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Chiari-Correia RD, Tumas V, Santos AC, Salmon CEG. Structural and functional differences in the brains of patients with MCI with and without depressive symptoms and their relations with Alzheimer's disease: an MRI study. PSYCHORADIOLOGY 2023; 3:kkad008. [PMID: 38666129 PMCID: PMC10917365 DOI: 10.1093/psyrad/kkad008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/19/2023] [Accepted: 06/12/2023] [Indexed: 04/28/2024]
Abstract
Background The mild cognitive impairment (MCI) stage among elderly individuals is very complex, and the level of diagnostic accuracy is far from ideal. Some studies have tried to improve the 'MCI due to Alzheimer's disease (AD)' classification by further stratifying these patients into subgroups. Depression-related symptoms may play an important role in helping to better define the MCI stage in elderly individuals. Objective In this work, we explored functional and structural differences in the brains of patients with nondepressed MCI (nDMCI) and patients with MCI with depressive symptoms (DMCI), and we examined how these groups relate to AD atrophy patterns and cognitive functioning. Methods Sixty-five participants underwent MRI exams and were divided into four groups: cognitively normal, nDMCI, DMCI, and AD. We compared the regional brain volumes, cortical thickness, and white matter microstructure measures using diffusion tensor imaging among groups. Additionally, we evaluated changes in functional connectivity using fMRI data. Results In comparison to the nDMCI group, the DMCI patients had more pronounced atrophy in the hippocampus and amygdala. Additionally, DMCI patients had asymmetric damage in the limbic-frontal white matter connection. Furthermore, two medial posterior regions, the isthmus of cingulate gyrus and especially the lingual gyrus, had high importance in the structural and functional differentiation between the two groups. Conclusion It is possible to differentiate nDMCI from DMCI patients using MRI techniques, which may contribute to a better characterization of subtypes of the MCI stage.
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Affiliation(s)
- Rodolfo Dias Chiari-Correia
- Department of Neurosciences and Behavioral Sciences, Ribeirao Preto Medical School, University of Sao Paulo, 3900 Bandeirantes Avenue, Ribeirao Preto SP, 14040-900, Brazil
| | - Vitor Tumas
- Department of Neurosciences and Behavioral Sciences, Ribeirao Preto Medical School, University of Sao Paulo, 3900 Bandeirantes Avenue, Ribeirao Preto SP, 14040-900, Brazil
| | - Antônio Carlos Santos
- Department of Medical Imaging, Hematology and Clinical Oncology, Ribeirao Preto Medical School, University of Sao Paulo, 3900 Bandeirantes Avenue, Ribeirao Preto SP, 14040-900, Brazil
| | - Carlos Ernesto G Salmon
- Department of Physics, Faculty of Philosophy, Sciences and Letters, University of Sao Paulo, 3900 Bandeirantes Avenue, Ribeirao Preto SP, 14040-900, Brazil
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Chen R, Lin Q, Wu J, Lin Y, Lin T, Wu W, Chen X, Wu S, Zeng G, Lin X, Wu Y, Liu N, Xiao Y, Chen H. Augmentation therapy with tandospirone citrate in vascular depression patients with mild cognitive impairment: A prospective randomized clinical trial. J Psychiatr Res 2023; 159:274-282. [PMID: 36774768 DOI: 10.1016/j.jpsychires.2022.12.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 11/04/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022]
Abstract
Cognitive impairment is a prominent clinical manifestation of vascular depression (VaDep). The current study aimed to assess the efficacy of tandospirone citrate in VaDep cases with mild cognitive impairment (VaDep-MCI) as well as the role of plasma monoamine neurotransmitters during the treatment. In this single-blind, randomized controlled study, 116 participants were randomly assigned to the tandospirone (tandospirone citrate-escitalopram) and control (escitalopram) groups. The primary endpoints were changes in cognitive test scores from baseline to Week 8, including the Rey Auditory Verbal Learning Test (RAVLT), Semantic Verbal Fluency (SVF) test, Trail Making Test (TMT), Digital Span Test (DST) and Clock Drawing Test (CDT) scores. Generalized estimating equation models were used to examine repeated measures. The results showed that compared with the changes in the control group from baseline to Week 8, the tandospirone group showed more significant changes in SVF score at Weeks 4 (p < 0.05) and 8 (p < 0.001), and TMT (B-A) score at Week 8 (p < 0.05). RAVLT, DST and DCT scores were relatively stable in both groups during the study period. Moreover, mediation analysis showed that these results were not mediated by the alleviation of depression symptoms. Partial Spearman correlation analysis showed that only plasma 5-hydroxytryptamine (5-HT) was positively correlated with Hamilton Depression Rating Scale score after Bonferroni correction (r = 0.347, p < 0.001). Augmentation therapy with tandospirone citrate improved the executive and language functions of VaDep-MCI patients. Additionally, plasma 5-HT levels may serve as a potential biomarker of VaDep severity. These findings may provide clinical insights into the treatment of vascular depression.
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Affiliation(s)
- Ronghua Chen
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China; Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China; Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China; Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
| | - Qianwen Lin
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China; Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China; Department of Sleep Center, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China; Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China
| | - Juan Wu
- Department of Clinical Laboratory, School of Medical Technology and Engineering, Fujian Medical University, Fuzhou, China
| | - Yongsen Lin
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China; Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China; Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China; Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
| | - Ting Lin
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China; Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China; Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China; Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
| | - Weiwei Wu
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China; Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China; Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China; Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
| | - Xinyan Chen
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China; Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China
| | - Shufang Wu
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China; Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China; Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China
| | - Guiying Zeng
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China; Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China; Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China
| | - Xiaohui Lin
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China; Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China; Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China; Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
| | - Yongxi Wu
- Department of Sleep Center, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China
| | - Nan Liu
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China; Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China; Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China; Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China.
| | - Yingchun Xiao
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China; Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China; Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China; Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China.
| | - Hongbin Chen
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China; Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China; Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China; Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China.
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Luttenbacher I, Phillips A, Kazemi R, Hadipour AL, Sanghvi I, Martinez J, Adamson MM. Transdiagnostic role of glutamate and white matter damage in neuropsychiatric disorders: A Systematic Review. J Psychiatr Res 2022; 147:324-348. [PMID: 35151030 DOI: 10.1016/j.jpsychires.2021.12.042] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/08/2021] [Accepted: 12/19/2021] [Indexed: 12/09/2022]
Abstract
Neuropsychiatric disorders including generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia (SZ) have been considered distinct categories of diseases despite their overlapping characteristics and symptomatology. We aimed to provide an in-depth review elucidating the role of glutamate/Glx and white matter (WM) abnormalities in these disorders from a transdiagnostic perspective. The PubMed online database was searched for studies published between 2010 and 2021. After careful screening, 401 studies were included. The findings point to decreased levels of glutamate in the Anterior Cingulate Cortex in both SZ and BD, whereas Glx is elevated in the Hippocampus in SZ and MDD. With regard to WM abnormalities, the Corpus Callosum and superior Longitudinal Fascicle were the most consistently identified brain regions showing decreased fractional anisotropy (FA) across all the reviewed disorders, except GAD. Additionally, the Uncinate Fasciculus displayed decreased FA in all disorders, except OCD. Decreased FA was also found in the inferior Longitudinal Fasciculus, inferior Fronto-Occipital Fasciculus, Thalamic Radiation, and Corona Radiata in SZ, BD, and MDD. Decreased FA in the Fornix and Corticospinal Tract were found in BD and SZ patients. The Cingulum and Anterior Limb of Internal Capsule exhibited decreased FA in MDD and SZ patients. The results suggest a gradual increase in severity from GAD to SZ defined by the number of brain regions with WM abnormality which may be partially caused by abnormal glutamate levels. WM damage could thus be considered a potential marker of some of the main neuropsychiatric disorders.
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Affiliation(s)
- Ines Luttenbacher
- Department of Social & Behavioral Sciences, University of Amsterdam, Amsterdam, Netherlands; Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Angela Phillips
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Reza Kazemi
- Department of Cognitive Psychology, Institute for Cognitive Science Studies, Tehran, Iran
| | - Abed L Hadipour
- Department of Cognitive Sciences, University of Messina, Messina, Italy
| | - Isha Sanghvi
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Department of Neuroscience, University of Southern California, Los Angeles, CA, USA
| | - Julian Martinez
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Palo Alto University, Palo Alto, CA, USA
| | - Maheen M Adamson
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA.
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Disruption of the structural and functional connectivity of the frontoparietal network underlies symptomatic anxiety in late-life depression. NEUROIMAGE-CLINICAL 2020; 28:102398. [PMID: 32919365 PMCID: PMC7491145 DOI: 10.1016/j.nicl.2020.102398] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 08/18/2020] [Accepted: 08/19/2020] [Indexed: 12/31/2022]
Abstract
LLD patients present lower functional connectivity in the right FPN. LLD patients present impaired white matter integrity in tracts to the right FPN. FPN alterations were negatively correlated with anxiety severity in LLD patients. The right IFG might be a crucial hub underlying the neuropathology of LLD.
The present study investigated functional connectivity and white matter integrity of the fronto-parietal network (FPN) to reveal the neural mechanisms that underlie late-life depression (LLD). Fifty patients with LLD and 40 non-depressed controls were included in the study. A multi-parametric approach was used by applying independent component analysis (ICA) to estimate functional connectivity of the FPN and by applying tractbased spatial statistics to examine white-matter integrity in tracts to the FPN. Patients with LLD exhibited functional abnormalities in the right inferior frontal gyrus, middle frontal gyrus, and inferior parietal gyrus and lower white matter fractional anisotropy in the right inferior fronto-occipital fasciculus, anterior thalamic radiation, and uncinate fasciculus. Alterations of functional connectivity and white matter fractional anisotropy in these regions were negatively correlated with the severity of symptomatic anxiety in LLD patients. The right inferior frontal gyrus might be a crucial hub in transferring information between these abnormal regions. Significant correlations were found between anxiety symptoms and brain alterations, suggesting that impairments in the FPN network might be involved in symptomatic anxiety in elderly individuals with depression.
