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Monereo-Sánchez J, Jansen JFA, van Boxtel MPJ, Backes WH, Köhler S, Stehouwer CDA, Linden DEJ, Schram MT. Association of hippocampal subfield volumes with prevalence, course and incidence of depressive symptoms: The Maastricht Study. Br J Psychiatry 2024; 224:66-73. [PMID: 37993980 PMCID: PMC10807974 DOI: 10.1192/bjp.2023.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 08/09/2023] [Accepted: 09/26/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Late-life depression has been associated with volume changes of the hippocampus. However, little is known about its association with specific hippocampal subfields over time. AIMS We investigated whether hippocampal subfield volumes were associated with prevalence, course and incidence of depressive symptoms. METHOD We extracted 12 hippocampal subfield volumes per hemisphere with FreeSurfer v6.0 using T1-weighted and fluid-attenuated inversion recovery 3T magnetic resonance images. Depressive symptoms were assessed at baseline and annually over 7 years of follow-up (9-item Patient Health Questionnaire). We used negative binominal, logistic, and Cox regression analyses, corrected for multiple comparisons, and adjusted for demographic, cardiovascular and lifestyle factors. RESULTS A total of n = 4174 participants were included (mean age 60.0 years, s.d. = 8.6, 51.8% female). Larger right hippocampal fissure volume was associated with prevalent depressive symptoms (odds ratio (OR) = 1.26, 95% CI 1.08-1.48). Larger bilateral hippocampal fissure (OR = 1.37-1.40, 95% CI 1.14-1.71), larger right molecular layer (OR = 1.51, 95% CI 1.14-2.00) and smaller right cornu ammonis (CA)3 volumes (OR = 0.61, 95% CI 0.48-0.79) were associated with prevalent depressive symptoms with a chronic course. No associations of hippocampal subfield volumes with incident depressive symptoms were found. Yet, lower left hippocampal amygdala transition area (HATA) volume was associated with incident depressive symptoms with chronic course (hazard ratio = 0.70, 95% CI 0.55-0.89). CONCLUSIONS Differences in hippocampal fissure, molecular layer and CA volumes might co-occur or follow the onset of depressive symptoms, in particular with a chronic course. Smaller HATA was associated with an increased risk of incident (chronic) depression. Our results could capture a biological foundation for the development of chronic depressive symptoms, and stresses the need to discriminate subtypes of depression to unravel its biological underpinnings.
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Affiliation(s)
- Jennifer Monereo-Sánchez
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands; and Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, the Netherlands
| | - Jacobus F. A. Jansen
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands; and Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, the Netherlands
| | - Martin P. J. van Boxtel
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands
| | - Walter H. Backes
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands; Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, the Netherlands; and School for Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands
| | - Sebastian Köhler
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands; and Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, the Netherlands
| | - Coen D. A. Stehouwer
- School for Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, the Netherlands; and Department of Internal Medicine, Maastricht University Medical Center, the Netherlands
| | - David E. J. Linden
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands
| | - Miranda T. Schram
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands; School for Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands; Department of Internal Medicine, Maastricht University Medical Center, the Netherlands; and Maastricht Heart + Vascular Center, Maastricht University Medical Center, the Netherlands
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2
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Warren SL, Hamza EA, Tindle R, Reid E, Whitfield P, Doumit A, Moustafa AA. Common Neuropsychiatric S ymptoms in Alzheimer's Disease, Mild Cognitive Impairment, and Subjective Memory Complaints: A Unified Framework. Curr Alzheimer Res 2023; 20:459-470. [PMID: 37873914 DOI: 10.2174/0115672050255489231012072014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/15/2023] [Accepted: 08/15/2023] [Indexed: 10/25/2023]
Abstract
The Alzheimer's disease (AD) continuum is a unique spectrum of cognitive impairment that typically involves the stages of subjective memory complaints (SMC), mild cognitive impairment (MCI), and AD dementia. Neuropsychiatric symptoms (NPS), such as apathy, anxiety, stress, and depression, are highly common throughout the AD continuum. However, there is a dearth of research on how these NPS vary across the AD continuum, especially SMC. There is also disagreement on the effects of specific NPS on each stage of the AD continuum due to their collinearity with other NPS, cognitive decline, and environmental factors (e.g., stress). In this article, we conduct a novel perspective review of the scientific literature to understand the presence of NPS across the AD continuum. Specifically, we review the effects of apathy, depression, anxiety, and stress in AD, MCI, and SMC. We then build on this knowledge by proposing two theories of NPS' occurrence across the AD continuum. Consequently, we highlight the current landscape, limitations (e.g., differing operationalization), and contentions surrounding the NPS literature. We also outline theories that could clear up contention and inspire future NPS research.
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Affiliation(s)
- Samuel L Warren
- School of Psychology, Faculty of Society and Design, Bond University, Gold Coast, Queensland, Australia
| | - Eid Abo Hamza
- Faculty of Education, Tanta University, Tanta, Egypt
- College of Education, Humanities & Social Sciences, Al Ain University, Al Ain, UAE
| | - Richard Tindle
- School of Psychology, University of Sunshine Coast, Sunshine Coast, Queensland, Australia
| | - Edwina Reid
- School of Psychology, Western Sydney University, Sydney, New South Wales, Australia
| | - Paige Whitfield
- School of Psychology, Western Sydney University, Sydney, New South Wales, Australia
| | - Adam Doumit
- School of Psychology, Western Sydney University, Sydney, New South Wales, Australia
| | - Ahmed A Moustafa
- School of Psychology, Faculty of Society and Design, Bond University, Gold Coast, Queensland, Australia
- Department of Human Anatomy and Physiology, The Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
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3
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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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Singh I, Edwards I, Rose'meyer R. The Role of Cortisol in the Development of Post-Stroke Dementia: A Narrative Review. HEART AND MIND 2022. [DOI: 10.4103/hm.hm_32_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Alexopoulos GS. Mechanisms and Treatment of Late-Life Depression. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2021; 19:340-354. [PMID: 34690604 DOI: 10.1176/appi.focus.19304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
(Appeared originally in Translational Psychiatry 2019; 9:188).
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Affiliation(s)
- George S Alexopoulos
- Weill Cornell Institute of Geriatric Psychiatry, 21 Bloomingdale Road, White Plains, NY 10605, USA
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Chu SF, Zhang Z, Zhou X, He WB, Yang B, Cui LY, He HY, Wang ZZ, Chen NH. Low corticosterone levels attenuate late life depression and enhance glutamatergic neurotransmission in female rats. Acta Pharmacol Sin 2021; 42:848-860. [PMID: 33028984 PMCID: PMC8149629 DOI: 10.1038/s41401-020-00536-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 09/11/2020] [Indexed: 12/24/2022] Open
Abstract
Sustained elevation of corticosterone (CORT) is one of the common causes of aging and major depression disorder. However, the role of elevated CORT in late life depression (LLD) has not been elucidated. In this study, 18-month-old female rats were subjected to bilateral adrenalectomy or sham surgery. Their CORT levels in plasma were adjusted by CORT replacement and the rats were divided into high-level CORT (H-CORT), low-level CORT (L-CORT), and Sham group. We showed that L-CORT rats displayed attenuated depressive symptoms and memory defects in behavioral tests as compared with Sham or H-CORT rats. Furthermore, we showed that glutamatergic transmission was enhanced in L-CORT rats, evidenced by enhanced population spike amplitude (PSA) recorded from the dentate gyrus of hippocampus in vivo and increased glutamate release from hippocampal synaptosomes caused by high frequency stimulation or CORT exposure. Intracerebroventricular injection of an enzymatic glutamate scavenger system, glutamic-pyruvic transmine (GPT, 1 μM), significantly increased the PSA in Sham rats, suggesting that extracelluar accumulation of glutamate might be the culprit of impaired glutamatergic transmission, which was dependent on the uptake by Glt-1 in astrocytes. We revealed that hippocampal Glt-1 expression level in the L-CORT rats was much higher than in Sham and H-CORT rats. In a gradient neuron-astrocyte coculture, we found that the expression of Glt-1 was decreased with the increase of neural percentage, suggesting that impairment of Glt-1 might result from the high level of CORT contributed neural damage. In sham rats, administration of DHK that inhibited Glt-1 activity induced significant LLD symptoms, whereas administration of RIL that promoted glutamate uptake significantly attenuated LLD. All of these results suggest that glutamatergic transmission impairment is one of important pathogenesis in LLD induced by high level of CORT, which provide promising clues for the treatment of LLD.
