Association of White Matter Integrity With Executive Function and Antidepressant Treatment Outcome in Patients With Late-Life Depression

BackgroundAlthough significant changes in both gray and white matter have been noted in late-life depression (LLD), the pathophysiology of implicated white-matter tracts has not been fully described. In this study we examined the integrity of specific white-matter tracts in LLD versus healthy controls (HC).MethodParticipants aged ⩾60 years were recruited from the community. The sample included 23 clinically diagnosed individuals with LLD and 23 HC. White-matter integrity metrics [fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD)] were calculated in the bilateral cingulum and uncinate fasciculus. Depression severity was measured using the Center for Epidemiological Studies Depression Scale (CESD). Composite scores for learning and memory and executive function were created using standardized neuropsychological assessments.ResultsWhite-matter integrity was lower in LLD versus HC in the bilateral cingulum and right uncinate fasciculus (p⩽0.05). In the whole sample, depression severity correlated with integrity in the bilateral cingulum and right uncinate fasciculus (p ⩽0.05). In patients, depression severity correlated with the integrity of the left uncinate fasciculus (p = 0.03); this tract also correlated with executive function (p = 0.02). Among HC, tract integrity did not correlate with depression scores; however, learning and memory correlated with integrity of the bilateral uncinate fasciculus and bilateral cingulum; executive function correlated with the right uncinate and left cingulum (p ⩽0.05).ConclusionsWhite-matter tract integrity was lower in LLD than in HC and was associated with depression severity across all participants. Tract integrity was associated with cognition in both groups but more robustly among HC.

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Increased White Matter Hyperintensity and Impact on Executive Function in Suicide Attempters with Late-Life Depression

SSRN Electronic Journal ◽

10.2139/ssrn.3685925 ◽

2020 ◽

Author(s):

Chemin Lin ◽

Huang Chih-Mao ◽

Helmet Karim ◽

Ho-Ling Liu ◽

Tatia M.C. Lee ◽

...

Keyword(s):

Executive Function ◽

White Matter ◽

Late Life ◽

White Matter Hyperintensity ◽

Late Life Depression ◽

Suicide Attempters

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Executive Function Predicts Antidepressant Treatment Noncompletion in Late-Life Depression

The Journal of Clinical Psychiatry ◽

10.4088/jcp.16m11371 ◽

2018 ◽

Vol 79 (3) ◽

Cited By ~ 7

Author(s):

Pilar Cristancho ◽

Eric J. Lenze ◽

David Dixon ◽

J. Philip Miller ◽

Benoit H. Mulsant ◽

...

Keyword(s):

Executive Function ◽

Antidepressant Treatment ◽

Late Life ◽

Late Life Depression

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Greater White Matter Hyperintensities and the Association with Executive Function in Suicide Attempters with Late-life Depression

Neurobiology of Aging ◽

10.1016/j.neurobiolaging.2020.12.016 ◽

2021 ◽

Author(s):

Chemin Lin ◽

Chih-Mao Huang ◽

Helmet T. Karim ◽

Ho-Ling Liu ◽

Tatia Mei-Chun Lee ◽

...

Keyword(s):

Executive Function ◽

White Matter ◽

White Matter Hyperintensities ◽

Late Life ◽

Late Life Depression ◽

Suicide Attempters

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Does the Framingham Stroke Risk Profile predict white-matter changes in late-life depression?

International Psychogeriatrics ◽

10.1017/s1041610211002183 ◽

2011 ◽

Vol 24 (4) ◽

pp. 524-531 ◽

Cited By ~ 16

Author(s):

Charlotte L. Allan ◽

Claire E. Sexton ◽

Ukwuori G. Kalu ◽

Lisa M. McDermott ◽

Mika Kivimäki ◽

...