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Rashidi-Ranjbar N, Rajji TK, Kumar S, Herrmann N, Mah L, Flint AJ, Fischer CE, Butters MA, Pollock BG, Dickie EW, Anderson JAE, Mulsant BH, Voineskos AN. Frontal-executive and corticolimbic structural brain circuitry in older people with remitted depression, mild cognitive impairment, Alzheimer's dementia, and normal cognition. Neuropsychopharmacology 2020; 45:1567-1578. [PMID: 32422643 PMCID: PMC7360554 DOI: 10.1038/s41386-020-0715-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 04/15/2020] [Accepted: 05/11/2020] [Indexed: 12/11/2022]
Abstract
A history of depression is a risk factor for dementia. Despite strong epidemiologic evidence, the pathways linking depression and dementia remain unclear. We assessed structural brain alterations in white and gray matter of frontal-executive and corticolimbic circuitries in five groups of older adults putatively at-risk for developing dementia- remitted depression (MDD), non-amnestic MCI (naMCI), MDD+naMCI, amnestic MCI (aMCI), and MDD+aMCI. We also examined two other groups: non-psychiatric ("healthy") controls (HC) and individuals with Alzheimer's dementia (AD). Magnetic resonance imaging (MRI) data were acquired on the same 3T scanner. Following quality control in these seven groups, from diffusion-weighted imaging (n = 300), we compared white matter fractional anisotropy (FA), mean diffusivity (MD), and from T1-weighted imaging (n = 333), subcortical volumes and cortical thickness in frontal-executive and corticolimbic regions of interest (ROIs). We also used exploratory graph theory analysis to compare topological properties of structural covariance networks and hub regions. We found main effects for diagnostic group in FA, MD, subcortical volume, and cortical thickness. These differences were largely due to greater deficits in the AD group and to a lesser extent aMCI compared with other groups. Graph theory analysis revealed differences in several global measures among several groups. Older individuals with remitted MDD and naMCI did not have the same white or gray matter changes in the frontal-executive and corticolimbic circuitries as those with aMCI or AD, suggesting distinct neural mechanisms in these disorders. Structural covariance global metrics suggested a potential difference in brain reserve among groups.
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Affiliation(s)
- Neda Rashidi-Ranjbar
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Tarek K Rajji
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Sanjeev Kumar
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Nathan Herrmann
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Sunnybrook Health Sciences Centre, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Linda Mah
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Baycrest Health Sciences, Rotman Research Institute, Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Alastair J Flint
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- University Health Network, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Corinne E Fischer
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Keenan Research Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Meryl A Butters
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Bruce G Pollock
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Erin W Dickie
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - John A E Anderson
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Benoit H Mulsant
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Aristotle N Voineskos
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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White Matter Integrity Underlying Depressive Symptoms in Dementia Caregivers. Am J Geriatr Psychiatry 2020; 28:578-582. [PMID: 31892441 PMCID: PMC7170753 DOI: 10.1016/j.jagp.2019.11.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/11/2019] [Accepted: 11/28/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVE We sought to determine whether the aspects of white matter connectivity implicated in major depression also relate to mild depressive symptoms in family dementia caregivers (dCGs). METHODS Forty-one dCGs (average age=69 years, standard deviation=6.4) underwent a 7 Tesla 64-direction (12-minute) diffusion-weighted imaging sequence. We compared the fractional anisotropy (FA) of 11 white matter features between dCGs with (n=20) and without (n=21) depressive symptoms (Patient Health Questionnaire-9 scores ≥5). RESULTS Caregivers reporting depression symptoms had lower FA in tracts connecting to the posterior cingulate cortex (Cohen's d = -0.9) and connecting dorsolateral prefrontal with rostral cingulate regions (Cohen's d = -1.2). CONCLUSIONS Posterior cingulate and dorsolateral prefrontal-to-rostral cingulate white matter, implicated in prior studies of major depression, appear relevant to mild depression in dCGs.
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Rashidi-Ranjbar N, Miranda D, Butters MA, Mulsant BH, Voineskos AN. Evidence for Structural and Functional Alterations of Frontal-Executive and Corticolimbic Circuits in Late-Life Depression and Relationship to Mild Cognitive Impairment and Dementia: A Systematic Review. Front Neurosci 2020; 14:253. [PMID: 32362808 PMCID: PMC7182055 DOI: 10.3389/fnins.2020.00253] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 03/06/2020] [Indexed: 01/12/2023] Open
Abstract
Depression is a risk factor for developing Alzheimer's disease and Related Dementia (ADRD). We conducted a systematic review between 2008 and October 2018, to evaluate the evidence for a conceptual mechanistic model linking depression and ADRD, focusing on frontal-executive and corticolimbic circuits. We focused on two neuroimaging modalities: diffusion-weighted imaging measuring white matter tract disruptions and resting-state functional MRI measuring alterations in network dynamics in late-life depression (LLD), mild cognitive impairment (MCI), and LLD+MCI vs. healthy control (HC) individuals. Our data synthesis revealed that in some but not all studies, impairment of both frontal-executive and corticolimbic circuits, as well as impairment of global brain topology was present in LLD, MCI, and LLD+MCI vs. HC groups. Further, posterior midline regions (posterior cingulate cortex and precuneus) appeared to have the most structural and functional alterations in all patient groups. Future cohort and longitudinal studies are required to address the heterogeneity of findings, and to clarify which subgroups of people with LLD are at highest risk for developing MCI and ADRD.
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Affiliation(s)
- Neda Rashidi-Ranjbar
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Dayton Miranda
- Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Meryl A Butters
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Benoit H Mulsant
- Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Aristotle N Voineskos
- Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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He Q, Li D, Turel O, Bechara A, Hser YI. White matter integrity alternations associated with cocaine dependence and long-term abstinence: Preliminary findings. Behav Brain Res 2019; 379:112388. [PMID: 31783090 DOI: 10.1016/j.bbr.2019.112388] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 11/21/2019] [Accepted: 11/25/2019] [Indexed: 01/19/2023]
Abstract
Cocaine dependence has been associated with deficits in white matter (WM) integrity. Nevertheless, what happens to WM integrity after long-term abstinence is not fully understood. To bridge this gap, changes in WM integrity were examined with diffusion tensor imaging (DTI) applied to 39 participants: 12 participants who used cocaine in the last year (CURRENT USERS), 20 who were at different stages of cocaine abstinence (ABSTINENCE) [five with 1-5 years of abstinence (ABS1), five with 6-10 years of abstinence (ABS2), and 10 with over 10 years of abstinence (ABS3)], and 7 healthy controls (CONTROLS). The CONTROL group had higher fractional anisotropy (FA) compared to CURRENT USERS in frontal cortex tracts, including the bilateral corpus callosum, bilateral superior longitudinal fasciculus, bilateral inferior fronto-occipital fasciculus, left internal capsule, left middle cingulum, and left ventral and dorsal medial frontal regions. The ABSTINENCE group also had higher FA compared to CURRENT USERS in frontal cortex tracts, such as the bilateral corpus callosum, bilateral superior longitudinal fasciculus, left inferior longitudinal fasciculus, left uncinate fasciculus, left inferior fronto-occipital fasciculus, and the left ventral and dorsal medial frontal regions. Tractography analysis showed (1) deficits in terms of number of fibers and fiber length in these regions, and that (2) while there was some recovery of white matter in dorsolateral regions during abstinence, duration of abstinence was not associated with such recovery. The results identified WM differences among cocaine users, cocaine abstinent participants, and controls. These preliminary findings point to WM tracts that recover, and some that do not, after long-term abstinence from cocaine.
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Affiliation(s)
- Qinghua He
- Faculty of Psychology, Southwest University, Beibei, Chongqing, China; Brain and Creativity Institute and Department of Psychology, University of Southern California, Los Angeles, CA, USA.
| | - Dandan Li
- Faculty of Psychology, Southwest University, Beibei, Chongqing, China
| | - Ofir Turel
- Brain and Creativity Institute and Department of Psychology, University of Southern California, Los Angeles, CA, USA; Information Systems and Decision Sciences, California State University, Fullerton, CA, USA
| | - Antoine Bechara
- Brain and Creativity Institute and Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Yih-Ing Hser
- Center for Advancing Longitudinal Drug Abuse Research, University of California, Los Angeles, CA, USA
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9
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Meyer CS, Schreiner PJ, Lim K, Battapady H, Launer LJ. Depressive Symptomatology, Racial Discrimination Experience, and Brain Tissue Volumes Observed on Magnetic Resonance Imaging. Am J Epidemiol 2019; 188:656-663. [PMID: 30657841 PMCID: PMC6438808 DOI: 10.1093/aje/kwy282] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 12/19/2018] [Accepted: 12/19/2018] [Indexed: 01/06/2023] Open
Abstract
Not much is known about brain structural change in younger populations and minorities. The cross-sectional relationship between depressive symptomatology and racial discrimination with structural measures of brain tissue volume was investigated using magnetic resonance images of 710 participants in the Coronary Artery Risk Development in Young Adults CARDIA Study in 2010. Those reporting depressive symptoms and racial discrimination had lower total brain matter volume compared with those who reported neither (-8.8 mL, 95% confidence interval (CI): -16.4, -1.2), those who reported depressive symptoms only (-10.9 mL, 95% CI: -20.4, -1.4), and those who reported racial discrimination only (-8.6 mL, 95% CI: -16.5, -0.8). Results were similar for total normal white matter. There were 103% higher odds (odds ratio = 2.03, 95% CI: 1.32, 3.14) of being in the highest quartile of white matter hyperintensities in those with depressive symptoms only compared to those without. Although tests for interaction by race were not statistically significant, sensitivity analyses stratified by race revealed inverse associations with total brain matter and total white matter volumes only among black participants with combined depressive symptomatology and experience of racial discrimination, and positive associations only among white participants with depressive symptoms with presence of white matter hyperintensities, suggesting future studies may focus on race.