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Affiliation(s)
- Shi-Feng Chu
- State Key Laboratory of Bioactive Substances and Functions of Natural Medicines, Institute of Materia Medica and Neuroscience Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100050, China
| | - Zhao Zhang
- State Key Laboratory of Bioactive Substances and Functions of Natural Medicines, Institute of Materia Medica and Neuroscience Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100050, China
| | - Xin Zhou
- State Key Laboratory of Bioactive Substances and Functions of Natural Medicines, Institute of Materia Medica and Neuroscience Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100050, China
| | - Wen-Bin He
- Shanxi Key Laboratory of Chinese Medicine Encephalopathy, Shanxi University of Chinese Medicine, Jinzhong, 030619, China
| | - Bo Yang
- Department of Pharmacy, Characteristic Medical Center of the Chinese People's Armed Police Force, Tianjin, 300300, China
| | - Li-Yuan Cui
- State Key Laboratory of Bioactive Substances and Functions of Natural Medicines, Institute of Materia Medica and Neuroscience Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100050, China
| | - Hong-Yuan He
- Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Zhen-Zhen Wang
- State Key Laboratory of Bioactive Substances and Functions of Natural Medicines, Institute of Materia Medica and Neuroscience Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100050, China
| | - Nai-Hong Chen
- State Key Laboratory of Bioactive Substances and Functions of Natural Medicines, Institute of Materia Medica and Neuroscience Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100050, China.
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Bessette KL, Karstens AJ, Crane NA, Peters AT, Stange JP, Elverman KH, Morimoto SS, Weisenbach SL, Langenecker SA. A Lifespan Model of Interference Resolution and Inhibitory Control: Risk for Depression and Changes with Illness Progression. Neuropsychol Rev 2020; 30:477-498. [PMID: 31942706 PMCID: PMC7363517 DOI: 10.1007/s11065-019-09424-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 12/06/2019] [Indexed: 12/20/2022]
Abstract
The cognitive processes involved in inhibitory control accuracy (IC) and interference resolution speed (IR) or broadly - inhibition - are discussed in this review, and both are described within the context of a lifespan model of mood disorders. Inhibitory control (IC) is a binary outcome (success or no for response selection and inhibition of unwanted responses) for any given event that is influenced to an extent by IR. IR refers to the process of inhibition, which can be manipulated by task design in earlier and later stages through use of distractors and timing, and manipulation of individual differences in response proclivity. We describe the development of these two processes across the lifespan, noting factors that influence this development (e.g., environment, adversity and stress) as well as inherent difficulties in assessing IC/IR prior to adulthood (e.g., cross-informant reports). We use mood disorders as an illustrative example of how this multidimensional construct can be informative to state, trait, vulnerability and neuroprogression of disease. We present aggregated data across numerous studies and methodologies to examine the lifelong development and degradation of this subconstruct of executive function, particularly in mood disorders. We highlight the challenges in identifying and measuring IC/IR in late life, including specificity to complex, comorbid disease processes. Finally, we discuss some potential avenues for treatment and accommodation of these difficulties across the lifespan, including newer treatments using cognitive remediation training and neuromodulation.
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Affiliation(s)
- Katie L Bessette
- Departments of Psychiatry and Psychology, University of Illinois at Chicago, Chicago, IL, USA
- Department of Psychiatry, University of Utah, 501 Chipeta Way, Salt Lake City, UT, 84108, USA
| | - Aimee J Karstens
- Departments of Psychiatry and Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Natania A Crane
- Departments of Psychiatry and Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Amy T Peters
- Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
| | - Jonathan P Stange
- Departments of Psychiatry and Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Kathleen H Elverman
- Neuropsychology Center, Aurora St. Luke's Medical Center, Milwaukee, WI, USA
| | - Sarah Shizuko Morimoto
- Department of Psychiatry, University of Utah, 501 Chipeta Way, Salt Lake City, UT, 84108, USA
| | - Sara L Weisenbach
- Department of Psychiatry, University of Utah, 501 Chipeta Way, Salt Lake City, UT, 84108, USA
- Mental Health Services, VA Salt Lake City, Salt Lake City, UT, USA
| | - Scott A Langenecker
- Departments of Psychiatry and Psychology, University of Illinois at Chicago, Chicago, IL, USA.
- Department of Psychiatry, University of Utah, 501 Chipeta Way, Salt Lake City, UT, 84108, USA.
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8
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Safarova TP, Gavrilova SI. [The use of neuroprotectors in the treatment of late depression]. Zh Nevrol Psikhiatr Im S S Korsakova 2020; 120:46-53. [PMID: 33205930 DOI: 10.17116/jnevro202012010246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Comparative evaluation of the effectiveness and safety of antidepressant monotherapy and combined antidepressant therapy with the inclusion of neuroprotectors in the treatment of depression in old and very old patients in a psychiatric hospital. MATERIALS AND METHODS The study included 2 groups of patients from the cohort of patients hospitalized in the gerontopsychiatric unit with mild and moderate depression (according to the ICD-10 classification) aged 60 years and older. The groups are comparable in their main demographic and clinical characteristics. Both groups received antidepressant monotherapy with venlafaxine (21 people) or combined therapy with the same antidepressant, but in combination with cerebrolysin or carnicetine (40 people) for 8 weeks. The efficacy of antidepressant therapy was evaluated with HAMD-17 and HARS; the effect of treatment on the level of cognitive activity of patients with MMSE and the 10-word memory test. RESULTS In the group of patients receiving combined antidepressant therapy, a significantly faster and more pronounced therapeutic response was observed compared to the group of patients treated with antidepressant monotherapy. In the group of combined therapy, an earlier (by 4 weeks) and significant (p<0.001) reduction of depressive and anxiety symptoms was established by the end of treatment, this group had a significantly higher number of respondents, as well as a better quality of therapeutic remission and a significant improvement in the cognitive functioning of patients compared to the monotherapy group. When comparing the effectiveness of different neuroprotectors (cerebrolysin or carnicetine), significant differences in the reduction of depressive and anxiety disorders in favor of carnicetine were established only at the end of the therapeutic course. CONCLUSION Combined antidepressant therapy with a combination of treatment with an antidepressant and a drug with neuroprotective properties can increase the effectiveness of antidepressant therapy in old and very old patients. Both cerebrolysin and carnicetine can be recommended for use in a psychiatric hospital to improve the quality of the therapeutic response and reduce the time of hospitalization.
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9
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Zeng M, Yu M, Qi G, Zhang S, Ma J, Hu Q, Zhang J, Li H, Wu H, Xu J. Concurrent alterations of white matter microstructure and functional activities in medication-free major depressive disorder. Brain Imaging Behav 2020; 15:2159-2167. [PMID: 33155171 DOI: 10.1007/s11682-020-00411-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 08/18/2020] [Accepted: 10/14/2020] [Indexed: 01/08/2023]
Abstract
Although numerous studies have revealed the structural and functional alterations in major depressive disorder (MDD) using unimodal diffusion magnetic resonance imaging (MRI) or functional MRI, however, the potential associations between changed microstructure and corresponding functional activities in the MDD has been largely uninvestigated. Herein, 27 medication-free MDD patients and 54 gender-, age-, and educational level-matched healthy controls (HC) were used to investigate the concurrent alterations of white matter microstructure and functional activities using tract-based spatial statistics (TBSS) analyses, fractional amplitude of low-frequency fluctuation (fALFF), and degree centrality (DC). The TBSS analyses revealed significantly decreased fractional anisotropy (FA) in the superior longitudinal fasciculus (SLF I) in the MDD patients compared to HC. Correlation analyses showed that decreased FA in the SLF I was significantly correlated with fALFF in left pre/postcentral gyrus and binary, weighted DC in right posterior cerebellum. Moreover, the fALFF in left pre/postcentral gyrus significantly reduced in MDD patients while binary and weighted DC in right posterior cerebellum significantly increased in MDD patients. Our results revealed concurrent structural and functional changes in MDD patients suggesting that the underlying structural disruptions are an important indicator of functional abnormalities.
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Affiliation(s)
- Min Zeng
- Department of Radiology, Pidu District People's Hospital, Chengdu, 625014, Chengdu, China
| | - Min Yu
- Department of Neonatology, Changzhou Children's Hospital, Changzhou, 213003, China
| | - Guiqiang Qi
- Department of Radiology, Pidu District People's Hospital, Chengdu, 625014, Chengdu, China
| | - Shaojin Zhang
- Department of Radiology, Pidu District People's Hospital, Chengdu, 625014, Chengdu, China
| | - Jijian Ma
- Department of Radiology, Pidu District People's Hospital, Chengdu, 625014, Chengdu, China
| | - Qingmao Hu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, 518055, Shenzhen, China.,CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, 518055, Shenzhen, China
| | - Jinhuan Zhang
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, 518055, Shenzhen, China.,The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, 518000, Shenzhen, China
| | - Hongxing Li
- Department of Neonatology, Changzhou Children's Hospital, Changzhou, 213003, China.
| | - Huawang Wu
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), 510370, Guangzhou, China.
| | - Jinping Xu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, 518055, Shenzhen, China.
