherlands
| | - Yvar van Mourik
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam UMC, Location VU University Medical Center, Amsterdam, The Netherlands
| | - August Benjamin Smit
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit, Amsterdam, The Netherlands
| | - Danai Riga
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit, Amsterdam, The Netherlands
- Molecular Neuroplasticity, German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Sabine Spijker
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit, Amsterdam, The Netherlands.
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48
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Yu OC, Jung B, Go H, Park M, Ha IH. Association between dementia and depression: a retrospective study using the Korean National Health Insurance Service-National Sample Cohort database. BMJ Open 2020; 10:e034924. [PMID: 33020075 PMCID: PMC7537455 DOI: 10.1136/bmjopen-2019-034924] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVES Dementia is common in people over the age of 65 years, with 80% of people with dementia older than 75 years. Previous studies have linked dementia to late-life depression, but the association between dementia and mid-life depression is poorly understood. Depression is a preventable and treatable medical condition, which means it is a modifiable factor that can potentially prevent or delay dementia. This study aimed to identify the association between dementia and depression within the life course. DESIGN A nationwide, retrospective propensity score matched cohort study associating dementia with depression. Depression diagnosed between the ages of 45 and 64 years was classified as 'mid-life' and 'late-life' if diagnosed at 65 years or older. Patients were considered to have depression when one or more International Statistical Classification of Diseases and Related Health Problems, 10th revision codes for depression were recorded as primary or secondary diagnosis. SETTING National Health Insurance Service-National Sample Cohort database of the National Health Insurance Service in South Korea, containing patient data from 2002 to 2013. PARTICIPANTS The study included 1824 and 374 852 patients in the case and control groups, respectively. A logistic regression analysis with complex sampling design was performed after adjusting for covariates, using the propensity score matching method without callipers, with a 1:1 nearest neighbour matching algorithm. PRIMARY AND SECONDARY OUTCOME MEASURES The association of mid-onset and late-onset depression with dementia in terms of sociodemographic characteristics, such as sex and age, within the Korean population. RESULTS Dementia was significantly associated with the presence of depression (OR=2.20, 95% CI=1.53-3.14); in particular, female patients with depression and patients aged 45-64 years with depression had increased odds of dementia (OR=2.65, 95% CI=1.78-3.93 and OR=2.72, 95% CI=1.41-5.24, respectively) CONCLUSION: Depression is an associated factor for dementia, especially among people aged 45-64 years (mid-life).
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Affiliation(s)
- Ok-Cheol Yu
- Department of Korean rehabilitation medicine, Janseng Hospital of Korean Medicine, Seoul, Republic of Korea
| | - Boyoung Jung
- Department of Health Administration, Hanyang Women's University, Seoul, Republic of Korea
| | - Hoyeon Go
- Korean Internal Medicine, Semyung University, Korea, Chungju, Republic of Korea
- Herbal medicine policy division, Ministry of Food and Drug safety, Sejong-si, Republic of Korea
| | - Minjung Park
- National Agency for Development of Innovative Technologies in Korean Medicine, National Institute of Korean Medicine Development, Seoul, Republic of Korea
| | - In-Hyuk Ha
- Department of clinical research, Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
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49
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Kumar S, Batist J, Ghazala Z, Zomorrodi RM, Brooks H, Goodman M, Blumberger DM, Daskalakis ZJ, Mulsant BH, Rajji TK. Effects of bilateral transcranial direct current stimulation on working memory and global cognition in older patients with remitted major depression: A pilot randomized clinical trial. Int J Geriatr Psychiatry 2020; 35:1233-1242. [PMID: 32525222 DOI: 10.1002/gps.5361] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 06/01/2020] [Accepted: 06/03/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVES To assess the effects of a 10-day course of bilateral anodal transcranial direct current stimulation (tDCS) of the dorsolateral prefrontal cortex (DLPFC) on working memory and global cognition in elderly participants with remitted major depressive disorder at 14 days (primary outcome) and 90 days (secondary outcome) post intervention. DESIGN Randomized double blind controlled trial (clinicaltrials.gov # NCT02212366). SETTING Community dwelling outpatient setting. PARTICIPANTS Sixty or older with previous single or recurrent episodes of major depression currently in full remission. INTERVENTION A 10 day course of active or sham bilateral DLPFC anodal tDCS. MEASUREMENTS (a) Working memory assessed by a computerized N back task, and (b) global cognition assessed by a standard paper and pencil neuropsychological test battery. RESULTS Thirty-three participants, (mean (SD) age = 66. 5 (5.7) year) were enrolled, out of which 18 (mean (SD) age = 66. 3 (5.8) year) were randomized to active tDCS and 15 (mean (SD) age = 66. 7 (5.8) years) to sham tDCS. All randomized participants except one from the sham group -completed the tDCS course. There were no differences between the groups on working memory performance or global cognition at 14 or 90 days post intervention. Both groups showed promising changes in working memory and global cognition over time. CONCLUSIONS tDCS was well tolerated in older patients with remitted MDD, however, as compared to the sham group, it did not improve working memory or global cognition. Future studies should investigate tDCS with alternative parameters to enhance cognition in this population.
