Background. Several clinical and neuroimaging
investigations support the notion that underlying brain changes may
relate to depression in older patients, especially those with a
later-age initial episode. However uncertainty still exists about
diagnostic and pathogenic significance of structural brain
abnormalities in aged depressives, in part because many studies lack
all-elderly and age-similar normal comparison populations.Methods. Brain morphology of elderly depressives
(N = 30) and normal controls (N = 36) was compared
by assessing magnetic resonance imaging (MRI) brain scans with
qualitative criteria-based scales. Ratings included lateral and third
ventricle enlargement, and cortical, medial temporal, and caudate
atrophy.Results. Significant differences between depressed and
control groups were not demonstrated. Later-onset depressives had
significantly more left medial temporal and left caudate atrophy than
early-onset counterparts of similar age. Medial temporal atrophy
significantly correlated with cognitive impairment and was not related
to physical illness. Depressives with medial temporal atrophy
(N = 7) were older and had later age at onset of depression
than those without such changes. Cerebrovascular disease risk factors
did not predict MRI abnormalities.Conclusions. Results indicate non-specificity and lack of
homogeneity of qualitatively measured structural brain changes in
geriatric depression, but suggest that pathology of specific,
lateralized brain regions may be implicated in some later-onset
patients. The relationship between medial temporal atrophy and
late-onset depression raises the possibility that such patients may
suffer from as-yet undeclared Alzheimer's disease. Lack of
association between cerebrovascular disease risk factors and brain
changes suggests other pathophysiological contributions.
Volumetric Magnetic Resonance Imaging Quantification of Longitudinal Brain Changes in Abstinent Alcoholics
