Hippocampal volume and subcortical white matter lesions in late life depression: comparison of early and late onset depression

ABSTRACT The neurobiological basis of neuroticism in late-life depression (LLD) is understudied. We hypothesized that older depressed subjects scoring high in measures of neuroticism would have smaller hippocampal and prefrontal volumes compared with non-neurotic older depressed subjects and with nondepressed comparison subjects based on previous research. Non-demented subjects were recruited and were either depressed with high neuroticism (n = 65), depressed with low neuroticism (n = 36), or never depressed (n = 27). For imaging outcomes focused on volumetric analyses, we found no significant between-group differences in hippocampal volume. However, we found several frontal lobe regions for which depressed subjects with high neuroticism scores had smaller volumes compared with non-neurotic older depressed subjects and with nondepressed comparison subjects, controlling for age and gender. These regions included the frontal pole, medial orbitofrontal cortex, and left pars orbitalis. In addition, we found that non-neurotic depressed subjects had a higher volume of non-white matter hypointensities on T1-weighted images (possibly related to cerebrovascular disease) than did neurotic depressed subjects. Our finding that depressed subjects low in neuroticism had higher volumes of non-white matter hypointensities is consistent with prior literature on “vascular depression.” In contrast, the finding that those high in neuroticism had smaller frontal volume than depressed subjects low in neuroticism and never-depressed subjects highlight the importance of frontal circuitry in the subgroup of older depressed individuals with comorbid neuroticism. Together, these results implicate different neural mechanisms in older neurotic and non-neurotic depressed groups and suggest that multiple biological pathologies may lead to different clinical expressions of LLD.

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Is the Clinical Expression of Late-Life Depression Influenced by Brain Changes? MRI Subcortical Neuroanatomical Correlates of Depressive Symptoms

International Psychogeriatrics ◽

10.1017/s1041610200006542 ◽

2000 ◽

Vol 12 (4) ◽

pp. 425-434 ◽

Cited By ~ 23

Author(s):

Steve Simpson ◽

Robert C. Baldwin ◽

Alan Jackson ◽

Alistair Burns ◽

Peter Thomas

Keyword(s):

Depressive Symptoms ◽

White Matter ◽

Late Onset ◽

Late Life ◽

Psychomotor Retardation ◽

First Episode ◽

Late Life Depression ◽

Clinical Expression ◽

Cross Sectional ◽

Vascular Depression

Background: “Vascular depression” has recently been proposed. It is characterized by magnetic resonance imaging (MRI) T2-weighted subcortical lesions, a late onset of first episode of depression, and reduced heritability; a cerebrovascular etiology is suggested. The validity of “vascular depression” might be strengthened if an association was found between the subcortical lesions used to define it and particular depressive symptoms. Methods: A blinded cross-sectional examination of DSM-III-R depressive symptoms (American Psychiatric Association, 1987) and MRI T2-weighted subcortical lesions in 44 patients with late-life depression. Results: Many associations were found; however, because of multiple comparisons, their significance is viewed with caution. The most robust finding was that psychomotor retardation was independently related to total white-matter score. The odds of showing psychomotor retardation was increased 1.9 times for every point increase in severity of white-matter change. Conclusion: In late-life depression the clinical expression of the depression is influenced by the pattern of MRI T2-weighted subcorticallesions. This gives some validity to the concept of an MRI-defined “vascular” subtype of late-life depression and strengthens the argument for including neuroimaging in the classification of late-life depression.

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Microbleeds in Late-Life Depression: Comparison of Early- and Late-Onset Depression

BioMed Research International ◽

10.1155/2014/682092 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 8

Author(s):

Chao Feng ◽

Min Fang ◽

Yu Xu ◽

Ting Hua ◽

Xue-Yuan Liu

Keyword(s):

White Matter ◽

Life Events ◽

Left Hemisphere ◽

White Matter Hyperintensities ◽

Late Onset ◽

Depression Scale ◽

Late Life ◽

Late Life Depression ◽

Cerebral Lesions ◽

Healthy Elderly

Late-life depression could be classified roughly as early-onset depression (EOD) and late-onset depression (LOD). LOD was proved to be associated with cerebral lesions including white matter hyperintensities (WMH) and silent brain infarctions (SBI), differently from EOD. However, it is unclear whether similar association is present between LOD and microbleeds which are also silent lesions. In this study, 195 patients of late-life depression were evaluated and divided into EOD, presenile-onset depression (POD), and LOD groups; 85 healthy elderly controls were enrolled as controls. Subjects were scanned by MRI including susceptibility weighted images to evaluate white matter hyperintensities (WMH), silent brain infarctions (SBI), and microbleeds. The severity of depression was evaluated with 15-item Geriatric Depression Scale. Psychosocial factors were investigated with Scale of Life Events and Lubben Social Network Scale. Logistic regression and linear regression were performed to identify the independent risk factors for depression. Results showed that LOD patients had higher prevalence of microbleeds than EOD, POD, and control patients. The prevalence of lobar microbleeds and microbleeds in the left hemisphere was the independent risk factor for the occurrence of LOD; a high number of microbleeds were associated with severe state of LOD, whereas life events and lack of social support were more important for EOD and POD. All these results indicated that Microbleeds especially lobar microbleeds and microbleeds in the left hemisphere were associated with LOD but not with EOD.

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