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Affiliation(s)
- Craig S Meyer
- Department of Medicine, School of Medicine, University of California, San Francisco, San Francisco, California
| | - Pamela J Schreiner
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Twin Cities, Minnesota
| | - Kelvin Lim
- Department of Psychiatry, School of Medicine, University of Minnesota, Twin Cities, Minnesota
| | - Harsha Battapady
- University of Pennsylvania Health System, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Lenore J Launer
- the Neuroepidemiology Section, National Institute on Aging, National Institutes of Health, Bethesda, Maryland
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Association between abnormal serum myelin-specific protein levels and white matter integrity in first-episode and drug-naïve patients with major depressive disorder. J Affect Disord 2018; 232:61-68. [PMID: 29477585 DOI: 10.1016/j.jad.2018.02.044] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Revised: 12/01/2017] [Accepted: 02/15/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND Although the structural abnormalities of white matter (WM) have been described in patients with major depressive disorder (MDD), the neuropathological changes remain unclear. The current study aimed to investigate the myelin oligodendrocyte glycoprotein (MOG) and myelin-associated glycoprotein (MAG) levels and their correlations with WM integrity in first-episode, drug-naïve MDD patients. METHODS We obtained diffusion tensor images of 102 first-episode, drug-naïve MDD patients and 81 age- and sex-matched controls. Serum MOG and MAG levels of all participants were measured and compared between the two groups. The correlations between WM integrity and MOG and MAG levels were examined. RESULTS MOG and MAG serum levels were significantly higher in MDD patients than in controls. Patients with MDD also showed decreased fractional anisotropy (FA) and axial diffusivity in the WM of the bilateral thalamus, right hippocampus, right temporal lobe, and left pulvinar. At the whole-brain level, no regions showed any correlations of diffusivity parameters with MOG or MAG levels in healthy subjects. However, we observed two-way correlations between the MOG and MAG levels and the FA and mean diffusivity values in the WM of the left middle frontal lobe, right inferior parietal lobe, and right supplementary motor area in MDD patients. LIMITATIONS Further investigation with a larger sample size and longitudinal studies are required to better understand the neuropathology of WM integrity in MDD. CONCLUSIONS Our findings represent the first evidence of a relationship between abnormal serum myelin-specific protein levels and impaired WM integrity, which may help to better understand the neurobiological mechanisms of MDD.
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WANG J, LI W, YUE L, HONG B, AN N, LI G, XIAO S. The Study of White Matter Hyperintensity (WMH) and Factors Related to Geriatric Late-Onset Depression. SHANGHAI ARCHIVES OF PSYCHIATRY 2018; 30:12-19. [PMID: 29719354 PMCID: PMC5925594 DOI: 10.11919/j.issn.1002-0829.217038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Geriatric depression is one of the most common and harmful mental illnesses seen in the elderly. However, there are few studies focusing on the relationship between late-onset depression (LOD) and social and psychological factors, as well as brain structure. AIMS To explore factors related to late-onset depression (LOD) in elderly patients. METHODS 24 first onset LOD patients over 60 years old (meeting ICD-10 diagnostic criteria for depression) and 23 non-depressed elders were selected for inclusion into this study. Scale assessments, including Fazelasscale for white matter hyperintensity (WMH) high signal level and the MTA-scale for medial temporal lobe atrophy levels, were combined with general demography and sociology data to find factors related to LOD. RESULTS There was no significant difference in age (t=0.419, p=0.678), gender (X2=1.705, p=0.244), or years of education (t=1.478, p=0.146) between the two groups. However, statistical differences were shown on scores on the WMH, (X2=7.817, p=0.008), periventricular white matter hyperintensity (PWMH)(Fisher exact test: p=0.031), having or not having religious beliefs (Fisher exact test: p=0.265) and family harmony (yes or no) (Fisher exact test: p=0.253) between the LOD group and control group. The results of linear regression analysis showed that the total score for WMH, religious beliefs (with or without) and family harmony (yes or no) were associated with depressive symptomology. CONCLUSION Scores on the WMH, religious beliefs and family harmony are all potentially related to LOD in elderly patients.
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Affiliation(s)
| | | | | | | | | | - Guanjun LI
- Alzheimer’s Disease and Related Disorders Center of the Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shifu XIAO
- Alzheimer’s Disease and Related Disorders Center of the Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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12
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Emsell L, Adamson C, De Winter FL, Billiet T, Christiaens D, Bouckaert F, Adamczuk K, Vandenberghe R, Seal ML, Sienaert P, Sunaert S, Vandenbulcke M. Corpus callosum macro and microstructure in late-life depression. J Affect Disord 2017; 222:63-70. [PMID: 28672181 DOI: 10.1016/j.jad.2017.06.063] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 05/31/2017] [Accepted: 06/26/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Differences in corpus callosum (CC) morphology and microstructure have been implicated in late-life depression and may distinguish between late and early-onset forms of the illness. However, a multimodal approach using complementary imaging techniques is required to disentangle microstructural alterations from macrostructural partial volume effects. METHODS 107 older adults were assessed: 55 currently-depressed patients without dementia and 52 controls without cognitive impairment. We investigated group differences and clinical associations in 7 sub-regions of the mid-sagittal corpus callosum using T1 anatomical data, white matter hyperintensity (WMH) quantification and two different diffusion MRI (dMRI) models (multi-tissue constrained spherical deconvolution, yielding apparent fibre density, AFD; and diffusion tensor imaging, yielding fractional anisotropy, FA and radial diffusivity, RD). RESULTS Callosal AFD was lower in patients compared to controls. There were no group differences in CC thickness, surface area, FA, RD, nor whole brain or WMH volume. Late-onset of depression was associated with lower FA, higher RD and lower AFD. There were no associations between any imaging measures and psychotic features or depression severity as assessed by the geriatric depression scale. WMH volume was associated with lower FA and AFD, and higher RD in patients. LIMITATIONS Patients were predominantly treatment-resistant. Measurements were limited to the mid-sagittal CC. dMRI analysis was performed on a smaller cohort, n=77. AFD was derived from low b-value data. CONCLUSIONS Callosal structure is largely preserved in LLD. WMH burden may impact on CC microstructure in late-onset depression suggesting vascular pathology has additional deleterious effects in these patients.
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Affiliation(s)
- Louise Emsell
- Old Age Psychiatry, University Psychiatric Centre (UPC) - KU Leuven, Belgium; Translational MRI & Radiology, KU Leuven & University Hospital Leuven, Belgium.
| | - Christopher Adamson
- Developmental Imaging, Murdoch Children's Research Institute, Victoria, Australia
| | | | - Thibo Billiet
- Translational MRI & Radiology, KU Leuven & University Hospital Leuven, Belgium
| | - Daan Christiaens
- Department of Electrical Engineering (ESAT), Processing of Speech and Images (PSI), Medical Image Computing, KU Leuven & Medical Imaging Research Center, University Hospital Leuven, Belgium; Division of Imaging Sciences and Biomedical Engineering, Kings College London, UK
| | - Filip Bouckaert
- Old Age Psychiatry, University Psychiatric Centre (UPC) - KU Leuven, Belgium; KU Leuven, University Psychiatric Center KU Leuven, Academic Center for ECT and Neurostimulation (AcCENT), Kortenberg, Belgium
| | - Katarzyna Adamczuk
- Laboratory for Cognitive Neurology, Department of Neurology, KU Leuven & University Hospital Leuven, Belgium; Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, USA
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurology, KU Leuven & University Hospital Leuven, Belgium
| | - Marc L Seal
- Developmental Imaging, Murdoch Children's Research Institute, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Victoria, Australia
| | - Pascal Sienaert
- KU Leuven, University Psychiatric Center KU Leuven, Academic Center for ECT and Neurostimulation (AcCENT), Kortenberg, Belgium
| | - Stefan Sunaert
- Translational MRI & Radiology, KU Leuven & University Hospital Leuven, Belgium
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13
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Ko PW, Lee HW, Kang K. Frontal Assessment Battery and Cerebrospinal Fluid Tap Test in Idiopathic Normal-Pressure Hydrocephalus. Eur Neurol 2017; 77:327-332. [PMID: 28472801 DOI: 10.1159/000472712] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 03/28/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND PURPOSE Our aim in this study was to assess whether the frontal assessment battery (FAB) could contribute to the differential diagnosis of cerebrospinal fluid tap test (CSFTT) responders and nonresponders with the hypothesis that CSFTT nonresponders had greater frontal lobe dysfunction. We also explored whether a relationship exists between FAB scores and gait disturbance in idiopathic normal-pressure hydrocephalus (INPH) patients. METHODS INPH subjects were selected in a consecutive order from a prospectively enrolled INPH registry. Fifty-one INPH patients constituted the final sample for analysis. RESULTS Logistic regression analysis using the FAB score as independent variable showed a significant influence of the FAB on the differential diagnosis of CSFTT responders and nonresponders (p = 0.025; OR 1.186; 95% CI 1.022-1.377). The FAB scores were negatively correlated with the Timed Up and Go test score (r = -0.382; p = 0.007), 10-meter walking test score (r = -0.351; p = 0.014), Gait Status Scale score (r = -0.382; p = 0.007), and INPH Grading Scale gait score (r = -0.370; p = 0.009). CONCLUSIONS Our findings may indicate a possibility for considering FAB scores in patients with ventriculomegaly as potential cognitive markers for the prediction of CSFTT response. Association between gait function and FAB scores suggests the involvement of similar circuits producing gait symptom and frontal lobe functions in INPH.
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Affiliation(s)
- Pan-Woo Ko
- Department of Neurology, Kyungpook National University School of Medicine, Daegu, South Korea
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14
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Hodgetts S, Gallagher P, Stow D, Ferrier IN, O'Brien JT. The impact and measurement of social dysfunction in late-life depression: an evaluation of current methods with a focus on wearable technology. Int J Geriatr Psychiatry 2017; 32:247-255. [PMID: 27911019 DOI: 10.1002/gps.4632] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 10/25/2016] [Accepted: 10/26/2016] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Depression is known to negatively impact social functioning, with patients commonly reporting difficulties maintaining social relationships. Moreover, a large body of evidence suggests poor social functioning is not only present in depression but that social functioning is an important factor in illness course and outcome. In addition, good social relationships can play a protective role against the onset of depressive symptoms, particularly in late-life depression. However, the majority of research in this area has employed self-report measures of social function. This approach is problematic, as due to their reliance on memory, such measures are prone to error from the neurocognitive impairments of depression, as well as mood-congruent biases. METHOD Narrative review based on searches of the Web of Science and PubMed database(s) from the start of the databases, until the end of 2015. RESULTS The present review provides an overview of the literature on social functioning in (late-life) depression and discusses the potential for new technologies to improve the measurement of social function in depressed older adults. In particular, the use of wearable technology to collect direct, objective measures of social activity, such as physical activity and speech, is considered. CONCLUSION In order to develop a greater understanding of social functioning in late-life depression, future research should include the development and validation of more direct, objective measures in conjunction with subjective self-report measures. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Sophie Hodgetts
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Peter Gallagher
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.,Newcastle University, Institute for Ageing, Newcastle upon Tyne, UK
| | - Daniel Stow
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - I Nicol Ferrier
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - John T O'Brien
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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15
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Chen JH, Yao ZJ, Qin JL, Yan R, Hua LL, Lu Q. Aberrant Global and Regional Topological Organization of the Fractional Anisotropy-weighted Brain Structural Networks in Major Depressive Disorder. Chin Med J (Engl) 2017; 129:679-89. [PMID: 26960371 PMCID: PMC4804414 DOI: 10.4103/0366-6999.178002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background: Most previous neuroimaging studies have focused on the structural and functional abnormalities of local brain regions in major depressive disorder (MDD). Moreover, the exactly topological organization of networks underlying MDD remains unclear. This study examined the aberrant global and regional topological patterns of the brain white matter networks in MDD patients. Methods: The diffusion tensor imaging data were obtained from 27 patients with MDD and 40 healthy controls. The brain fractional anisotropy-weighted structural networks were constructed, and the global network and regional nodal metrics of the networks were explored by the complex network theory. Results: Compared with the healthy controls, the brain structural network of MDD patients showed an intact small-world topology, but significantly abnormal global network topological organization and regional nodal characteristic of the network in MDD were found. Our findings also indicated that the brain structural networks in MDD patients become a less strongly integrated network with a reduced central role of some key brain regions. Conclusions: All these resulted in a less optimal topological organization of networks underlying MDD patients, including an impaired capability of local information processing, reduced centrality of some brain regions and limited capacity to integrate information across different regions. Thus, these global network and regional node-level aberrations might contribute to understanding the pathogenesis of MDD from the view of the brain network.