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10
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Alexopoulos GS. Mechanisms and treatment of late-life depression. Transl Psychiatry 2019; 9:188. [PMID: 31383842 PMCID: PMC6683149 DOI: 10.1038/s41398-019-0514-6] [Citation(s) in RCA: 267] [Impact Index Per Article: 53.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 11/26/2018] [Accepted: 01/01/2019] [Indexed: 01/25/2023] Open
Abstract
Depression predisposes to medical illnesses and advances biological aging indicated by shorter telomere length, accelerated brain aging and advanced epigenetic aging. Medical illnesses also increase the risk of late-life depression. The reciprocal relationships of depression with aging-related and disease-related processes have generated pathogenetic hypotheses and provided treatment targets. Targeting risk factors of vascular disease in mid-life is a logical approach in prevention of vascular depression. The depression-executive dysfunction and the vascular depression syndromes have clinical presentations and neuroimaging findings consistent with frontostriatal abnormalities. Dopamine D2/3 agonists are effective in depression of Parkinson's disease and their efficacy needs to be assessed in these two syndromes. Computerized cognitive remediation targeting functions of the cognitive control network may improve both executive functions and depressive symptoms of late-life major depression. Significant progress has been made in neurostimulation treatments in depressed younger adults. TMS targeting deep structures responsible for mood regulation is well tolerated by older adults and its efficacy in syndromes of late-life depression needs to be studied. Efficacious psychotherapies for late-life depression exist, but are underutilized in part because of their complexity. Streamlined, stepped psychotherapies targeting behaviors assumed to result from dysfunction of brain networks implicated in late-life depression can be easy to learn and have potential for dissemination. However, their effectiveness needs further investigation. Depression increases the risk of dementing disorders. Antidepressants are rather ineffective in treating depression of demented patients, but long-term use of antidepressants may reduce the risk of dementia. However, confirmation studies are needed.
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Affiliation(s)
- George S. Alexopoulos
- 000000041936877Xgrid.5386.8Weill Cornell Institute of Geriatric Psychiatry, 21 Bloomingdale Road, White Plains, NY 10605 USA
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11
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Safarova TP, Gavrilova SI, Yakovleva OB, Sheshenin VS, Kornilov VV, Shipilova ES. [Augmentation with carnicetine for late depression]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:65-75. [PMID: 31317892 DOI: 10.17116/jnevro201911905165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM Comparative evaluation of the efficacy and safety of antidepressant monotherapy and complex antidepressant therapy in combination with carnicetine in the treatment of depression in elderly patients in a psychiatric hospital. MATERIAL AND METHODS Two groups of hospitalized patients, aged from 60 to 79 years, with mild or moderate depression (according to ICD-10), comparable in basic demographic and clinical characteristics, received mono- or complex (in combination with carnicetine) antidepressant therapy for 8 weeks. Treatment efficacy was assessed with HAM-D, HARS, CGI-S and CGI-I; the level of cognitive activity was assessed with MMSE, the 10-word memory test and clock drawing test. RESULTS It has been established that the use of complex antidepressants therapy with the inclusion of carnicetine allows to achieve a more rapid and pronounced therapeutic response compared to antidepressant monotherapy. This is confirmed by the earlier (by the 4th week) and significant reduction of depressive and anxiety symptoms (p<0.01), a greater number of responders and better quality of depressive outcomes to the end of treatment and a more rapid improvement in cognitive functioning. CONCLUSION The results allow us to recommend the inclusion of carnicetine for the augmentation of antidepressant therapy in elderly patients of the psychiatric hospital to achieve a more rapid and complete therapeutic response and reduce the duration of hospitalization.
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Affiliation(s)
- T P Safarova
- Mental Health Research Center, Ministry of Scienes and Higher Education Moscow, Russia
| | - S I Gavrilova
- Mental Health Research Center, Ministry of Scienes and Higher Education Moscow, Russia
| | - O B Yakovleva
- Mental Health Research Center, Ministry of Scienes and Higher Education Moscow, Russia
| | - V S Sheshenin
- Mental Health Research Center, Ministry of Scienes and Higher Education Moscow, Russia
| | - V V Kornilov
- Mental Health Research Center, Ministry of Scienes and Higher Education Moscow, Russia
| | - E S Shipilova
- Mental Health Research Center, Ministry of Scienes and Higher Education Moscow, Russia
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12
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Ancelin ML, Carrière I, Artero S, Maller J, Meslin C, Ritchie K, Ryan J, Chaudieu I. Lifetime major depression and grey-matter volume. J Psychiatry Neurosci 2019; 44:45-53. [PMID: 30565905 PMCID: PMC6306287 DOI: 10.1503/jpn.180026] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND There is evidence of structural brain alterations in major depressive disorder (MDD), but little is known about how these alterations might be affected by age at onset or genetic vulnerability. This study examines whether lifetime episodes of MDD are associated with specific alterations in grey-matter volume, and whether those alterations vary according to sex or serotonin transporter-linked promoter region (5-HTTLPR) genotype (LL, SL or SS). METHODS We used structural MRI to acquire anatomic scans from 610 community-dwelling participants. We derived quantitative regional estimates of grey-matter volume in 16 subregions using FreeSurfer software. We diagnosed MDD according to DSM-IV criteria. We adjusted analyses for age, sex, total brain volume, education level, head injury and comorbidities. RESULTS Lifetime MDD was associated with a smaller insula, thalamus, ventral diencephalon, pallidum and nucleus accumbens and with a larger pericalcarine region in both men and women. These associations remained after adjustment for false discovery rate. Lifetime MDD was also associated with a smaller caudate nucleus and amygdala in men and with a larger rostral anterior cingulate cortex in women. Late-onset first episodes of MDD (after age 50 years) were associated with a larger rostral anterior cingulate cortex and lingual and pericalcarine regions; early-onset MDD was associated with a smaller ventral diencephalon and nucleus accumbens. Some associations differed according to 5-HTTLPR genotype: the thalamus was smaller in participants with MDD and the LL genotype; pericalcarine and lingual volumes were higher in those with the SL genotype. LIMITATIONS This study was limited by its cross-sectional design. CONCLUSION Major depressive disorder was associated with persistent volume reductions in the deep nuclei and insula and with enlargements in visual cortex subregions; alterations varied according to age of onset and genotype.
