Treatment-Specific Hippocampal Subfield Volume Changes With Antidepressant Medication or Cognitive-Behavior Therapy in Treatment-Naive Depression

Background: Hippocampal atrophy has been consistently reported in major depressive disorder with more recent focus on subfields. However, literature on hippocampal volume changes after antidepressant treatment has been limited. The first-line treatments for depression include antidepressant medication (ADM) or cognitive-behavior therapy (CBT). To understand the differential effects of CBT and ADM on the hippocampus, we investigated the volume alterations of hippocampal subfields with treatment, outcome, and chronicity in treatment-naïve depression patients.Methods: Treatment-naïve depressed patients from the PReDICT study were included in this analysis. A total of 172 patients who completed 12 weeks of randomized treatment with CBT (n = 45) or ADM (n = 127) were included for hippocampal subfield volume analysis. Forty healthy controls were also included for the baseline comparison. Freesurfer 6.0 was used to segment 26 hippocampal substructures and bilateral whole hippocampus from baseline and week 12 structural MRI scans. A generalized linear model with covariates of age and gender was used for group statistical tests. A linear mixed model for the repeated measures with covariates of age and gender was used to examine volumetric changes over time and the contributing effects of treatment type, outcome, and illness chronicity.Results: Of the 172 patients, 85 achieved remission (63/127 ADM, 22/45 CBT). MDD patients showed smaller baseline volumes than healthy controls in CA1, CA3, CA4, parasubiculum, GC-ML-DG, Hippocampal Amygdala Transition Area (HATA), and fimbria. Over 12 weeks of treatment, further declines in the volumes of CA1, fimbria, subiculum, and HATA were observed regardless of treatment type or outcome. CBT remitters, but not ADM remitters, showed volume reduction in the right hippocampal tail. Unlike ADM remitters, ADM non-responders had a decline in volume in the bilateral hippocampal tails. Baseline volume of left presubiculum (regardless of treatment type) and right fimbria and HATA in CBT patients were correlated with a continuous measure of clinical improvement. Chronicity of depression had no effect on any measures of hippocampal subfield volumes.Conclusion: Two first-line antidepressant treatments, CBT and ADM, have different effects on hippocampal tail after 12 weeks. This finding suggests that remission achieved via ADM may protect against progressive hippocampal atrophy by altering neuronal plasticity or supporting neurogenesis. Studies with multimodal neuroimaging, including functional and structural analysis, are needed to assess further the impact of two different antidepressant treatments on hippocampal subfields.

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Health-Related Quality of Life In Patients with Chronic Myeloid Leukemia Undergoing First Line Treatment with Imatinib for at Least Three Years Compared with the General Population. A Multicenter Study Including 448 Patients

Blood ◽

10.1182/blood.v116.21.2273.2273 ◽

2010 ◽

Vol 116 (21) ◽

pp. 2273-2273

Author(s):

Fabio Efficace ◽

Michele Baccarani ◽

Massimo Breccia ◽

Giuliana Alimena ◽

Gianantonio Rosti ◽

...

Keyword(s):