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Affiliation(s)
| | - Zhi-Jian Yao
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China
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16
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O'Brien JT, Gallagher P, Stow D, Hammerla N, Ploetz T, Firbank M, Ladha C, Ladha K, Jackson D, McNaney R, Ferrier IN, Olivier P. A study of wrist-worn activity measurement as a potential real-world biomarker for late-life depression. Psychol Med 2017; 47:93-102. [PMID: 27667663 PMCID: PMC5197921 DOI: 10.1017/s0033291716002166] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 08/01/2016] [Accepted: 08/02/2016] [Indexed: 12/03/2022]
Abstract
BACKGROUND Late-life depression (LLD) is associated with a decline in physical activity. Typically this is assessed by self-report questionnaires and, more recently, with actigraphy. We sought to explore the utility of a bespoke activity monitor to characterize activity profiles in LLD more precisely. METHOD The activity monitor was worn for 7 days by 29 adults with LLD and 30 healthy controls. Subjects underwent neuropsychological assessment and quality of life (QoL) (36-item Short-Form Health Survey) and activities of daily living (ADL) scales (Instrumental Activities of Daily Living Scale) were administered. RESULTS Physical activity was significantly reduced in LLD compared with controls (t = 3.63, p < 0.001), primarily in the morning. LLD subjects showed slower fine motor movements (t = 3.49, p < 0.001). In LLD patients, activity reductions were related to reduced ADL (r = 0.61, p < 0.001), lower QoL (r = 0.65, p < 0.001), associative learning (r = 0.40, p = 0.036), and higher Montgomery-Åsberg Depression Rating Scale score (r = -0.37, p < 0.05). CONCLUSIONS Patients with LLD had a significant reduction in general physical activity compared with healthy controls. Assessment of specific activity parameters further revealed the correlates of impairments associated with LLD. Our study suggests that novel wearable technology has the potential to provide an objective way of monitoring real-world function.
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Affiliation(s)
- J. T. O'Brien
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - P. Gallagher
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
- Newcastle University Institute for Ageing, Newcastle upon Tyne, UK
| | - D. Stow
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - N. Hammerla
- Open Lab, Newcastle University, Newcastle upon Tyne, UK
| | - T. Ploetz
- Open Lab, Newcastle University, Newcastle upon Tyne, UK
| | - M. Firbank
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - C. Ladha
- Open Lab, Newcastle University, Newcastle upon Tyne, UK
| | - K. Ladha
- Open Lab, Newcastle University, Newcastle upon Tyne, UK
| | - D. Jackson
- Open Lab, Newcastle University, Newcastle upon Tyne, UK
| | - R. McNaney
- Open Lab, Newcastle University, Newcastle upon Tyne, UK
| | - I. N. Ferrier
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - P. Olivier
- Open Lab, Newcastle University, Newcastle upon Tyne, UK
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17
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Structural and Functional Connectivity of Default Mode Network underlying the Cognitive Impairment in Late-onset Depression. Sci Rep 2016; 6:37617. [PMID: 27886212 PMCID: PMC5122858 DOI: 10.1038/srep37617] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 10/28/2016] [Indexed: 12/30/2022] Open
Abstract
To identify the association between the functional and structural changes of default mode network (DMN) underlying the cognitive impairment in Late-onset depression (LOD), 32 LOD patients and 39 normal controls were recruited and underwent resting-state fMRI, DTI scans, and cognitive assessments. Seed-based correlation analysis was conducted to explore the functional connectivity (FC) of the DMN. Deterministic tractography between FC-impaired regions was performed to examine the structural connectivity (SC). Partial correlation analyses were employed to evaluate the cognitive association of those altered FC and SC. Compared with controls, LOD patients showed decreased FC between DMN and the cingulo-opercular network (CON), as well as the thalamus. Decreased FA and increased RD of these fiber tracts connecting DMN with CON were found in LOD patient. The DMN-CON FC and the FA, RD of the fiber tracts were both significantly correlated with the cognitive performance. Therefore, the cognitive impairment in LOD might be associated with the decreased FC between the DMN and the CON, which probably resulted from the demyelination of the white matter.
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18
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Aizenstein HJ, Baskys A, Boldrini M, Butters MA, Diniz BS, Jaiswal MK, Jellinger KA, Kruglov LS, Meshandin IA, Mijajlovic MD, Niklewski G, Pospos S, Raju K, Richter K, Steffens DC, Taylor WD, Tene O. Vascular depression consensus report - a critical update. BMC Med 2016; 14:161. [PMID: 27806704 PMCID: PMC5093970 DOI: 10.1186/s12916-016-0720-5] [Citation(s) in RCA: 145] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 10/14/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Vascular depression is regarded as a subtype of late-life depression characterized by a distinct clinical presentation and an association with cerebrovascular damage. Although the term is commonly used in research settings, widely accepted diagnostic criteria are lacking and vascular depression is absent from formal psychiatric manuals such as the Diagnostic and Statistical Manual of Mental Disorders, 5th edition - a fact that limits its use in clinical settings. Magnetic resonance imaging (MRI) techniques, showing a variety of cerebrovascular lesions, including extensive white matter hyperintensities, subcortical microvascular lesions, lacunes, and microinfarcts, in patients with late life depression, led to the introduction of the term "MRI-defined vascular depression". DISCUSSION This diagnosis, based on clinical and MRI findings, suggests that vascular lesions lead to depression by disruption of frontal-subcortical-limbic networks involved in mood regulation. However, despite multiple MRI approaches to shed light on the spatiotemporal structural changes associated with late life depression, the causal relationship between brain changes, related lesions, and late life depression remains controversial. While postmortem studies of elderly persons who died from suicide revealed lacunes, small vessel, and Alzheimer-related pathologies, recent autopsy data challenged the role of these lesions in the pathogenesis of vascular depression. Current data propose that the vascular depression connotation should be reserved for depressed older patients with vascular pathology and evident cerebral involvement. Based on current knowledge, the correlations between intra vitam neuroimaging findings and their postmortem validity as well as the role of peripheral markers of vascular disease in late life depression are discussed. CONCLUSION The multifold pathogenesis of vascular depression as a possible subtype of late life depression needs further elucidation. There is a need for correlative clinical, intra vitam structural and functional MRI as well as postmortem MRI and neuropathological studies in order to confirm the relationship between clinical symptomatology and changes in specific brain regions related to depression. To elucidate the causal relationship between regional vascular brain changes and vascular depression, animal models could be helpful. Current treatment options include a combination of vasoactive drugs and antidepressants, but the outcomes are still unsatisfying.
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Affiliation(s)
- Howard J Aizenstein
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Andrius Baskys
- Memory Disorders Clinic, Riverside Psychiatric Medical Group, Riverside, CA, USA
| | - Maura Boldrini
- Department of Psychiatry, Columbia University, New York, NY, USA.,Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
| | - Meryl A Butters
- Department of Psychiatry, University of Pittsburgh Medical School, Pittsburgh, PA, USA
| | - Breno S Diniz
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Manoj Kumar Jaiswal
- Department of Psychiatry, Columbia University, New York, NY, USA.,Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - Kurt A Jellinger
- Institute of Clinical Neurobiology, Alberichgasse 5/13, Vienna, A-1150, Austria.
| | - Lev S Kruglov
- Department of Geriatric Psychiatry of the St. Petersburg Psychoneurological Research Institute named after V. M. Bekhterev, Medical Faculty of St. Petersburg University, St. Petersburg, Russia
| | - Ivan A Meshandin
- Clinical Department, Scientific and Practical Center of Psychoneurology named after V. M. Soloviev, St. Petersburg, Russia
| | - Milija D Mijajlovic
- Neurology Clinic, Clinical Center of Serbia, School of Medicine University of Belgrade, Belgrade, Serbia
| | - Guenter Niklewski
- University Clinic for Psychiatry and Psychotherapy, Paracelsus Private Medical University, Nuremberg, Germany
| | - Sarah Pospos
- Memory Disorders Clinic, Riverside Psychiatric Medical Group, Riverside, CA, USA
| | - Keerthy Raju
- Consultant in Old Age Psychiatry, Cheshire and Wirral Partnership NHS Foundation Trust, Chester, UK
| | - Kneginja Richter
- University Clinic for Psychiatry and Psychotherapy, Paracelsus Private Medical University, Nuremberg, Germany.,Faculty for Social Sciences, Technical University of Nuremberg Georg Simon Ohm, Nuremberg, Germany
| | - David C Steffens
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, USA
| | - Warren D Taylor
- Department of Psychiatry, The Center for Cognitive Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Veterans Affairs Medical Center, The Geriatric Research, Education, and Clinical Center (GRECC), Tennessee Valley Healthcare System, Nashville, TN, USA
| | - Oren Tene
- Departments of Neurology and Psychiatry, Tel Aviv Medical Center, Tel Aviv, Israel.,Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv, Israel
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Kang K, Yoon U, Choi W, Lee HW. Diffusion tensor imaging of idiopathic normal-pressure hydrocephalus and the cerebrospinal fluid tap test. J Neurol Sci 2016; 364:90-6. [DOI: 10.1016/j.jns.2016.02.067] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 02/12/2016] [Accepted: 02/29/2016] [Indexed: 10/22/2022]
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20
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Patel MJ, Andreescu C, Price JC, Edelman KL, Reynolds CF, Aizenstein HJ. Machine learning approaches for integrating clinical and imaging features in late-life depression classification and response prediction. Int J Geriatr Psychiatry 2015; 30:1056-67. [PMID: 25689482 PMCID: PMC4683603 DOI: 10.1002/gps.4262] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 12/19/2014] [Accepted: 01/05/2015] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Currently, depression diagnosis relies primarily on behavioral symptoms and signs, and treatment is guided by trial and error instead of evaluating associated underlying brain characteristics. Unlike past studies, we attempted to estimate accurate prediction models for late-life depression diagnosis and treatment response using multiple machine learning methods with inputs of multi-modal imaging and non-imaging whole brain and network-based features. METHODS Late-life depression patients (medicated post-recruitment) (n = 33) and older non-depressed individuals (n = 35) were recruited. Their demographics and cognitive ability scores were recorded, and brain characteristics were acquired using multi-modal magnetic resonance imaging pretreatment. Linear and nonlinear learning methods were tested for estimating accurate prediction models. RESULTS A learning method called alternating decision trees estimated the most accurate prediction models for late-life depression diagnosis (87.27% accuracy) and treatment response (89.47% accuracy). The diagnosis model included measures of age, Mini-mental state examination score, and structural imaging (e.g. whole brain atrophy and global white mater hyperintensity burden). The treatment response model included measures of structural and functional connectivity. CONCLUSIONS Combinations of multi-modal imaging and/or non-imaging measures may help better predict late-life depression diagnosis and treatment response. As a preliminary observation, we speculate that the results may also suggest that different underlying brain characteristics defined by multi-modal imaging measures-rather than region-based differences-are associated with depression versus depression recovery because to our knowledge this is the first depression study to accurately predict both using the same approach. These findings may help better understand late-life depression and identify preliminary steps toward personalized late-life depression treatment.