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Affiliation(s)
- Marie-Laure Ancelin
- From INSERM, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France (Ancelin, Carrière, Artero, Ritchie, Ryan, Chaudieu); Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and Alfred Hospital, Australia (Maller); Centre for Mental Health Research, Australian National University, Canberra, Australia (Maller, Meslin); General Electric Healthcare, Australia (Maller); Center for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom (Ritchie); and Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia (Ryan)
| | - Isabelle Carrière
- From INSERM, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France (Ancelin, Carrière, Artero, Ritchie, Ryan, Chaudieu); Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and Alfred Hospital, Australia (Maller); Centre for Mental Health Research, Australian National University, Canberra, Australia (Maller, Meslin); General Electric Healthcare, Australia (Maller); Center for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom (Ritchie); and Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia (Ryan)
| | - Sylvaine Artero
- From INSERM, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France (Ancelin, Carrière, Artero, Ritchie, Ryan, Chaudieu); Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and Alfred Hospital, Australia (Maller); Centre for Mental Health Research, Australian National University, Canberra, Australia (Maller, Meslin); General Electric Healthcare, Australia (Maller); Center for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom (Ritchie); and Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia (Ryan)
| | - Jerome Maller
- From INSERM, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France (Ancelin, Carrière, Artero, Ritchie, Ryan, Chaudieu); Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and Alfred Hospital, Australia (Maller); Centre for Mental Health Research, Australian National University, Canberra, Australia (Maller, Meslin); General Electric Healthcare, Australia (Maller); Center for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom (Ritchie); and Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia (Ryan)
| | - Chantal Meslin
- From INSERM, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France (Ancelin, Carrière, Artero, Ritchie, Ryan, Chaudieu); Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and Alfred Hospital, Australia (Maller); Centre for Mental Health Research, Australian National University, Canberra, Australia (Maller, Meslin); General Electric Healthcare, Australia (Maller); Center for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom (Ritchie); and Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia (Ryan)
| | - Karen Ritchie
- From INSERM, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France (Ancelin, Carrière, Artero, Ritchie, Ryan, Chaudieu); Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and Alfred Hospital, Australia (Maller); Centre for Mental Health Research, Australian National University, Canberra, Australia (Maller, Meslin); General Electric Healthcare, Australia (Maller); Center for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom (Ritchie); and Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia (Ryan)
| | - Joanne Ryan
- From INSERM, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France (Ancelin, Carrière, Artero, Ritchie, Ryan, Chaudieu); Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and Alfred Hospital, Australia (Maller); Centre for Mental Health Research, Australian National University, Canberra, Australia (Maller, Meslin); General Electric Healthcare, Australia (Maller); Center for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom (Ritchie); and Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia (Ryan)
| | - Isabelle Chaudieu
- From INSERM, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France (Ancelin, Carrière, Artero, Ritchie, Ryan, Chaudieu); Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and Alfred Hospital, Australia (Maller); Centre for Mental Health Research, Australian National University, Canberra, Australia (Maller, Meslin); General Electric Healthcare, Australia (Maller); Center for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom (Ritchie); and Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia (Ryan)
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Association of Genetic Variation at AQP4 Locus with Vascular Depression. Biomolecules 2018; 8:biom8040164. [PMID: 30563176 PMCID: PMC6316852 DOI: 10.3390/biom8040164] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 11/27/2018] [Accepted: 11/27/2018] [Indexed: 02/07/2023] Open
Abstract
Despite its substantial clinical importance, specific genetic variants associated with depression have not yet been identified. We sought to identify genetic variants associated with depression by (a) focusing on a more homogenous subsample (vascular depression) and (b) applying a three-stage approach. First, we contacted 730 participants with a confirmed atherosclerotic disease (coronary artery disease) from a population-based study population (German Myocardial Infarction Family Study IV) for psychiatric assessment with the Mini International Neuropsychiatric Interview. Second, we genotyped these patients using genome-wide single nucleotide polymorphism (SNP) arrays. Third, we characterized the SNP via in-silico analysis. The final sample consisted of 342 patients (78.3% male, age = 63.2 ± 9.9 years), 22.8% with a severe depressive disorder. Variant rs528732638 on chromosome 18q11.2 was a genome-wide significant variant and was associated with 3.6-fold increase in the odds of lifetime depression. The locus belongs to a linkage disequilibrium block showing expression quantitative trait loci effects on three putative cis-regulated genes, including the aquaporin 4 (AQP4) locus. AQP4 is already known to mediate the formation of ischemic edema in the brain and heart, increasing the size and extent of resulting lesions. Our findings indicate that AQP4 may also play a role in the etiopathology of vascular depression.
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Safarova TP, Yakovleva OB, Sheshenin VS, Gavrilova SI. Methods of augmentation of antidepressant therapy (on the model of complex therapy with the inclusion of actovegin) in gerontopsychiatric hospital. Zh Nevrol Psikhiatr Im S S Korsakova 2018; 118:55-63. [DOI: 10.17116/jnevro201811806255] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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15
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Wade BSC, Sui J, Hellemann G, Leaver AM, Espinoza RT, Woods RP, Abbott CC, Joshi SH, Narr KL. Inter and intra-hemispheric structural imaging markers predict depression relapse after electroconvulsive therapy: a multisite study. Transl Psychiatry 2017; 7:1270. [PMID: 29217832 PMCID: PMC5802464 DOI: 10.1038/s41398-017-0020-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 07/30/2017] [Indexed: 01/18/2023] Open
Abstract
Relapse of depression following treatment is high. Biomarkers predictive of an individual's relapse risk could provide earlier opportunities for prevention. Since electroconvulsive therapy (ECT) elicits robust and rapidly acting antidepressant effects, but has a >50% relapse rate, ECT presents a valuable model for determining predictors of relapse-risk. Although previous studies have associated ECT-induced changes in brain morphometry with clinical response, longer-term outcomes have not been addressed. Using structural imaging data from 42 ECT-responsive patients obtained prior to and directly following an ECT treatment index series at two independent sites (UCLA: n = 17, age = 45.41±12.34 years; UNM: n = 25; age = 65.00±8.44), here we test relapse prediction within 6-months post-ECT. Random forests were used to predict subsequent relapse using singular and ratios of intra and inter-hemispheric structural imaging measures and clinical variables from pre-, post-, and pre-to-post ECT. Relapse risk was determined as a function of feature variation. Relapse was well-predicted both within site and when cohorts were pooled where top-performing models yielded balanced accuracies of 71-78%. Top predictors included cingulate isthmus asymmetry, pallidal asymmetry, the ratio of the paracentral to precentral cortical thickness and the ratio of lateral occipital to pericalcarine cortical thickness. Pooling cohorts and predicting relapse from post-treatment measures provided the best classification performances. However, classifiers trained on each age-disparate cohort were less informative for prediction in the held-out cohort. Post-treatment structural neuroimaging measures and the ratios of connected regions commonly implicated in depression pathophysiology are informative of relapse risk. Structural imaging measures may have utility for devising more personalized preventative medicine approaches.
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Affiliation(s)
- Benjamin S C Wade
- Department of Neurology, UCLA, Ahmanson-Lovelace Brain Mapping Center, Los Angeles, USA
- Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, USA
| | - Jing Sui
- The Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
- Chinese Academy of Sciences Center for Excellence in Brain Science, Institute of Automation, Beijing, China
| | - Gerhard Hellemann
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute, UCLA, Los Angeles, USA
| | - Amber M Leaver
- Department of Neurology, UCLA, Ahmanson-Lovelace Brain Mapping Center, Los Angeles, USA
| | - Randall T Espinoza
- Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, USA
| | - Roger P Woods
- Department of Neurology, UCLA, Ahmanson-Lovelace Brain Mapping Center, Los Angeles, USA
| | | | - Shantanu H Joshi
- Department of Neurology, UCLA, Ahmanson-Lovelace Brain Mapping Center, Los Angeles, USA
| | - Katherine L Narr
- Department of Neurology, UCLA, Ahmanson-Lovelace Brain Mapping Center, Los Angeles, USA.
- Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, USA.
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A specific pattern of gray matter atrophy in Alzheimer's disease with depression. J Neurol 2017; 264:2101-2109. [PMID: 28856425 DOI: 10.1007/s00415-017-8603-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 08/21/2017] [Accepted: 08/22/2017] [Indexed: 01/16/2023]
Abstract
Considering the high incidence of depressive symptoms in Alzheimer's disease (AD), we conducted a large-sample study to investigate the pattern of gray matter (GM) abnormalities that differentiates depressive from non-depressive AD patients. We included 201 AD patients who underwent MRI assessment and categorized them into depressive and non-depressive subgroups based on the Geriatric Depression Scale (GDS; cut-off score: ≤9). We performed whole-brain voxel-based morphometry analysis in 173 patients after MRI quality control and used between-group comparisons and regression analysis models to analyze the volumetric data controlling for nuisance variables. Depressive AD patients had extensive GM volume loss mainly in the paracentral region, specifically in post- and pre-central gyrus, supplementary motor areas and thalamus compared to non-depressive patients. Similar findings were obtained for the group of 173 patients using regression analysis and GDS score as predictor variable. We provided the first clear demonstration of a unique pattern of GM atrophy that characterizes AD patients with depression which is consistent with regions implicated in the phenomenon of psychomotor retardation that characterizes depression.
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17
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Ma HT. Structural changes of cingulate cortex in post stroke depression. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2016:1099-1102. [PMID: 28268517 DOI: 10.1109/embc.2016.7590895] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Disruption of neural connections among regions regulating mood and cognition rather than cerebrovascular lesions may contribute to post-stroke depression (PSD). In this paper, we hypothesized that structural abnormalities in white matter structure like cingulate cortex induced by focal infarcts would play a role in mood regulation or depression after stroke onset. Various DTI coefficients including FA, RD and ADC with multiple signal distribution measurements were collected and statistically analyzed. The results identify significant differences in volume and multiple diffusion indices of DTI intensity distribution in cingulate cortex between PSD patients and the normal control. It indicates the neuronal loss secondary to demyelination in cingulate cortex due to stroke. Additionally, the volume loss of cingulate cortex in PSD patients observed in the results may further demonstrate the reduction of glial cells in cingulate cortex, as the axonal number/size changed little.
