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

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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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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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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