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Affiliation(s)
- Meenal J Patel
- Department of Bioengineering, University of Pittsburgh, PA, USA
| | - Carmen Andreescu
- Department of Psychiatry, University of Pittsburgh School of Medicine, PA, USA
| | - Julie C Price
- Department of Radiology, University of Pittsburgh Medical Center, PA, USA
| | - Kathryn L Edelman
- Department of Psychiatry, University of Pittsburgh School of Medicine, PA, USA
| | - Charles F Reynolds
- Department of Psychiatry, University of Pittsburgh School of Medicine, PA, USA
- Department of Neurology, University of Pittsburgh, PA, USA
- Department of Neuroscience, University of Pittsburgh, PA, USA
| | - Howard J Aizenstein
- Department of Bioengineering, University of Pittsburgh, PA, USA
- Department of Psychiatry, University of Pittsburgh School of Medicine, PA, USA
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21
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Jiang W, Gong G, Wu F, Kong L, Chen K, Cui W, Ren L, Fan G, Sun W, Ma H, Xu K, Tang Y, Wang F. The papez circuit in first-episode, treatment-naive adults with major depressive disorder: combined atlas-based tract-specific quantification analysis and voxel-based analysis. PLoS One 2015; 10:e0126673. [PMID: 25996480 PMCID: PMC4440648 DOI: 10.1371/journal.pone.0126673] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 04/06/2015] [Indexed: 11/18/2022] Open
Abstract
Previous findings suggest that the Papez Circuit may have a role in major depressive disorders. We used atlas-based tract-specific quantification analysis and voxel-based analysis to examine the integrity of white matter tracts involved in mood regulation (including tracts in the Papez Circuit). Diffusion tensor imaging acquired from 35 first-episode, treatment-naive adults with major depressive disorders and 34 healthy adult controls were compared. Our statistical approach compared structural integrity of 11 major white matter tracts between the major depressive disorder and adult controls, as well as illness duration influence in patients. Fractional anisotropy was decreased in the hippocampal cingulum and in the anterior thalamic radiation according to both analytical approaches, all of which were important tracts included in the Papez Circuit. Our results support the role of the Papez Circuit in major depressive disorders with the minimal probability of false positive due to similar findings in both analyses that have complementary advantages. Dysfunction of the Papez Circuit may be a potential marker for studying the pathogenesis of major depressive disorders.
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Affiliation(s)
- Wenyan Jiang
- Department of Psychiatry, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning, PR China
- Department of Radiology, The Liaoning Cancer Hospital & Institute, Shenyang 110042, Liaoning, PR China
| | - Gaolang Gong
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, PR China
| | - Feng Wu
- Department of Psychiatry, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning, PR China
| | - Lingtao Kong
- Department of Psychiatry, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning, PR China
| | - Kaiyuan Chen
- Department of Psychiatry, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning, PR China
| | - Wenhui Cui
- Department of Psychiatry, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning, PR China
| | - Ling Ren
- Department of Radiology, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning, PR China
| | - Guoguang Fan
- Department of Radiology, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning, PR China
| | - Wenge Sun
- Department of Radiology, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning, PR China
| | - Huan Ma
- Department of Psychiatry, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning, PR China
| | - Ke Xu
- Department of Radiology, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning, PR China
- * E-mail: (KX); (YT)
| | - Yanqing Tang
- Department of Psychiatry, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning, PR China
- * E-mail: (KX); (YT)
| | - Fei Wang
- Department of Psychiatry, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning, PR China
- Department of Radiology, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning, PR China
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, United States of America
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van Uden IWM, Tuladhar AM, de Laat KF, van Norden AGW, Norris DG, van Dijk EJ, Tendolkar I, de Leeuw FE. White matter integrity and depressive symptoms in cerebral small vessel disease: The RUN DMC study. Am J Geriatr Psychiatry 2015; 23:525-35. [PMID: 25151438 DOI: 10.1016/j.jagp.2014.07.002] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 07/01/2014] [Accepted: 07/12/2014] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Depressive symptoms are common in elderly with cerebral small vessel disease (SVD). As not every individual with SVD experiences depressive symptoms, other factors might play a role. We therefore investigated the white matter (WM) integrity of the white matter tracts in elderly with depressive symptoms, independent of global cognitive function, by applying the tract-based spatial statistics (TBSS). DESIGN Prospective cohort study with cross-sectional baseline data. SETTING Radboud University Nijmegen Medical Centre, The Netherlands. PARTICIPANTS 438 individuals aged between 50-85 years, with SVD without dementia. MEASUREMENTS Diffusion tensor imaging parameters and depressive symptoms, assessed with the Center for Epidemiologic Studies Depression Scale. RESULTS Compared with non-depressed participants (N = 287), those with depressive symptoms (N = 151) had lower fractional anisotropy in the genu and body of the corpus callosum, bilateral inferior fronto-occipital fasciculus, uncinate fasciculus, and corona radiata. These differences disappeared after adjustment for white matter hyperintensities (WMH) and lacunar infarcts. Mean-, axial- and radial diffusivity were higher in these areas in participants with depressive symptoms. After additional adjustment for WMH and lacunar infarcts, the changes observed in radial diffusivity also disappeared. Adding global cognition as confounding variable altered the diffusion parameters only slightly. CONCLUSION This study indicates that elderly with depressive symptoms show a lower WM integrity, independent of global cognitive function, and that the presence of SVD is mostly responsible, affecting the fronto-subcortical regions and hereby disrupting the neural circuitry involved in mood regulation.
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Affiliation(s)
- Ingeborg W M van Uden
- Department of Neurology, Radboudumc, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Anil M Tuladhar
- Department of Neurology, Radboudumc, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands; Centre for Cognitive Neuroimaging, Radboudumc, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Karlijn F de Laat
- Department of Neurology, Radboudumc, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands; Department of Neurology, HagaZiekenhuis, The Hague, The Netherlands
| | - Anouk G W van Norden
- Department of Neurology, Radboudumc, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands; Department of Neurology, Amphia Ziekenhuis, Breda, The Netherlands
| | - David G Norris
- Centre for Cognitive Neuroimaging, Radboudumc, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands; MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands; Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, Essen, Germany
| | - Ewoud J van Dijk
- Department of Neurology, Radboudumc, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Indira Tendolkar
- Department of Psychiatry, Radboudumc, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Frank-Erik de Leeuw
- Department of Neurology, Radboudumc, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
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23
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Isaac L, Main KL, Soman S, Gotlib IH, Furst AJ, Kinoshita LM, Fairchild JK, Yesavage JA, Ashford JW, Bayley PJ, Adamson MM. The impact of depression on Veterans with PTSD and traumatic brain injury: a diffusion tensor imaging study. Biol Psychol 2015; 105:20-8. [PMID: 25559772 DOI: 10.1016/j.biopsycho.2014.12.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 12/15/2014] [Accepted: 12/23/2014] [Indexed: 12/20/2022]
Abstract
A significant proportion of military personnel deployed in support of Operation Enduring Freedom and Operation Iraqi Freedom were exposed to war-zone events associated with traumatic brain injury (TBI), depression (DEP) and posttraumatic stress disorder (PTSD). The co-occurrence of TBI, PTSD and DEP in returning Veterans has recently increased research and clinical interest. This study tested the hypothesis that white matter abnormalities are further impacted by depression. Of particular relevance is the uncinate fasciculus (UF), which is a key fronto-temporal tract involved in mood regulation, and the cingulum; a tract that connects to the hippocampus involved in memory integration. Diffusion tensor imaging (DTI) was performed on 25 patients with a combination of PTSD, TBI and DEP and 20 patients with PTSD and TBI (no DEP). Microstructural changes of white matter were found in the cingulum and UF. Fractional anisotropy (FA) was lower in Veterans with DEP compared to those without DEP.
