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

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

American Journal of Geriatric Psychiatry ◽

10.1016/j.jagp.2021.01.004 ◽

2021 ◽

Author(s):

Xiaofu He ◽

Elena Pueraro ◽

Yoojean Kim ◽

Carolina Montes Garcia ◽

Ben Maas ◽

...

Keyword(s):

Treatment Outcome ◽

Executive Function ◽

White Matter ◽

Antidepressant Treatment ◽

Late Life ◽

White Matter Integrity ◽

Late Life Depression

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Relationship between progression of brain white matter changes and late-life depression: 3-year results from the LADIS study

The British Journal of Psychiatry ◽

10.1192/bjp.bp.111.098897 ◽

2012 ◽

Vol 201 (1) ◽

pp. 40-45 ◽

Cited By ~ 53

Author(s):

Michael J. Firbank ◽

Andrew Teodorczuk ◽

Wiesje M. Van Der Flier ◽

Alida A. Gouw ◽

Anders Wallin ◽

...

Keyword(s):

White Matter ◽

Depression Scale ◽

Late Life ◽

The Elderly ◽

Late Life Depression ◽

White Matter Changes ◽

Brain White Matter ◽

History Of ◽

Depressive Episodes ◽

History Of Depression

BackgroundBrain white matter changes (WMC) and depressive symptoms are linked, but the directionality of this association remains unclear.AimsTo investigate the relationship between baseline and incident depression and progression of white matter changes.MethodIn a longitudinal multicentre pan-European study (Leukoaraiosis and Disability in the elderly, LADIS), participants aged over 64 underwent baseline magnetic resonance imaging (MRI) and clinical assessments. Repeat scans were obtained at 3 years. Depressive outcomes were assessed in terms of depressive episodes and the Geriatric Depression Scale (GDS). Progression of WMC was measured using the modified Rotterdam Progression scale.ResultsProgression of WMC was significantly associated with incident depression during year 3 of the study (P = 0.002) and remained significant after controlling for transition to disability, baseline WMC and baseline history of depression. There was no significant association between progression of WMC and GDS score, and no significant relationship between progression of WMC and history of depression at baseline.ConclusionsOur results support the vascular depression hypothesis and implicate WMC as causal in the pathogenesis of late-life depression.

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How Do Age-related White Matter Changes Such as MRI Hyperintensities and Amyloid Deposition Relate to ECT Outcome in Late Life Depression?

European Psychiatry ◽

10.1016/s0924-9338(15)31838-1 ◽

2015 ◽

Vol 30 ◽

pp. 135

Author(s):

L. Emsell ◽

F. Bouckaert ◽

F.L. De Winter ◽

J. Obbels ◽

A. Dols ◽

...

Keyword(s):

White Matter ◽

Late Life ◽

Amyloid Deposition ◽

Late Life Depression ◽

White Matter Changes ◽

Age Related

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White matter integrity within the corpus callosum differentiates late-life bipolar and unipolar depression

Bipolar Disorders ◽

10.1111/j.1399-5618.2012.01050.x ◽

2012 ◽

Vol 14 (7) ◽

pp. 790-791 ◽

Cited By ~ 7

Author(s):

Claire E. Sexton ◽

Charlotte L. Allan ◽

Clare E. Mackay ◽

Klaus P. Ebmeier

Keyword(s):

White Matter ◽

Corpus Callosum ◽

Late Life ◽

Unipolar Depression ◽

White Matter Integrity

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Corpus callosum size may predict late-life depression in women: A 10-year follow-up study

European Psychiatry ◽

10.1016/j.eurpsy.2014.09.332 ◽

2014 ◽

Vol 29 (S3) ◽

pp. 546-547

Author(s):

F. Cyprien ◽

P. Courtet ◽

P. Poulain ◽

J. Maller ◽

C. Meslin ◽

...

Keyword(s):

White Matter ◽

Corpus Callosum ◽

Elderly Women ◽

Late Life ◽

Magnetic Resonance Images ◽

Community Dwelling ◽

Cerebral White Matter ◽

Intracranial Volume ◽

Late Life Depression

BackgroundRecent research on late-life depression (LLD) pathophysiology suggests the implication of abnormalities in cerebral white matter [1] and particularly in interhemispheric transfer [2]. Corpus callosum (CC) is the main brain interhemispheric commissure [3]. Hence, we investigated the association between baseline CC measures and risk of LDD.MethodsWe studied 467 non-demented individuals without LLD at baseline from a cohort of community-dwelling people aged 80 years or younger (the ESPRIT study). LLD was assessed at year 2, 4, 7 and 10 of the study follow-up. At baseline, T1-weighted magnetic resonance images were manually traced to measure the mid-sagittal areas of the anterior, mid and posterior CC. Multivariate Cox proportional hazards models stratified by sex were used to predict LLD incidence over 10 years.ResultsA significant interaction between gender and CC size was found (P = 0.02). LLD incidence in elderly women, but not in men, was significantly associated with smaller anterior (HR 1.37 [1.05–1.79] P = 0.017), mid (HR 1.43 [1.09–1.86] P = 0.008), posterior (HR1.39 [1.12–1.74] P = 0.002) and total (HR 1.53 [1.16–2.00] P = 0.002) CC areas at baseline in Cox models adjusted for age, education, global cognitive impairment, ischemic pathologies, left-handedness, white matter lesion, intracranial volume and past depression.LimitationsThe main limitation was the retrospective assessment of major depression.ConclusionsSmaller CC size is a predictive factor of incident LLD over 10 years in elderly women. Our finding suggests a possible role of CC and reduced interhemispheric connectivity in LLD pathophysiology. Extensive explorations are needed to clarify the mechanisms leading to CC morphometric changes in mood disorders.

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