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18
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Su L, Faluyi YO, Hong YT, Fryer TD, Mak E, Gabel S, Hayes L, Soteriades S, Williams GB, Arnold R, Passamonti L, Rodríguez PV, Surendranathan A, Bevan-Jones RW, Coles J, Aigbirhio F, Rowe JB, O'Brien JT. Neuroinflammatory and morphological changes in late-life depression: the NIMROD study. Br J Psychiatry 2016; 209:525-526. [PMID: 27758838 PMCID: PMC5152879 DOI: 10.1192/bjp.bp.116.190165] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 07/03/2016] [Accepted: 07/08/2016] [Indexed: 11/30/2022]
Abstract
We studied neuroinflammation in individuals with late-life depression, as a risk factor for dementia, using [11C]PK11195 positron emission tomography (PET). Five older participants with major depression and 13 controls underwent PET and multimodal 3T magnetic resonance imaging (MRI), with blood taken to measure C-reactive protein (CRP). We found significantly higher CRP levels in those with late-life depression and raised [11C]PK11195 binding compared with controls in brain regions associated with depression, including subgenual anterior cingulate cortex, and significant hippocampal subfield atrophy in cornu ammonis 1 and subiculum. Our findings suggest neuroinflammation requires further investigation in late-life depression, both as a possible aetiological factor and a potential therapeutic target.
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Affiliation(s)
- L Su
- Li Su, PhD, Yetunde O. Faluyi, MBChB, Department of Psychiatry, University of Cambridge, UK; Young T. Hong, PhD, Tim D. Fryer, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Elijah Mak, BA, Department of Psychiatry, University of Cambridge, UK; Silvy Gabel, MSc, Department of Psychiatry, University of Cambridge, UK and Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands; Lawrence Hayes, MBBS, Soteris Soteriades, BA, Department of Psychiatry, University of Cambridge, UK; Guy B. Williams, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Robert Arnold, BSc, Department of Psychiatry, University of Cambridge, UK; Luca Passamonti, MD, Patricia Vázquez Rodríguez, MSc, Department of Clinical Neurosciences, University of Cambridge, UK, Ajenthan Surendranathan, MRCP, Richard W. Bevan-Jones, MBBChir, Department of Psychiatry, University of Cambridge, UK; Jonathan Coles, PhD, Division of Anaesthesia, Department of Medicine, University of Cambridge, UK; Franklin Aigbirhio, DPhil, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; James B. Rowe, PhD, Department of Clinical Neurosciences, University of Cambridge and Medical Research Council, Cognition and Brain Sciences Unit, Cambridge, UK; John T. O'Brien, DM, Department of Psychiatry, University of Cambridge, UK
| | - Y O Faluyi
- Li Su, PhD, Yetunde O. Faluyi, MBChB, Department of Psychiatry, University of Cambridge, UK; Young T. Hong, PhD, Tim D. Fryer, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Elijah Mak, BA, Department of Psychiatry, University of Cambridge, UK; Silvy Gabel, MSc, Department of Psychiatry, University of Cambridge, UK and Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands; Lawrence Hayes, MBBS, Soteris Soteriades, BA, Department of Psychiatry, University of Cambridge, UK; Guy B. Williams, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Robert Arnold, BSc, Department of Psychiatry, University of Cambridge, UK; Luca Passamonti, MD, Patricia Vázquez Rodríguez, MSc, Department of Clinical Neurosciences, University of Cambridge, UK, Ajenthan Surendranathan, MRCP, Richard W. Bevan-Jones, MBBChir, Department of Psychiatry, University of Cambridge, UK; Jonathan Coles, PhD, Division of Anaesthesia, Department of Medicine, University of Cambridge, UK; Franklin Aigbirhio, DPhil, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; James B. Rowe, PhD, Department of Clinical Neurosciences, University of Cambridge and Medical Research Council, Cognition and Brain Sciences Unit, Cambridge, UK; John T. O'Brien, DM, Department of Psychiatry, University of Cambridge, UK
| | - Y T Hong
- Li Su, PhD, Yetunde O. Faluyi, MBChB, Department of Psychiatry, University of Cambridge, UK; Young T. Hong, PhD, Tim D. Fryer, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Elijah Mak, BA, Department of Psychiatry, University of Cambridge, UK; Silvy Gabel, MSc, Department of Psychiatry, University of Cambridge, UK and Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands; Lawrence Hayes, MBBS, Soteris Soteriades, BA, Department of Psychiatry, University of Cambridge, UK; Guy B. Williams, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Robert Arnold, BSc, Department of Psychiatry, University of Cambridge, UK; Luca Passamonti, MD, Patricia Vázquez Rodríguez, MSc, Department of Clinical Neurosciences, University of Cambridge, UK, Ajenthan Surendranathan, MRCP, Richard W. Bevan-Jones, MBBChir, Department of Psychiatry, University of Cambridge, UK; Jonathan Coles, PhD, Division of Anaesthesia, Department of Medicine, University of Cambridge, UK; Franklin Aigbirhio, DPhil, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; James B. Rowe, PhD, Department of Clinical Neurosciences, University of Cambridge and Medical Research Council, Cognition and Brain Sciences Unit, Cambridge, UK; John T. O'Brien, DM, Department of Psychiatry, University of Cambridge, UK
| | - T D Fryer
- Li Su, PhD, Yetunde O. Faluyi, MBChB, Department of Psychiatry, University of Cambridge, UK; Young T. Hong, PhD, Tim D. Fryer, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Elijah Mak, BA, Department of Psychiatry, University of Cambridge, UK; Silvy Gabel, MSc, Department of Psychiatry, University of Cambridge, UK and Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands; Lawrence Hayes, MBBS, Soteris Soteriades, BA, Department of Psychiatry, University of Cambridge, UK; Guy B. Williams, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Robert Arnold, BSc, Department of Psychiatry, University of Cambridge, UK; Luca Passamonti, MD, Patricia Vázquez Rodríguez, MSc, Department of Clinical Neurosciences, University of Cambridge, UK, Ajenthan Surendranathan, MRCP, Richard W. Bevan-Jones, MBBChir, Department of Psychiatry, University of Cambridge, UK; Jonathan Coles, PhD, Division of Anaesthesia, Department of Medicine, University of Cambridge, UK; Franklin Aigbirhio, DPhil, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; James B. Rowe, PhD, Department of Clinical Neurosciences, University of Cambridge and Medical Research Council, Cognition and Brain Sciences Unit, Cambridge, UK; John T. O'Brien, DM, Department of Psychiatry, University of Cambridge, UK
| | - E Mak
- Li Su, PhD, Yetunde O. Faluyi, MBChB, Department of Psychiatry, University of Cambridge, UK; Young T. Hong, PhD, Tim D. Fryer, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Elijah Mak, BA, Department of Psychiatry, University of Cambridge, UK; Silvy Gabel, MSc, Department of Psychiatry, University of Cambridge, UK and Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands; Lawrence Hayes, MBBS, Soteris Soteriades, BA, Department of Psychiatry, University of Cambridge, UK; Guy B. Williams, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Robert Arnold, BSc, Department of Psychiatry, University of Cambridge, UK; Luca Passamonti, MD, Patricia Vázquez Rodríguez, MSc, Department of Clinical Neurosciences, University of Cambridge, UK, Ajenthan Surendranathan, MRCP, Richard W. Bevan-Jones, MBBChir, Department of Psychiatry, University of Cambridge, UK; Jonathan Coles, PhD, Division of Anaesthesia, Department of Medicine, University of Cambridge, UK; Franklin Aigbirhio, DPhil, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; James B. Rowe, PhD, Department of Clinical Neurosciences, University of Cambridge and Medical Research Council, Cognition and Brain Sciences Unit, Cambridge, UK; John T. O'Brien, DM, Department of Psychiatry, University of Cambridge, UK
| | - S Gabel
- Li Su, PhD, Yetunde O. Faluyi, MBChB, Department of Psychiatry, University of Cambridge, UK; Young T. Hong, PhD, Tim D. Fryer, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Elijah Mak, BA, Department of Psychiatry, University of Cambridge, UK; Silvy Gabel, MSc, Department of Psychiatry, University of Cambridge, UK and Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands; Lawrence Hayes, MBBS, Soteris Soteriades, BA, Department of Psychiatry, University of Cambridge, UK; Guy B. Williams, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Robert Arnold, BSc, Department of Psychiatry, University of Cambridge, UK; Luca Passamonti, MD, Patricia Vázquez Rodríguez, MSc, Department of Clinical Neurosciences, University of Cambridge, UK, Ajenthan Surendranathan, MRCP, Richard W. Bevan-Jones, MBBChir, Department of Psychiatry, University of Cambridge, UK; Jonathan Coles, PhD, Division of Anaesthesia, Department of Medicine, University of Cambridge, UK; Franklin Aigbirhio, DPhil, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; James B. Rowe, PhD, Department of Clinical Neurosciences, University of Cambridge and Medical Research Council, Cognition and Brain Sciences Unit, Cambridge, UK; John T. O'Brien, DM, Department of Psychiatry, University of Cambridge, UK