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Affiliation(s)
- Linda Isaac
- War Related Illness and Injury Study Center, The Veterans Affairs Palo Alto HealthCare System, Palo Alto, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
| | - Keith L Main
- War Related Illness and Injury Study Center, The Veterans Affairs Palo Alto HealthCare System, Palo Alto, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Salil Soman
- War Related Illness and Injury Study Center, The Veterans Affairs Palo Alto HealthCare System, Palo Alto, USA; Department of Radiology, Stanford University, Stanford, CA, USA
| | - Ian H Gotlib
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Ansgar J Furst
- War Related Illness and Injury Study Center, The Veterans Affairs Palo Alto HealthCare System, Palo Alto, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA
| | - Lisa M Kinoshita
- The Veterans Affairs Palo Alto HealthCare System, Palo Alto, USA
| | - J Kaci Fairchild
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; The Veterans Affairs Palo Alto HealthCare System, Palo Alto, USA
| | - Jerome A Yesavage
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; The Veterans Affairs Palo Alto HealthCare System, Palo Alto, USA
| | - J Wesson Ashford
- War Related Illness and Injury Study Center, The Veterans Affairs Palo Alto HealthCare System, Palo Alto, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Peter J Bayley
- War Related Illness and Injury Study Center, The Veterans Affairs Palo Alto HealthCare System, Palo Alto, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Maheen M Adamson
- War Related Illness and Injury Study Center, The Veterans Affairs Palo Alto HealthCare System, Palo Alto, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
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24
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Wen MC, Steffens DC, Chen MK, Zainal NH. Diffusion tensor imaging studies in late-life depression: systematic review and meta-analysis. Int J Geriatr Psychiatry 2014; 29:1173-84. [PMID: 24798480 DOI: 10.1002/gps.4129] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 02/11/2014] [Indexed: 01/18/2023]
Abstract
OBJECTIVES Late-life depression (LLD) is the association with more cerebrovascular susceptibilities and white matter damage that can be assessed with diffusion tensor imaging (DTI). To better understand the white matter pathological alterations in LLD, we conducted a systematic review and meta-analysis. METHODS We searched MEDLINE, EMBASE, PsycINFO, PubMed, and Google Scholar databases for DTI studies comparing patients with LLD and healthy controls. For each study, details regarding participants, imaging methods, and results were extracted. Fractional anisotropy, an index of white matter integrity, was the dependent variable for group comparison. Effect sizes indicating the degree of group difference were estimated by random-effects meta-analysis. RESULTS A total of 15 eligible studies were included in the qualitative systematic review, nine of which were suitable for quantitative meta-analyses for the dorsolateral prefrontal cortex (DLPFC), corpus callosum, cingulum, and uncinate fasciculus (UF). Compared with the healthy control group, the LLD group showed lower fractional anisotropy in the DLPFC and UF with a large and a medium effect size, respectively, although heterogeneity and publication bias were found in the DLPFC. CONCLUSION Diffusion tensor imaging studies of LLD consistently showed reduced anisotropy in the DLPFC and UF of patients with LLD. These damaged regions are located with the frontostriatal and limbic networks. Thus, our findings showed that the disruption of frontal and frontal-to-limbic white matter tracts contributes to the pathogenesis of LLD.
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25
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Reppermund S, Zhuang L, Wen W, Slavin MJ, Trollor JN, Brodaty H, Sachdev PS. White matter integrity and late-life depression in community-dwelling individuals: diffusion tensor imaging study using tract-based spatial statistics. Br J Psychiatry 2014; 205:315-20. [PMID: 25147370 DOI: 10.1192/bjp.bp.113.142109] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Late-life depression has been associated with white matter changes in studies using the regions of interest approach. AIMS To 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. METHOD The 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. RESULTS Individuals 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. CONCLUSIONS Reduced 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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Affiliation(s)
- Simone Reppermund
- Simone Reppermund, PhD, Lin Zhuang, PhD, Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney; Wei Wen, PhD, Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, University of New South Wales and Neuropsychiatric Institute, Prince of Wales Hospital, Sydney; Melissa J. Slavin, PhD, Centre for Healthy Brain Ageing and Dementia Collaborative Research Centre, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney; Julian N. Trollor, MD, Centre for Healthy Brain Ageing and Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney; Henry Brodaty, MD, DSc, Centre for Healthy Brain Ageing and Dementia Collaborative Research Centre, School of Psychiatry, UNSW Medicine, University of New South Wales and Aged Care Psychiatry, Prince of Wales Hospital, Sydney; Perminder S. Sachdev, MD, PhD, Centre for Healthy Brain Ageing and Dementia Collaborative Research Centre, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney and Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, Australia
| | - Lin Zhuang
- Simone Reppermund, PhD, Lin Zhuang, PhD, Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney; Wei Wen, PhD, Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, University of New South Wales and Neuropsychiatric Institute, Prince of Wales Hospital, Sydney; Melissa J. Slavin, PhD, Centre for Healthy Brain Ageing and Dementia Collaborative Research Centre, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney; Julian N. Trollor, MD, Centre for Healthy Brain Ageing and Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney; Henry Brodaty, MD, DSc, Centre for Healthy Brain Ageing and Dementia Collaborative Research Centre, School of Psychiatry, UNSW Medicine, University of New South Wales and Aged Care Psychiatry, Prince of Wales Hospital, Sydney; Perminder S. Sachdev, MD, PhD, Centre for Healthy Brain Ageing and Dementia Collaborative Research Centre, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney and Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, Australia
| | - Wei Wen
- Simone Reppermund, PhD, Lin Zhuang, PhD, Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney; Wei Wen, PhD, Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, University of New South Wales and Neuropsychiatric Institute, Prince of Wales Hospital, Sydney; Melissa J. Slavin, PhD, Centre for Healthy Brain Ageing and Dementia Collaborative Research Centre, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney; Julian N. Trollor, MD, Centre for Healthy Brain Ageing and Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney; Henry Brodaty, MD, DSc, Centre for Healthy Brain Ageing and Dementia Collaborative Research Centre, School of Psychiatry, UNSW Medicine, University of New South Wales and Aged Care Psychiatry, Prince of Wales Hospital, Sydney; Perminder S. Sachdev, MD, PhD, Centre for Healthy Brain Ageing and Dementia Collaborative Research Centre, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney and Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, Australia
| | - Melissa J Slavin
- Simone Reppermund, PhD, Lin Zhuang, PhD, Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney; Wei Wen, PhD, Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, University of New South Wales and Neuropsychiatric Institute, Prince of Wales Hospital, Sydney; Melissa J. Slavin, PhD, Centre for Healthy Brain Ageing and Dementia Collaborative Research Centre, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney; Julian N. Trollor, MD, Centre for Healthy Brain Ageing and Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney; Henry Brodaty, MD, DSc, Centre for Healthy Brain Ageing and Dementia Collaborative Research Centre, School of Psychiatry, UNSW Medicine, University of New South Wales and Aged Care Psychiatry, Prince of Wales Hospital, Sydney; Perminder S. Sachdev, MD, PhD, Centre for Healthy Brain Ageing and Dementia Collaborative Research Centre, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney and Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, Australia
| | - Julian N Trollor
- Simone Reppermund, PhD, Lin Zhuang, PhD, Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney; Wei Wen, PhD, Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, University of New South Wales and Neuropsychiatric Institute, Prince of Wales Hospital, Sydney; Melissa J. Slavin, PhD, Centre for Healthy Brain Ageing and Dementia Collaborative Research Centre, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney; Julian N. Trollor, MD, Centre for Healthy Brain Ageing and Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney; Henry Brodaty, MD, DSc, Centre for Healthy Brain Ageing and Dementia Collaborative Research Centre, School of Psychiatry, UNSW Medicine, University of New South Wales and Aged Care Psychiatry, Prince of Wales Hospital, Sydney; Perminder S. Sachdev, MD, PhD, Centre for Healthy Brain Ageing and Dementia Collaborative Research Centre, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney and Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, Australia
| | - Henry Brodaty
- Simone Reppermund, PhD, Lin Zhuang, PhD, Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney; Wei Wen, PhD, Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, University of New South Wales and Neuropsychiatric Institute, Prince of Wales Hospital, Sydney; Melissa J. Slavin, PhD, Centre for Healthy Brain Ageing and Dementia Collaborative Research Centre, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney; Julian N. Trollor, MD, Centre for Healthy Brain Ageing and Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney; Henry Brodaty, MD, DSc, Centre for Healthy Brain Ageing and Dementia Collaborative Research Centre, School of Psychiatry, UNSW Medicine, University of New South Wales and Aged Care Psychiatry, Prince of Wales Hospital, Sydney; Perminder S. Sachdev, MD, PhD, Centre for Healthy Brain Ageing and Dementia Collaborative Research Centre, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney and Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, Australia
| | - Perminder S Sachdev
- Simone Reppermund, PhD, Lin Zhuang, PhD, Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney; Wei Wen, PhD, Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, University of New South Wales and Neuropsychiatric Institute, Prince of Wales Hospital, Sydney; Melissa J. Slavin, PhD, Centre for Healthy Brain Ageing and Dementia Collaborative Research Centre, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney; Julian N. Trollor, MD, Centre for Healthy Brain Ageing and Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney; Henry Brodaty, MD, DSc, Centre for Healthy Brain Ageing and Dementia Collaborative Research Centre, School of Psychiatry, UNSW Medicine, University of New South Wales and Aged Care Psychiatry, Prince of Wales Hospital, Sydney; Perminder S. Sachdev, MD, PhD, Centre for Healthy Brain Ageing and Dementia Collaborative Research Centre, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney and Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, Australia
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26
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Guo W, Liu F, Xun G, Hu M, Guo X, Xiao C, Chen H, Chen J, Zhao J. Disrupted white matter integrity in first-episode, drug-naive, late-onset depression. J Affect Disord 2014; 163:70-5. [PMID: 24836090 DOI: 10.1016/j.jad.2014.03.044] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 03/25/2014] [Accepted: 03/26/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Abnormalities of white matter integrity in frontal and limbic regions have been postulated to play a key role in the pathophysiology of geriatric depression. However, there is no diffusion tensor imaging (DTI) study in patients with first-episode, drug-naive, late-onset depression (LOD). The aim of this study was to investigate whole-brain fractional anisotropy (FA) difference between patients with LOD and healthy controls without a previously determined region of interest. METHODS The sample included 15 patients with first-episode, drug-naive LOD and 15 age-, sex-, and education-matched healthy controls. The tract-based spatial statistics (TBSS) method was employed to analyze the DTI data. RESULTS Lower FA in the white matter of bilateral parahippocampal gyrus was observed in patients with LOD relative to healthy controls by voxel-wise statistics with the TBSS method. Patients did not have higher FA values in any brain regions compared to healthy controls. There was no correlation between the abnormal FA value in bilateral parahippocampal gyrus and depression severity or related factors. LIMITATIONS The present study should be considered preliminary due to relatively small sample size. CONCLUSIONS Our findings suggest that loss of white matter integrity in parahippocampal gyrus may be associated with the pathophysiology of LOD, and thus highlight the limbic contribution to the pathophysiology of LOD.
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Affiliation(s)
- Wenbin Guo
- Mental Health Institute of the Second Xiangya Hospital, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan 410011, China; Mental Health Center, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Feng Liu
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, China
| | - Guanglei Xun
- Shandong Mental Health Center, Jinan, Shandong 250014, China
| | - Maorong Hu
- Mental Hospital of Nanchang University & Mental Health Center of Jiangxi Province, Nanchang, Jiangxi 330029, China
| | - Xiaofeng Guo
- Mental Health Institute of the Second Xiangya Hospital, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan 410011, China
| | - Changqing Xiao
- Mental Health Center, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Huafu Chen
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, China
| | - Jindong Chen
- Mental Health Institute of the Second Xiangya Hospital, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan 410011, China.
| | - Jingping Zhao
- Mental Health Center, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi 530021, China.