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Affiliation(s)
- Sanjeev Kumar
- Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Judah Batist
- Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Zaid Ghazala
- Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Reza M Zomorrodi
- Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Heather Brooks
- Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Michelle Goodman
- Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Daniel M Blumberger
- Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Zafiris J Daskalakis
- Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Benoit H Mulsant
- Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Tarek K Rajji
- Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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50
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Brouwer J, van den Berg F, Knooihuizen R, Loerts H, Keijzer M. Exploring Language Learning as a Potential Tool against Cognitive Impairment in Late-Life Depression: Two Meta-Analyses and Suggestions for Future Research. Behav Sci (Basel) 2020; 10:E132. [PMID: 32878051 PMCID: PMC7551097 DOI: 10.3390/bs10090132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 11/16/2022] Open
Abstract
Late-life depression (LLD) affects about an eighth of community-dwelling seniors. LLD impacts well-being, with loneliness and small social networks being typical. It has also been linked to cognitive dysfunction and an increased risk of developing dementia. Safety and efficacy of pharmacological treatments for LLD have been debated, and cognitive dysfunction often persists even after remission. Various cognitive interventions have been proposed for LLD. Among these, one has received special attention: foreign language learning could serve as a social intervention that simultaneously targets brain structures affected in LLD. Lifelong bilingualism may significantly delay the onset of cognitive impairment symptoms by boosting cognitive reserve. Even late-life foreign language learning without lifelong bilingualism can train cognitive flexibility. It is then counterintuitive that the effects of language learning on LLD have never been examined. In order to create a theoretical basis for further interdisciplinary research, this paper presents a status quo of current work through two meta-analyses investigating cognitive functioning in LLD on the one hand and in senior bilinguals or seniors following a language course on the other hand. While LLD was consistently associated with cognitive dysfunction, inconsistent results were found for bilingualism and language learners. Possible reasons for this and suggestions for future research are subsequently discussed.
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Affiliation(s)
- Jelle Brouwer
- Department of Linguistics & English as a Second Language, University of Groningen, 9712 EK Groningen, The Netherlands; (F.v.d.B.); (R.K.); (M.K.)
| | - Floor van den Berg
- Department of Linguistics & English as a Second Language, University of Groningen, 9712 EK Groningen, The Netherlands; (F.v.d.B.); (R.K.); (M.K.)
| | - Remco Knooihuizen
- Department of Linguistics & English as a Second Language, University of Groningen, 9712 EK Groningen, The Netherlands; (F.v.d.B.); (R.K.); (M.K.)
| | - Hanneke Loerts
- Department of Minorities and Multilingualism, University of Groningen, 9712 EK Groningen, The Netherlands;
| | - Merel Keijzer
- Department of Linguistics & English as a Second Language, University of Groningen, 9712 EK Groningen, The Netherlands; (F.v.d.B.); (R.K.); (M.K.)
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