| | - L Hayes
- Li Su, PhD, Yetunde O. Faluyi, MBChB, Department of Psychiatry, University of Cambridge, UK; Young T. Hong, PhD, Tim D. Fryer, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Elijah Mak, BA, Department of Psychiatry, University of Cambridge, UK; Silvy Gabel, MSc, Department of Psychiatry, University of Cambridge, UK and Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands; Lawrence Hayes, MBBS, Soteris Soteriades, BA, Department of Psychiatry, University of Cambridge, UK; Guy B. Williams, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Robert Arnold, BSc, Department of Psychiatry, University of Cambridge, UK; Luca Passamonti, MD, Patricia Vázquez Rodríguez, MSc, Department of Clinical Neurosciences, University of Cambridge, UK, Ajenthan Surendranathan, MRCP, Richard W. Bevan-Jones, MBBChir, Department of Psychiatry, University of Cambridge, UK; Jonathan Coles, PhD, Division of Anaesthesia, Department of Medicine, University of Cambridge, UK; Franklin Aigbirhio, DPhil, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; James B. Rowe, PhD, Department of Clinical Neurosciences, University of Cambridge and Medical Research Council, Cognition and Brain Sciences Unit, Cambridge, UK; John T. O'Brien, DM, Department of Psychiatry, University of Cambridge, UK
| | - S Soteriades
- Li Su, PhD, Yetunde O. Faluyi, MBChB, Department of Psychiatry, University of Cambridge, UK; Young T. Hong, PhD, Tim D. Fryer, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Elijah Mak, BA, Department of Psychiatry, University of Cambridge, UK; Silvy Gabel, MSc, Department of Psychiatry, University of Cambridge, UK and Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands; Lawrence Hayes, MBBS, Soteris Soteriades, BA, Department of Psychiatry, University of Cambridge, UK; Guy B. Williams, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Robert Arnold, BSc, Department of Psychiatry, University of Cambridge, UK; Luca Passamonti, MD, Patricia Vázquez Rodríguez, MSc, Department of Clinical Neurosciences, University of Cambridge, UK, Ajenthan Surendranathan, MRCP, Richard W. Bevan-Jones, MBBChir, Department of Psychiatry, University of Cambridge, UK; Jonathan Coles, PhD, Division of Anaesthesia, Department of Medicine, University of Cambridge, UK; Franklin Aigbirhio, DPhil, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; James B. Rowe, PhD, Department of Clinical Neurosciences, University of Cambridge and Medical Research Council, Cognition and Brain Sciences Unit, Cambridge, UK; John T. O'Brien, DM, Department of Psychiatry, University of Cambridge, UK
| | - G B Williams
- Li Su, PhD, Yetunde O. Faluyi, MBChB, Department of Psychiatry, University of Cambridge, UK; Young T. Hong, PhD, Tim D. Fryer, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Elijah Mak, BA, Department of Psychiatry, University of Cambridge, UK; Silvy Gabel, MSc, Department of Psychiatry, University of Cambridge, UK and Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands; Lawrence Hayes, MBBS, Soteris Soteriades, BA, Department of Psychiatry, University of Cambridge, UK; Guy B. Williams, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Robert Arnold, BSc, Department of Psychiatry, University of Cambridge, UK; Luca Passamonti, MD, Patricia Vázquez Rodríguez, MSc, Department of Clinical Neurosciences, University of Cambridge, UK, Ajenthan Surendranathan, MRCP, Richard W. Bevan-Jones, MBBChir, Department of Psychiatry, University of Cambridge, UK; Jonathan Coles, PhD, Division of Anaesthesia, Department of Medicine, University of Cambridge, UK; Franklin Aigbirhio, DPhil, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; James B. Rowe, PhD, Department of Clinical Neurosciences, University of Cambridge and Medical Research Council, Cognition and Brain Sciences Unit, Cambridge, UK; John T. O'Brien, DM, Department of Psychiatry, University of Cambridge, UK
| | - R Arnold
- Li Su, PhD, Yetunde O. Faluyi, MBChB, Department of Psychiatry, University of Cambridge, UK; Young T. Hong, PhD, Tim D. Fryer, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Elijah Mak, BA, Department of Psychiatry, University of Cambridge, UK; Silvy Gabel, MSc, Department of Psychiatry, University of Cambridge, UK and Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands; Lawrence Hayes, MBBS, Soteris Soteriades, BA, Department of Psychiatry, University of Cambridge, UK; Guy B. Williams, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Robert Arnold, BSc, Department of Psychiatry, University of Cambridge, UK; Luca Passamonti, MD, Patricia Vázquez Rodríguez, MSc, Department of Clinical Neurosciences, University of Cambridge, UK, Ajenthan Surendranathan, MRCP, Richard W. Bevan-Jones, MBBChir, Department of Psychiatry, University of Cambridge, UK; Jonathan Coles, PhD, Division of Anaesthesia, Department of Medicine, University of Cambridge, UK; Franklin Aigbirhio, DPhil, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; James B. Rowe, PhD, Department of Clinical Neurosciences, University of Cambridge and Medical Research Council, Cognition and Brain Sciences Unit, Cambridge, UK; John T. O'Brien, DM, Department of Psychiatry, University of Cambridge, UK
| | - L Passamonti
- Li Su, PhD, Yetunde O. Faluyi, MBChB, Department of Psychiatry, University of Cambridge, UK; Young T. Hong, PhD, Tim D. Fryer, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Elijah Mak, BA, Department of Psychiatry, University of Cambridge, UK; Silvy Gabel, MSc, Department of Psychiatry, University of Cambridge, UK and Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands; Lawrence Hayes, MBBS, Soteris Soteriades, BA, Department of Psychiatry, University of Cambridge, UK; Guy B. Williams, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Robert Arnold, BSc, Department of Psychiatry, University of Cambridge, UK; Luca Passamonti, MD, Patricia Vázquez Rodríguez, MSc, Department of Clinical Neurosciences, University of Cambridge, UK, Ajenthan Surendranathan, MRCP, Richard W. Bevan-Jones, MBBChir, Department of Psychiatry, University of Cambridge, UK; Jonathan Coles, PhD, Division of Anaesthesia, Department of Medicine, University of Cambridge, UK; Franklin Aigbirhio, DPhil, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; James B. Rowe, PhD, Department of Clinical Neurosciences, University of Cambridge and Medical Research Council, Cognition and Brain Sciences Unit, Cambridge, UK; John T. O'Brien, DM, Department of Psychiatry, University of Cambridge, UK
| | - P Vázquez Rodríguez
- Li Su, PhD, Yetunde O. Faluyi, MBChB, Department of Psychiatry, University of Cambridge, UK; Young T. Hong, PhD, Tim D. Fryer, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Elijah Mak, BA, Department of Psychiatry, University of Cambridge, UK; Silvy Gabel, MSc, Department of Psychiatry, University of Cambridge, UK and Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands; Lawrence Hayes, MBBS, Soteris Soteriades, BA, Department of Psychiatry, University of Cambridge, UK; Guy B. Williams, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Robert Arnold, BSc, Department of Psychiatry, University of Cambridge, UK; Luca Passamonti, MD, Patricia Vázquez Rodríguez, MSc, Department of Clinical Neurosciences, University of Cambridge, UK, Ajenthan Surendranathan, MRCP, Richard W. Bevan-Jones, MBBChir, Department of Psychiatry, University of Cambridge, UK; Jonathan Coles, PhD, Division of Anaesthesia, Department of Medicine, University of Cambridge, UK; Franklin Aigbirhio, DPhil, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; James B. Rowe, PhD, Department of Clinical Neurosciences, University of Cambridge and Medical Research Council, Cognition and Brain Sciences Unit, Cambridge, UK; John T. O'Brien, DM, Department of Psychiatry, University of Cambridge, UK
| | - A Surendranathan
- Li Su, PhD, Yetunde O. Faluyi, MBChB, Department of Psychiatry, University of Cambridge, UK; Young T. Hong, PhD, Tim D. Fryer, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Elijah Mak, BA, Department of Psychiatry, University of Cambridge, UK; Silvy Gabel, MSc, Department of Psychiatry, University of Cambridge, UK and Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands; Lawrence Hayes, MBBS, Soteris Soteriades, BA, Department of Psychiatry, University of Cambridge, UK; Guy B. Williams, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Robert Arnold, BSc, Department of Psychiatry, University of Cambridge, UK; Luca Passamonti, MD, Patricia Vázquez Rodríguez, MSc, Department of Clinical Neurosciences, University of Cambridge, UK, Ajenthan Surendranathan, MRCP, Richard W. Bevan-Jones, MBBChir, Department of Psychiatry, University of Cambridge, UK; Jonathan Coles, PhD, Division of Anaesthesia, Department of Medicine, University of Cambridge, UK; Franklin Aigbirhio, DPhil, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; James B. Rowe, PhD, Department of Clinical Neurosciences, University of Cambridge and Medical Research Council, Cognition and Brain Sciences Unit, Cambridge, UK; John T. O'Brien, DM, Department of Psychiatry, University of Cambridge, UK