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27
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Li W, Muftuler LT, Chen G, Ward BD, Budde MD, Jones JL, Franczak MB, Antuono PG, Li SJ, Goveas JS. Effects of the coexistence of late-life depression and mild cognitive impairment on white matter microstructure. J Neurol Sci 2014; 338:46-56. [PMID: 24387897 PMCID: PMC4428544 DOI: 10.1016/j.jns.2013.12.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 12/04/2013] [Accepted: 12/09/2013] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OBJECTIVE Late-life depression (LLD) and amnestic mild cognitive impairment (aMCI) are associated with white matter (WM) disruptions of the fronto-limbic and interhemispheric tracts implicated in mood regulation and episodic memory functions. This work investigates the extent of these WM abnormalities in patients LLD and aMCI when these diseases occur alone and when they coexist. MATERIALS AND METHODS Eighty-four subjects separated into cognitively normal (n=33), LLD (n=20), aMCI (n=18), and comorbid aMCI and LLD (n=13) completed Diffusion Tensor Imaging (DTI) scans. Tract-based spatial statistics was employed to skeletonize multiple DTI indices of the cingulum, corpus callosum, fornix and uncinate fasciculus. Analysis of covariance and post-hoc tests compared group differences. Multiple linear regressions were performed between DTI and behavioral measures for the whole sample and within individual patient groups. RESULTS Divergent microstructural disruptions were identified in LLD- and aMCI-only groups, whereas the comorbid group showed widespread abnormalities especially in the hippocampal cingulum and fornix tracts. The LLD groups also showed significant disruptions in the uncinate fasciculus and corpus callosal tracts. Higher depressive symptom and lower episodic memory scores were associated with increased diffusivity measures in the fornix and hippocampal cingulum across all subjects. CONCLUSIONS Widespread WM microstructural disruptions are present when LLD and aMCI are comorbid -especially in the medial temporal lobe tracts. These WM disruptions may be a marker of disease severity. Also, multiple DTI parameters should be used when evaluating the WM fiber integrity in LLD and aMCI.
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Affiliation(s)
- Wenjun Li
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - L Tugan Muftuler
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Gang Chen
- Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - B Douglas Ward
- Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Matthew D Budde
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Jennifer L Jones
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA.
| | | | - Piero G Antuono
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Shi-Jiang Li
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA; Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Joseph S Goveas
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
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28
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Tadayonnejad R, Ajilore O. Brain network dysfunction in late-life depression: a literature review. J Geriatr Psychiatry Neurol 2014; 27:5-12. [PMID: 24381233 DOI: 10.1177/0891988713516539] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
As a common psychiatric disorder in the growing geriatric population, late-life depression (LLD) has a negative impact on the cognitive, affective, and somatic domains of the lives of the elderly individuals. Accumulating evidence from the structural and functional imaging studies on LLD supports a "network dysfunction model" rather than a "lesion pathology model" for understanding the underlying biological mechanism in this mental disorder. In this work, we used network dysfunction model as a conceptual framework for reviewing recent neuroimaging findings in LLD. Our focus was on 4 major neurocircuits that have been shown to be involved in LLD: default mood network, cognitive control network, affective/frontolimbic network, and corticostriatal circuits. Findings of LLD-related gray and white matter structural abnormalities and resting-state and task-based functional changes were discussed for each network separately. We extended our review by summarizing the latest works that apply graph theory-based network analysis techniques for testing alterations in whole-brain network properties associated with LLD.
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Affiliation(s)
- Reza Tadayonnejad
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
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29
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Duffy SL, Paradise M, Hickie IB, Lewis SJ, Naismith SL, Lagopoulos J. Cognitive impairment with and without depression history: an analysis of white matter microstructure. J Psychiatry Neurosci 2014; 39:135-43. [PMID: 24359878 PMCID: PMC3937282 DOI: 10.1503/jpn.130079] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Mild cognitive impairment (MCI) and late-life depression are clinical syndromes that often co-occur and may represent an early manifestation of neurodegenerative disease. The present study examined white matter microstructure in patients with MCI with and without a history of major depression compared with healthy controls. METHODS Older adults with MCI and no history of major depression (MCI), adults with MCI and euthymic major depression (MCI-MD) and healthy controls underwent comprehensive medical, psychiatric and neuropsychological assessments. Participants also underwent diffusion tensor imaging, which was analyzed using tract-based spatial statistics. White matter hyperintensity (WMH) burden and medical burden were also quantified. RESULTS We enrolled 30 participants in the MCI group, 36 in the MCI-MD group and 22 in the control group. Compared with controls, participants in the MCI group had significantly reduced fractional anisotropy (FA) in the corpus callosum, superior longitudinal fasciculus (SLF), corona radiata and posterior thalamic radiation. Participants in the MCI-MD group had significantly reduced FA in the corpus callosum, internal capsule, external capsule, corona radiata, posterior thalamic radiation, sagittal striatum, fornix, SLF, uncinate fasciculus and right cingulum compared with controls. No significant differences in FA were observed between the MCI and MCI-MD groups. Participants in the MCI-MD group had greater medical burden (p = 0.020) and WMH burden than controls (p = 0.013). LIMITATIONS Study limitations include the cross-sectional design and antidepressant medication use. CONCLUSION To our knowledge, this study is the first to compare white matter microstructure in patients with MCI with and without a history of major depression and suggests that a common underlying structural white matter change may underpin cognitive impairment in both MCI groups. Further research is needed to delineate the pathophysiological mechanisms underlying these microstructural changes.
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Affiliation(s)
| | | | | | | | - Sharon L. Naismith
- Correspondence to: S.L. Naismith, Ageing Brain Centre, 94 Mallett St., Camperdown NSW 2050 Australia;
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O'Brien JT. Clinical significance of white matter changes. Am J Geriatr Psychiatry 2014; 22:133-7. [PMID: 24041523 DOI: 10.1016/j.jagp.2013.07.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 07/25/2013] [Accepted: 07/25/2013] [Indexed: 10/26/2022]
Abstract
Although their clinical significance has long been debated, it has now been well established, both from cross-sectional and longitudinal studies, that white matter lesions on magnetic resonance imaging are associated with a number of adverse outcomes, including cognitive impairment, functional disability, death, neurologic problems, and depression. Novel imaging methods now allow testing of models of the pathogenesis of such lesions, which will open new avenues for therapeutic intervention to try to prevent or delay the developments of such changes.
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Affiliation(s)
- John T O'Brien
- Department of Psychiatry, University of Cambridge, and Cambridgeshire and Peterborough NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom.
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Lamar M, Zhou XJ, Charlton RA, Dean D, Little D, Deoni SC. In vivo quantification of white matter microstructure for use in aging: a focus on two emerging techniques. Am J Geriatr Psychiatry 2014; 22:111-21. [PMID: 24080382 PMCID: PMC3947219 DOI: 10.1016/j.jagp.2013.08.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 05/31/2013] [Accepted: 08/12/2013] [Indexed: 12/30/2022]
Abstract
Human brain imaging has seen many advances in the quantification of white matter in vivo. For example, these advances have revealed the association between white matter damage and vascular disease as well as their impact on risk for and development of dementia and depression in an aging population. Current neuroimaging methods to quantify white matter damage provide a foundation for understanding such age-related neuropathology; however, these methods are not as adept at determining the underlying microstructural abnormalities signaling at risk tissue or driving white matter damage in the aging brain. This review will begin with a brief overview of the use of diffusion tensor imaging (DTI) in understanding white matter alterations in aging before focusing in more detail on select advances in both diffusion-based methods and multi-component relaxometry techniques for imaging white matter microstructural integrity within myelin sheaths and the axons they encase. Although DTI greatly extended the field of white matter interrogation, these more recent technological advances will add clarity to the underlying microstructural mechanisms that contribute to white matter damage. More specifically, the methods highlighted in this review may prove more sensitive (and specific) for determining the contribution of myelin versus axonal integrity to the aging of white matter in brain.
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Affiliation(s)
- Melissa Lamar
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL; Graduate Program in Neuroscience, University of Illinois at Chicago, Chicago, IL.
| | - Xiaohong Joe Zhou
- Center for Magnetic Resonance Research and Departments of Radiology and Neurosurgery, University of Illinois at Chicago, Chicago, IL
| | - Rebecca A Charlton
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL
| | - Douglas Dean
- School of Engineering, Brown University, Providence, RI
| | - Deborah Little
- Scott & White Healthcare and Texas A&M Health Sciences, Temple, TX
| | - Sean C Deoni
- School of Engineering, Brown University, Providence, RI
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Lamar M, Charlton RA, Ajilore O, Zhang A, Yang S, Barrick TR, Rhodes E, Kumar A. Prefrontal vulnerabilities and whole brain connectivity in aging and depression. Neuropsychologia 2013; 51:1463-70. [PMID: 23680399 DOI: 10.1016/j.neuropsychologia.2013.05.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 04/22/2013] [Accepted: 05/06/2013] [Indexed: 10/26/2022]
Abstract
Studies exploring the underpinnings of age-related neurodegeneration suggest fronto-limbic alterations that are increasingly vulnerable in the presence of disease including late life depression. Less work has assessed the impact of this specific vulnerability on widespread brain circuitry. Seventy-nine older adults (healthy controls=45; late life depression=34) completed translational tasks shown in non-human primates to rely on fronto-limbic networks involving dorsolateral (Self-Ordered Pointing Task) or orbitofrontal (Object Alternation Task) cortices. A sub-sample of participants also completed diffusion tensor imaging for white matter tract quantification (uncinate and cingulum bundle; n=58) and whole brain tract-based spatial statistics (n=62). Despite task associations to specific white matter tracts across both groups, only healthy controls demonstrated significant correlations between widespread tract integrity and cognition. Thus, increasing Object Alternation Task errors were associated with decreasing fractional anisotropy in the uncinate in late life depression; however, only in healthy controls was the uncinate incorporated into a larger network of white matter vulnerability associating fractional anisotropy with Object Alternation Task errors using whole brain tract-based spatial statistics. It appears that the whole brain impact of specific fronto-limbic vulnerabilities in aging may be eclipsed in the presence of disease-specific neuropathology like that seen in late life depression.