General Population ◽

Data Center ◽

Myeloid Leukemia ◽

First Line ◽

Age And Gender ◽

Sf 36 ◽

Patient Reported ◽

And Gender ◽

First Line Treatment

Abstract Abstract 2273 Background: While Imatinib (IM) has revolutionized treatment for chronic myeloid leukemia (CML), demonstrating outstanding survival figures, currently no data exist on mid to long term impact of disease burden and therapy from the patients’ perspective. Aim: The main objective of this study is to identify specific limitations of quality of life (QoL) in CML survivors who are undergoing first line treatment with IM in comparison with controls from the general population. Patient-reported symptom prevalence was also investigated. Patients and methods: Patients were recruited in 26 centers, randomly selected to geographically represent the whole study country. Patients selection criteria included: being in treatment with IM for at least three years and being in complete cytogenetic response at the time of study entry. All patients were invited by their treating physicians in the hospital to participate and all consenting patients were requested to complete a Health Survey Packet at home. Pre-paid reply envelopes were also provided with the request to send back completed Surveys to an independent National coordinating Data Center. Generic QoL was assessed with the SF-36 that consists of 36 items covering eight generic health status/QoL domains: physical functioning (PF), role limitations due to physical health (RP), bodily pain (BP), general health perceptions (GH), vitality (VT), social functioning (SF), role limitations due to emotional problems (RE), and mental health (MH). All scales ranging between 0 and 100 with higher scores representing better outcomes. A previously devised patient-reported CML Symptom Checklist was used to investigate 9 symptoms of possible major concern in these patients. Mean SF-36 scores were compared to available national general population reference values and all analyses were adjusted for age and gender. Statistical comparisons were all adjusted for multiple testing. Differences in mean scores were expressed in Cohen effect sizes (ES; with 0.2, 0.5, and 0.8 indicating small, medium, and large ES, respectively) and clinical significance. Results: Between March and December 2009, 448 patients were recruited in a large national-based survivorship project. Patients’ compliance was optimal with 94% of patients (N=421) returning a valid Health Survey Packet to the National coordinating Data center. At study participation, mean age of patients was 56 years (59% male and 41% female) and median time of IM therapy was 5 years. Seventy-seven percent of patients were receiving standard dose of 400 mg and 43% had at least one comorbidity. Age and gender adjusted comparisons with general population norms revealed worse outcomes for the following scales: RP (P<.001; ES=0.3), GH (P<.001; ES=0.4) and RE (P=.01; ES=0.2). The largest clinically meaningful difference (Δ=12.3 points) was found for the RP domain with mean scores of 61.4 vs. 73.7 respectively for the CML and the general population. Age specific comparisons, adjusted by gender, (55-64; 65–74 and >75 years) suggested an almost uniform pattern in all scales with worse outcomes between CML patients and population controls among the youngest groups. GH was significantly worse in younger patients (55-64) (P=.03; ES=0.4) and no differences were found in the older age groups compared with population norms. Prevalence of reported symptoms (with any level of concern) was: fatigue (82%); problems with muscular cramps (78%); problems with musculoskeletal pain (72%); problems with edema (70%); skin problems (47%); diarrhea (43%); headache (39%); abdominal discomfort and nausea (28%). Conclusion: This study suggests that while still being on treatment with IM for years, CML patients might expect to have a QoL profile broadly similar to that of general population in many areas. However, role limitations (i.e., in work or other regular daily activities) due to physical health seem the major constraint faced by these patients; there is also an indication that younger patients might be those experiencing major limitations. Additional analyses will be undertaken to ascertain the impact of symptoms and other laboratory and clinical data on specific QoL domains. Such unique patient-reported data supplements conventional information on clinical efficacy of IM and may support both clinicians and patients in making more informed treatment decisions in this area. Disclosures: Rosti: Novartis: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Bristol M. Squibb: Honoraria, Speakers Bureau; Roche: Speakers Bureau.

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Volumetric pulp chambers measurements in mandibular and maxillary permanent first molar using cone-beam computed tomography by age and gender

International Dental Research ◽

10.5577/intdentres.2019.vol9.no1.5 ◽

2019 ◽

Vol 9 (1) ◽

pp. 30-40 ◽

Cited By ~ 1

Author(s):

Anıl Açıklar Kavas ◽

Emin Caner Tümen

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Age Groups ◽

Cone Beam ◽

Pulp Chamber ◽

Volume Changes ◽

Age And Gender ◽

Chamber Volume ◽

Molar Teeth ◽

And Gender

Aim: The aim of this study was to demonstrate the anatomical structure of pulp chamber, measure the volume of the total pulp chambers in mm3 and evaluate the pulp chamber volume changes by age and gender statistically in mandibular and maxillary first molars by means of CBCT. Methodology: In our study, CBCT examinations of patients between the ages of 7-18 years, which were carried out due to different reasons were evaluated retrospectively. The CBCT images of healthy total of 160 lower and upper right permanent first molar teeth were selected randomly and the volumes of the total pulp chamber were measured in mm3 with the 3D Slicer software program. We analyzed the collected data with statistical analysis methods and we evaluated whether there was any difference between the patients grouped according to the age in respect of volume changes in the total pulp chamber and whether there was any difference between the mean volume values and gender of the patients within the same group. Results: Comparison of the volume measurements of the lower and upper first permanent molar teeth between the groups showed that the volume values of the total pulp chamber decreased depending on the age (p<0.05). Regarding gender, volume decrease related to age was statistically more significant among females. We determined in all age groups except age 7-9 group that the volume value of the total pulp chamber of the upper permanent first molar teeth was statistically higher than the volume value of the total pulp chamber of the lower permanent first molar teeth (p<0,05). Conclusion: We believe that CBCT is an easy and conservative method for the 3D-imaging of the pulp chamber, volume measurement and examination of the dimensional changes of the total pulp chamber depending on deposition of secondary dentin. How to cite this article: Açıklar Kavas A, Tümen EC. Volumetric pulp chambers measurements in mandibular and maxillary permanent first molar using cone-beam computed tomography by age and gender. Int Dent Res 2019;9(1):30-40. Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

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Variation in health-related quality of life (HRQOL) by line of therapy, age, and gender among patients with chronic lymphocytic leukemia.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.7086 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 7086-7086

Author(s):

Christopher Flowers ◽

Charles Michael Farber ◽

Ian Flinn ◽

David L. Grinblatt ◽

Neil E. Kay ◽

...