| | - R W Bevan-Jones
- Li Su, PhD, Yetunde O. Faluyi, MBChB, Department of Psychiatry, University of Cambridge, UK; Young T. Hong, PhD, Tim D. Fryer, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Elijah Mak, BA, Department of Psychiatry, University of Cambridge, UK; Silvy Gabel, MSc, Department of Psychiatry, University of Cambridge, UK and Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands; Lawrence Hayes, MBBS, Soteris Soteriades, BA, Department of Psychiatry, University of Cambridge, UK; Guy B. Williams, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Robert Arnold, BSc, Department of Psychiatry, University of Cambridge, UK; Luca Passamonti, MD, Patricia Vázquez Rodríguez, MSc, Department of Clinical Neurosciences, University of Cambridge, UK, Ajenthan Surendranathan, MRCP, Richard W. Bevan-Jones, MBBChir, Department of Psychiatry, University of Cambridge, UK; Jonathan Coles, PhD, Division of Anaesthesia, Department of Medicine, University of Cambridge, UK; Franklin Aigbirhio, DPhil, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; James B. Rowe, PhD, Department of Clinical Neurosciences, University of Cambridge and Medical Research Council, Cognition and Brain Sciences Unit, Cambridge, UK; John T. O'Brien, DM, Department of Psychiatry, University of Cambridge, UK
| | - J Coles
- Li Su, PhD, Yetunde O. Faluyi, MBChB, Department of Psychiatry, University of Cambridge, UK; Young T. Hong, PhD, Tim D. Fryer, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Elijah Mak, BA, Department of Psychiatry, University of Cambridge, UK; Silvy Gabel, MSc, Department of Psychiatry, University of Cambridge, UK and Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands; Lawrence Hayes, MBBS, Soteris Soteriades, BA, Department of Psychiatry, University of Cambridge, UK; Guy B. Williams, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Robert Arnold, BSc, Department of Psychiatry, University of Cambridge, UK; Luca Passamonti, MD, Patricia Vázquez Rodríguez, MSc, Department of Clinical Neurosciences, University of Cambridge, UK, Ajenthan Surendranathan, MRCP, Richard W. Bevan-Jones, MBBChir, Department of Psychiatry, University of Cambridge, UK; Jonathan Coles, PhD, Division of Anaesthesia, Department of Medicine, University of Cambridge, UK; Franklin Aigbirhio, DPhil, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; James B. Rowe, PhD, Department of Clinical Neurosciences, University of Cambridge and Medical Research Council, Cognition and Brain Sciences Unit, Cambridge, UK; John T. O'Brien, DM, Department of Psychiatry, University of Cambridge, UK
| | - F Aigbirhio
- Li Su, PhD, Yetunde O. Faluyi, MBChB, Department of Psychiatry, University of Cambridge, UK; Young T. Hong, PhD, Tim D. Fryer, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Elijah Mak, BA, Department of Psychiatry, University of Cambridge, UK; Silvy Gabel, MSc, Department of Psychiatry, University of Cambridge, UK and Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands; Lawrence Hayes, MBBS, Soteris Soteriades, BA, Department of Psychiatry, University of Cambridge, UK; Guy B. Williams, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Robert Arnold, BSc, Department of Psychiatry, University of Cambridge, UK; Luca Passamonti, MD, Patricia Vázquez Rodríguez, MSc, Department of Clinical Neurosciences, University of Cambridge, UK, Ajenthan Surendranathan, MRCP, Richard W. Bevan-Jones, MBBChir, Department of Psychiatry, University of Cambridge, UK; Jonathan Coles, PhD, Division of Anaesthesia, Department of Medicine, University of Cambridge, UK; Franklin Aigbirhio, DPhil, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; James B. Rowe, PhD, Department of Clinical Neurosciences, University of Cambridge and Medical Research Council, Cognition and Brain Sciences Unit, Cambridge, UK; John T. O'Brien, DM, Department of Psychiatry, University of Cambridge, UK
| | - J B Rowe
- Li Su, PhD, Yetunde O. Faluyi, MBChB, Department of Psychiatry, University of Cambridge, UK; Young T. Hong, PhD, Tim D. Fryer, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Elijah Mak, BA, Department of Psychiatry, University of Cambridge, UK; Silvy Gabel, MSc, Department of Psychiatry, University of Cambridge, UK and Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands; Lawrence Hayes, MBBS, Soteris Soteriades, BA, Department of Psychiatry, University of Cambridge, UK; Guy B. Williams, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Robert Arnold, BSc, Department of Psychiatry, University of Cambridge, UK; Luca Passamonti, MD, Patricia Vázquez Rodríguez, MSc, Department of Clinical Neurosciences, University of Cambridge, UK, Ajenthan Surendranathan, MRCP, Richard W. Bevan-Jones, MBBChir, Department of Psychiatry, University of Cambridge, UK; Jonathan Coles, PhD, Division of Anaesthesia, Department of Medicine, University of Cambridge, UK; Franklin Aigbirhio, DPhil, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; James B. Rowe, PhD, Department of Clinical Neurosciences, University of Cambridge and Medical Research Council, Cognition and Brain Sciences Unit, Cambridge, UK; John T. O'Brien, DM, Department of Psychiatry, University of Cambridge, UK
| | - J T O'Brien
- Li Su, PhD, Yetunde O. Faluyi, MBChB, Department of Psychiatry, University of Cambridge, UK; Young T. Hong, PhD, Tim D. Fryer, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Elijah Mak, BA, Department of Psychiatry, University of Cambridge, UK; Silvy Gabel, MSc, Department of Psychiatry, University of Cambridge, UK and Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands; Lawrence Hayes, MBBS, Soteris Soteriades, BA, Department of Psychiatry, University of Cambridge, UK; Guy B. Williams, PhD, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; Robert Arnold, BSc, Department of Psychiatry, University of Cambridge, UK; Luca Passamonti, MD, Patricia Vázquez Rodríguez, MSc, Department of Clinical Neurosciences, University of Cambridge, UK, Ajenthan Surendranathan, MRCP, Richard W. Bevan-Jones, MBBChir, Department of Psychiatry, University of Cambridge, UK; Jonathan Coles, PhD, Division of Anaesthesia, Department of Medicine, University of Cambridge, UK; Franklin Aigbirhio, DPhil, Wolfson Brain Imaging Centre and Department of Clinical Neurosciences, University of Cambridge, UK; James B. Rowe, PhD, Department of Clinical Neurosciences, University of Cambridge and Medical Research Council, Cognition and Brain Sciences Unit, Cambridge, UK; John T. O'Brien, DM, Department of Psychiatry, University of Cambridge, UK
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19
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Chen VCH, Shen CY, Liang SHY, Li ZH, Tyan YS, Liao YT, Huang YC, Lee Y, McIntyre RS, Weng JC. Assessment of abnormal brain structures and networks in major depressive disorder using morphometric and connectome analyses. J Affect Disord 2016; 205:103-111. [PMID: 27423425 DOI: 10.1016/j.jad.2016.06.066] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 06/14/2016] [Accepted: 06/15/2016] [Indexed: 01/11/2023]
Abstract
BACKGROUND It is hypothesized that the phenomenology of major depressive disorder (MDD) is subserved by disturbances in the structure and function of brain circuits; however, findings of structural abnormalities using MRI have been inconsistent. Generalized q-sampling imaging (GQI) methodology provides an opportunity to assess the functional integrity of white matter tracts in implicated circuits. METHODS The study population was comprised of 16 outpatients with MDD (mean age 44.81±2.2 years) and 30 age- and gender-matched healthy controls (mean age 45.03±1.88 years). We excluded participants with any other primary mental disorder, substance use disorder, or any neurological illnesses. We used T1-weighted 3D MRI with voxel-based morphometry (VBM) and vertex-wise shape analysis, and GQI with voxel-based statistical analysis (VBA), graph theoretical analysis (GTA) and network-based statistical (NBS) analysis to evaluate brain structure and connectivity abnormalities in MDD compared to healthy controls correlates with clinical measures of depressive symptom severity, Hamilton Depression Rating Scale 17-item (HAMD) and Hospital Anxiety and Depression Scale (HADS). RESULTS Using VBM and vertex-wise shape analyses, we found significant volumetric decreases in the hippocampus and amygdala among subjects with MDD (p<0.001). Using GQI, we found decreases in diffusion anisotropy in the superior longitudinal fasciculus and increases in diffusion probability distribution in the frontal lobe among subjects with MDD (p<0.01). In GTA and NBS analyses, we found several disruptions in connectivity among subjects with MDD, particularly in the frontal lobes (p<0.05). In addition, structural alterations were correlated with depressive symptom severity (p<0.01). LIMITATIONS Small sample size; the cross-sectional design did not allow us to observe treatment effects in the MDD participants. CONCLUSIONS Our results provide further evidence indicating that MDD may be conceptualized as a brain disorder with abnormal circuit structure and connectivity.