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Affiliation(s)
- Melissa Lamar
- Department of Psychiatry, University of Illinois at Chicago, 1601W Taylor St, MC912, Chicago, IL 60601, USA.
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Jellinger KA. Organic bases of late-life depression: a critical update. J Neural Transm (Vienna) 2013; 120:1109-25. [PMID: 23355089 DOI: 10.1007/s00702-012-0945-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Accepted: 11/30/2012] [Indexed: 02/07/2023]
Abstract
Late-life depression (LLD) is frequently associated with cognitive impairment and increases the risk of subsequent dementia. Cerebrovascular disease, deep white matter lesions, Alzheimer disease (AD) and dementia with Lewy bodies (DLB) have all been hypothesized to contribute to this increased risk, and a host of studies have looked at the interplay between cerebrovascular disease and LLD. This has resulted in new concepts of LLD, such as "vascular depression", but despite multiple magnetic resonance imaging (MRI) studies in this field, the relationship between structural changes in human brain and LLD is still controversial. While pathological findings of suicide in some elderly persons revealed multiple lacunes, small vessel cerebrovascular disease, AD-related lesions or multiple neurodegenerative pathologies, recent autopsy data challenged the role of subcortical lacunes and white matter lesions as major morphological substrates of depressive symptoms as well as poorer executive function and memory. Several neuropathological studies, including a personal clinico-pathological study in a small cohort of elderly persons with LLD and age-matched controls confirmed that lacunes, periventricular and deep white matter demyelination as well as AD-related lesions are usually unrelated to the occurrence of LLD. In the same line, neuropathological data show that early-onset depression is not associated with an acceleration of age-related neurodegenerative changes. Very recent data on the critical role of glia-modulating neuronal dysfunction and degeneration in depression are discussed.
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Affiliation(s)
- Kurt A Jellinger
- Institute of Clinical Neurobiology, Kenyongasse 18, 1070 Vienna, Austria.
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Abstract
PURPOSE OF REVIEW This article reviews literature published over the period January 2011-June 2012 on biomarkers in major depression. RECENT FINDINGS Although a large body of research accumulated over the past decades points to distinct biological mechanisms being involved in the pathophysiology of major depressive disorder (MDD), its precise pathobiology is not yet fully understood. In the last 2 years, substantial new research has been generated in an attempt to identify and characterize novel candidate biomarkers for MDD. This review provides an update on biomarker research in MDD and summarizes the most recent results from neuroimaging, genetic, epigenetic, and neurochemical studies in MDD. SUMMARY Promising new findings report high diagnostic accuracy for metabonomic and epigenetic approaches as well as combinatorial functional neuroimaging approaches, which are currently representing the forefront of MDD biomarker development.
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Bezerra DM, Pereira FRS, Cendes F, Jackowski MP, Nakano EY, Moscoso MAA, Ribeiz SRI, Avila R, Castro CCD, Bottino CMC. DTI voxelwise analysis did not differentiate older depressed patients from older subjects without depression. J Psychiatr Res 2012; 46:1643-9. [PMID: 23040088 DOI: 10.1016/j.jpsychires.2012.09.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2012] [Revised: 08/19/2012] [Accepted: 09/01/2012] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Neuroimaging has been widely used in studies to investigate depression in the elderly because it is a noninvasive technique, and it allows the detection of structural and functional brain alterations. Fractional anisotropy (FA) and mean diffusivity (MD) are neuroimaging indexes of the microstructural integrity of white matter, which are measured using diffusion tensor imaging (DTI). The aim of this study was to investigate differences in FA or MD in the entire brain without a previously determined region of interest (ROI) between depressed and non-depressed elderly patients. METHOD Brain magnetic resonance imaging scans were obtained from 47 depressed elderly patients, diagnosed according to DSM-IV criteria, and 36 healthy elderly patients as controls. Voxelwise statistical analysis of FA data was performed using tract-based spatial statistics (TBSS). RESULTS After controlling for age, no significant differences among FA and MD parameters were observed in the depressed elderly patients. No significant correlations were found between cognitive performance and FA or MD parameters. CONCLUSION There were no significant differences among FA or MD values between mildly or moderately depressed and non-depressed elderly patients when the brain was analyzed without a previously determined ROI.
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Affiliation(s)
- Diana Moitinho Bezerra
- Old Age Research Group - PROTER, Institute and Department of Psychiatry, University of São Paulo, São Paulo, Brazil.
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Neuropathological substrates and structural changes in late-life depression: the impact of vascular burden. Acta Neuropathol 2012; 124:453-64. [PMID: 22836715 DOI: 10.1007/s00401-012-1021-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Revised: 07/13/2012] [Accepted: 07/17/2012] [Indexed: 01/01/2023]
Abstract
A first episode of depression after 65 years of age has long been associated with both severe macrovascular and small microvascular pathology. Among the three more frequent forms of depression in old age, post-stroke depression has been associated with an abrupt damage of cortical circuits involved in monoamine production and mood regulation. Late-onset depression (LOD) in the absence of stroke has been related to lacunes and white matter lesions that invade both the neocortex and subcortical nuclei. Recurrent late-life depression is thought to induce neuronal loss in the hippocampal formation and white matter lesions that affect limbic pathways. Despite an impressive number of magnetic resonance imaging (MRI) studies in this field, the presence of a causal relationship between structural changes in the human brain and LOD is still controversial. The present article provides a critical overview of the contribution of neuropathology in post-stroke, late-onset, and late-life recurrent depression. Recent autopsy findings challenge the role of stroke location in the occurrence of post-stroke depression by pointing to the deleterious effect of subcortical lacunes. Despite the lines of evidences supporting the association between MRI-assessed white matter changes and mood dysregulation, lacunes, periventricular and deep white matter demyelination are all unrelated to the occurrence of LOD. In the same line, neuropathological data show that early-onset depression is not associated with an acceleration of aging-related neurodegenerative changes in the human brain. However, they also provide data in favor of the neurotoxic theory of depression by showing that neuronal loss occurs in the hippocampus of chronically depressed patients. These three paradigms are discussed in the light of the complex relationships between psychosocial determinants and biological vulnerability in affective disorders.
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Naismith SL, Norrie LM, Mowszowski L, Hickie IB. The neurobiology of depression in later-life: Clinical, neuropsychological, neuroimaging and pathophysiological features. Prog Neurobiol 2012; 98:99-143. [DOI: 10.1016/j.pneurobio.2012.05.009] [Citation(s) in RCA: 169] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Revised: 05/03/2012] [Accepted: 05/09/2012] [Indexed: 02/07/2023]
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Zuo N, Fang J, Lv X, Zhou Y, Hong Y, Li T, Tong H, Wang X, Wang W, Jiang T. White matter abnormalities in major depression: a tract-based spatial statistics and rumination study. PLoS One 2012; 7:e37561. [PMID: 22666366 PMCID: PMC3364284 DOI: 10.1371/journal.pone.0037561] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Accepted: 04/25/2012] [Indexed: 11/18/2022] Open
Abstract
Increasing evidence indicates that major depressive disorder (MDD) is usually accompanied by altered white matter in the prefrontal cortex, the parietal lobe and the limbic system. As a behavioral abnormity of MDD, rumination has been believed to be a substantial indicator of the mental state of the depressive state. So far, however, no report that we are aware of has evaluated the relationship between white matter alterations and the ruminative state. In this study, we first explored the altered white matter using a tract-based spatial statistics (TBSS) method based on diffusion tensor imaging of 19 healthy and 16 depressive subjects. We then investigated correlations between the altered white matter microstructure in the identified altered regions and the severity of ruminations measured by the ruminative response scale. Our results demonstrated altered white matter microstructure in circuits connecting the prefrontal lobe, the parietal lobe and the limbic system (p<0.005, uncorrected), findings which support previous research. More importantly, the result also indicated that a greater alteration in the white matter is associated with a more ruminative state (p<0.05, Bonferroni corrected). The detected abnormalities in the white matter should be interpreted cautiously because of the small sample size in this study. This finding supports the psychometric significance of white matter deficits in MDD.
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Affiliation(s)
- Nianming Zuo
- LIAMA Center for Computational Medicine, National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Jiliang Fang
- Laboratory for Functional Brain Imaging, Department of Radiology, Guang-an-men Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xueyu Lv
- Department of Psychology, Guang-an-men Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yuan Zhou
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Yang Hong
- Laboratory for Functional Brain Imaging, Department of Radiology, Guang-an-men Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Tao Li
- Department of Psychology, Guang-an-men Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Haibing Tong
- Laboratory for Functional Brain Imaging, Department of Radiology, Guang-an-men Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaoling Wang
- Laboratory for Functional Brain Imaging, Department of Radiology, Guang-an-men Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Weidong Wang
- Department of Psychology, Guang-an-men Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- * E-mail: (TZJ); (WDW)
| | - Tianzi Jiang
- LIAMA Center for Computational Medicine, National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
- The Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
- * E-mail: (TZJ); (WDW)
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Walther S, Hügli S, Höfle O, Federspiel A, Horn H, Bracht T, Wiest R, Strik W, Müller TJ. Frontal white matter integrity is related to psychomotor retardation in major depression. Neurobiol Dis 2012; 47:13-9. [PMID: 22426387 DOI: 10.1016/j.nbd.2012.03.019] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Accepted: 03/01/2012] [Indexed: 12/20/2022] Open
Abstract
Altered frontal white matter integrity has been reported in major depression. Still, the behavioral correlates of these alterations are not established. In healthy subjects, motor activity correlated with white matter integrity in the motor system. To explore the relation of white matter integrity and motor activity in major depressive disorder, we investigated 21 medicated patients with major depressive disorder and 21 matched controls using diffusion tensor imaging and wrist actigraphy at the same day. Patients had lower activity levels (AL) compared with controls. Fractional anisotropy (FA) differed between groups in frontal white matter regions and the posterior cingulum. AL was linearly associated with white matter integrity in two clusters within the motor system. Controls had an exclusive positive association of FA and AL in white matter underneath the right dorsal premotor cortex. Only patients had a positive association within the posterior cingulum. Furthermore, patients had negative associations of FA and AL underneath the left primary motor cortex and within the left parahippocampal gyrus white matter. These differences in the associations between structure and behavior may contribute to well-known impaired motor planning or gait disturbances in major depressive disorder. Therefore, signs of psychomotor slowing in major depressive disorder may be linked to changes of the white matter integrity of the motor system.
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Affiliation(s)
- Sebastian Walther
- University Hospital of Psychiatry, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland.
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