Keyword(s):

White Matter ◽

Corpus Callosum ◽

Stroke Risk ◽

Late Life ◽

Risk Profile ◽

The Body ◽

White Matter Integrity ◽

Late Life Depression ◽

White Matter Changes ◽

Depressed Group

ABSTRACTBackground: Cardiovascular risk factors and diseases are important etiological factors in depression, particularly late-life depression. Brain changes associated with vascular disease and depression can be detected using magnetic resonance imaging. Using diffusion tensor imaging (DTI), we investigated whether the Framingham Stroke Risk Profile (FSRP), a well-validated risk prediction algorithm, is associated with changes in white-matter connectivity. We hypothesized that depressed participants would show reduced white-matter integrity with higher FSRP, and non-depressed controls (matched for mean vascular risk) would show minimal co-variance with white-matter changes.Methods: Thirty-six participants with major depression (age 71.8 ± 7.7 years, mean FSRP 10.3 ± 7.6) and 25 controls (age 71.8 ± 7.3 years, mean FSRP 10.1 ± 7.7) were clinically interviewed and examined, followed by 60-direction DTI on a 3.0 Tesla scanner. Image analysis was performed using FSL tools (www.fmrib.ox.ac.uk/fsl) to assess the correlation between FSRP and fractional anisotropy (FA). Voxelwise statistical analysis of the FA data was carried out using Tract Based Spatial Statistics. The significance threshold for correlations was set at p < 0.05 using threshold-free cluster-enhancement. Partial correlation analysis investigated significant correlations in each group.Results: Participants in the depressed group showed highly significant correlations between FSRP and FA within the body of corpus callosum (r = −0.520, p = 0.002), genu of corpus callosum (r = −0.468, p = 0.005), splenium of corpus callosum (r = −0.536, p = 0.001), and cortico-spinal tract (r = −0.473, p = 0.005). In controls, there was only one significant correlation in the body of corpus callosum (r = −0.473, p = 0.023).Conclusions: FSRP is associated with impairment in white-matter integrity in participants with depression; these results suggest support for the vascular depression hypothesis.

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White matter integrity and late-life depression in community-dwelling individuals: diffusion tensor imaging study using tract-based spatial statistics

The British Journal of Psychiatry ◽

10.1192/bjp.bp.113.142109 ◽

2014 ◽

Vol 205 (4) ◽

pp. 315-320 ◽

Cited By ~ 28

Author(s):

Simone Reppermund ◽

Lin Zhuang ◽

Wei Wen ◽

Melissa J. Slavin ◽

Julian N. Trollor ◽

...

Keyword(s):

Depressive Symptoms ◽

White Matter ◽

Spatial Statistics ◽

Late Life ◽

White Matter Integrity ◽

Late Life Depression ◽

White Matter Changes ◽

History Of ◽

Tract Based Spatial Statistics ◽

History Of Depression

BackgroundLate-life depression has been associated with white matter changes in studies using the regions of interest approach.AimsTo investigate the cross-sectional and longitudinal relationship between white matter integrity and depression in community-dwelling individuals using diffusion tensor imaging with tract-based spatial statistics.MethodThe sample comprised 381 participants aged between 72 and 92 years who were assessed twice within 2 years. Depressive symptoms were measured with the Geriatric Depression Scale. Tract-based spatial statistics were applied to investigate white matter integrity in currently depressed v. non-depressed elderly people and in those with a history of depression v. no history of depression. The relationship between white matter integrity and development of depressive symptoms after 2 years were analysed with logistic regression.ResultsIndividuals with current depression had widespread white matter integrity reduction compared with non-depressed elderly people. Significant fractional anisotropy reductions were found in 45 brain areas with the most notable findings in the frontal lobe, association and projection fibres. A history of depression was not associated with reduced fractional anisotropy. White matter changes in the superior frontal gyrus, posterior thalamic radiation, superior longitudinal fasciculus and in the body of corpus callosum predicted depression at follow-up.ConclusionsReduced white matter integrity is associated with late-life depression and predicts future depressive symptoms whereas a history of depression is not related to white matter changes. Disruption to white matter integrity may be a biomarker to predict late-life depression.

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