Keyword(s):

Chronic Lymphocytic Leukemia ◽

Statistical Significance ◽

The United States ◽

Lymphocytic Leukemia ◽

Age Group ◽

First Line ◽

Hrqol Score ◽

Age And Gender ◽

And Gender ◽

Line Of Therapy

7086 Background: The HRQOL of patients (pts) with chronic lymphocytic leukemia (CLL) has not been adequately delineated across patient, disease and treatment characteristics. We evaluated HRQOL of CLL pts undergoing treatment in the United States (US) by age, gender and line of therapy. Methods: Data were collected in Connect CLL, a prospective observational US registry. Physicians provided data on demographics, clinical characteristics and line of therapy at enrollment. HRQOL was self-reported by pts at enrollment using the Functional Assessment of Cancer Therapy-Leukemia, an instrument that yields a leukemia-specific total HRQOL score (FACT-Leu) and a cancer-specific total HRQOL score (FACT-G). Mean total scores were analyzed by line of therapy, age and gender. Statistical significance was ascertained by ANOVA using SAS 9.2. Multivariate analyses were conducted to assess the relative association of line of therapy, age and gender with HRQOL. Results: Among 1,252 pts enrolled from 161 geographically diverse centers (90% community, 8% academic, 2% veterans/military), pts were predominantly male (63%), white (89%) with mean age 69 yrs. Pts were categorized by line of therapy at enrollment: First 61%, Second 18%, Third 11%, Higher 9%; and by age group: <65 33%, 65-74 35%, 75+ 32%. Univariate analyses suggested that the total FACT-Leu score was significantly better in men than women (P=0.004); in pts aged 65-74 vs younger or older pts (P=0.033); and in pts initiating first-line treatment vs pts receiving subsequent treatments (P=0.0002). Similar results were found with the FACT-G score except that gender differences were not statistically significant. Multivariate analysis confirmed that line of therapy (P=0.007), gender (P<0.0001), and age group (P=0.039) were each associated with significant differences in the FACT-Leu total score. Conclusions: Results from the Connect CLL Registry indicate that HRQOL is better among pts initiating first-line therapy compared to pts initiating subsequent treatments, and that this remains true when age and gender are considered. Future analyses should determine how HRQOL may change over time relative to treatment and treatment response.

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A longitudinal study of age- and gender-related annual rate of volume changes in regional gray matter in healthy adults

Human Brain Mapping ◽

10.1002/hbm.22067 ◽

2012 ◽

Vol 34 (9) ◽

pp. 2292-2301 ◽

Cited By ~ 27

Author(s):

Yasuyuki Taki ◽

Benjamin Thyreau ◽

Shigeo Kinomura ◽

Kazunori Sato ◽

Ryoi Goto ◽

...

Keyword(s):

Longitudinal Study ◽

Gray Matter ◽

Healthy Adults ◽

Annual Rate ◽

Volume Changes ◽

Age And Gender ◽

And Gender

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Knee Fat Pad Volumes in Patients with Hemophilia and Their Relationship with Osteoarthritis

Arthritis ◽

10.1155/2017/1578623 ◽

2017 ◽

Vol 2017 ◽

pp. 1-8 ◽

Cited By ~ 2

Author(s):

Annette von Drygalski ◽

Katherine C. Rappazzo ◽

Richard F. W. Barnes ◽

Eric Y. Chang

Keyword(s):

Infrapatellar Fat Pad ◽

Control Cohort ◽

Resonance Imaging ◽

Fat Pad ◽

Volume Changes ◽

Age And Gender ◽

Radiographic Osteoarthritis ◽

Hemophilic Arthropathy ◽

And Gender

Hemophilic arthropathy is a progressive, disabling condition with poorly understood pathobiology. Since there is an emerging interest to study the role of intra-articular fat pad size and biology in arthritic conditions, we explored fat pad volume changes in hemophilic arthropathy and to what extent they differed from osteoarthritis. We matched a cohort of 13 adult patients with hemophilic arthropathy of the knee with age- and gender-matched cohorts without osteoarthritis (“control cohort”) and with the same degree of radiographic osteoarthritis (“OA cohort”) in 1 : 2 fashion. Infrapatellar fat pad (IPFP) and suprapatellar fat pad (SPFP) volumes were calculated based on magnetic resonance imaging and differences in fat pad volumes, demographics, height, weight, and osteoarthritis scores were evaluated. Fat pad volumes were positively associated with body size parameters in all three cohorts but were unaffected by the degree of osteoarthritis. While IPFP volumes did not differ between cohorts, SPFP volumes expanded disproportionally with weight in hemophilia patients. Our observations indicate that IPFPs and SPFPs behave biologically differently in response to different arthritic stimuli. The exaggerated expansion of the SPFP in hemophilia patients highlights the importance of further studying the implications of fat pad biology for progression of hemophilic arthropathy.

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