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Affiliation(s)
- Vincent Chin-Hung Chen
- School of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Chao-Yu Shen
- Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan; Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Sophie Hsin-Yi Liang
- School of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Zhen-Hui Li
- Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan
| | - Yeu-Sheng Tyan
- Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan; Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yin-To Liao
- Department of Psychiatry, Chung Shan Medical University, Taichung, Taiwan
| | - Yin-Chen Huang
- Department of Neurosurgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yena Lee
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Canada
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Jun-Cheng Weng
- Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan; Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan.
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20
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Allan CL, Sexton CE, Filippini N, Topiwala A, Mahmood A, Zsoldos E, Singh-Manoux A, Shipley MJ, Kivimaki M, Mackay CE, Ebmeier KP. Sub-threshold depressive symptoms and brain structure: A magnetic resonance imaging study within the Whitehall II cohort. J Affect Disord 2016; 204:219-25. [PMID: 27372409 PMCID: PMC5022868 DOI: 10.1016/j.jad.2016.06.049] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 05/19/2016] [Accepted: 06/11/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Late-life sub-threshold depressive symptoms (i.e. depressive symptoms that do not meet the criteria for a diagnosis of major depressive disorder) are associated with impaired physical health and function, and increased risk of major depressive disorder. Magnetic resonance imaging (MRI) studies examining late-life major depressive disorder find structural brain changes in grey and white matter. However, the extent to which late-life sub-threshold depression is associated with similar hallmarks is not well established. METHODS Participants with no history of major depressive disorder were selected from the Whitehall Imaging Sub-Study (n=358, mean age 69±5 years, 17% female). Depressive symptoms were measured using the Centre for Epidemiological Studies Depression Scale (CES-D) at three previous Whitehall II Study phases (2003-04, 2007-09 and 2012-13) and at the time of the MRI scan (2012-14). The relationships between current and cumulative depressive symptoms and MRI brain measures were explored using Voxel-Based Morphometry (VBM) for grey matter and Tract Based Spatial Statistics (TBSS) for white matter. RESULTS Current sub-threshold depressive symptoms were associated with significant reductions in fractional anisotropy and increases in axial and radial diffusivity. There were no significant relationships between current depressive symptoms and grey matter measures, or cumulative depressive symptoms and MRI measures. LIMITATIONS The prevalence (10%) of sub-threshold depressive symptoms means that analyses may be underpowered to detect subtle differences in brain structure. CONCLUSIONS Current sub-threshold depressive symptoms are associated with changes in white matter microstructure, indicating that even mild depressive symptoms are associated with similar MRI hallmarks to those in major depressive disorder.
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Affiliation(s)
| | | | - Nicola Filippini
- Department of Psychiatry, University of Oxford, Warneford Hospital, OX3 7JX, United Kingdom
| | - Anya Topiwala
- Department of Psychiatry, University of Oxford, Warneford Hospital, OX3 7JX, United Kingdom
| | - Abda Mahmood
- Department of Psychiatry, University of Oxford, Warneford Hospital, OX3 7JX, United Kingdom
| | - Enikő Zsoldos
- Department of Psychiatry, University of Oxford, Warneford Hospital, OX3 7JX, United Kingdom
| | - Archana Singh-Manoux
- Department of Psychiatry, University of Oxford, Warneford Hospital, OX3 7JX, United Kingdom
| | - Martin J. Shipley
- Department of Psychiatry, University of Oxford, Warneford Hospital, OX3 7JX, United Kingdom
| | - Mika Kivimaki
- Department of Psychiatry, University of Oxford, Warneford Hospital, OX3 7JX, United Kingdom
| | - Clare E. Mackay
- Department of Psychiatry, University of Oxford, Warneford Hospital, OX3 7JX, United Kingdom
| | - Klaus P. Ebmeier
- Department of Psychiatry, University of Oxford, Warneford Hospital, OX3 7JX, United Kingdom
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21
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Goodwin GM. Neuropsychological and neuroimaging evidence for the involvement of the frontal lobes in depression: 20 years on. J Psychopharmacol 2016; 30:1090-1094. [PMID: 27462086 DOI: 10.1177/0269881116661074] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
In 1997, neuropsychological and neuroimaging evidence supported the involvement of the frontal lobes and indeed the brain in depression. This was a challenge to conventional phenomenology and linked with the imperative to use neuroscience to understand major mental illness. Since that time, we are seeing ever more convincing evidence for the genetic basis of mental illness (including depression), relevant abnormality in grey and white matter and neuropsychological analysis of brain function. It has proved more difficult to pin down structural abnormality in major depression at the cellular level, but a focus on glial cells is increasingly justified by the evidence. Neuroscience continues to be a buttress against anti-scientific impulses in psychiatry and can help attract young people to enter it as a profession.
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Affiliation(s)
- Guy M Goodwin
- University of Oxford Department of Psychiatry, Warneford Hospital, Oxford, UK
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22
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Kang E, Wen Z, Song H, Christian KM, Ming GL. Adult Neurogenesis and Psychiatric Disorders. Cold Spring Harb Perspect Biol 2016; 8:cshperspect.a019026. [PMID: 26801682 DOI: 10.1101/cshperspect.a019026] [Citation(s) in RCA: 125] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Psychiatric disorders continue to be among the most challenging disorders to diagnose and treat because there is no single genetic or anatomical locus that is causative for the disease. Current treatments are often blunt tools used to ameliorate the most severe symptoms, at the risk of disrupting functional neural systems. There is a critical need to develop new therapeutic strategies that can target circumscribed functional or anatomical domains of pathology. Adult hippocampal neurogenesis may be one such domain. Here, we review the evidence suggesting that adult hippocampal neurogenesis plays a role in emotional regulation and forms of learning and memory that include temporal and spatial memory encoding and context discrimination, and that its dysregulation is associated with psychiatric disorders, such as affective disorders, schizophrenia, and drug addiction. Further, adult neurogenesis has proven to be an effective model to investigate basic processes of neuronal development and converging evidence suggests that aberrant neural development may be an etiological factor, even in late-onset diseases. Constitutive neurogenesis in the hippocampus of the mature brain reflects large-scale plasticity unique to this region and could be a potential hub for modulation of a subset of cognitive and affective behaviors that are affected by multiple psychiatric disorders.
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Affiliation(s)
- Eunchai Kang
- Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205 Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
| | - Zhexing Wen
- Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205 Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
| | - Hongjun Song
- Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205 Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205 The Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205 Graduate Program in Cellular and Molecular Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
| | - Kimberly M Christian
- Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205 Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
| | - Guo-Li Ming
- Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205 Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205 The Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205 Graduate Program in Cellular and Molecular Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205 Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
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23
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Meurs M, Roest AM, Groenewold NA, Franssen CFM, Westerhuis R, Kloppenburg WD, Doornbos B, Beukema L, Lindmäe H, de Groot JC, van Tol MJ, de Jonge P. Gray matter volume and white matter lesions in chronic kidney disease: exploring the association with depressive symptoms. Gen Hosp Psychiatry 2016; 40:18-24. [PMID: 27040607 DOI: 10.1016/j.genhosppsych.2016.02.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 02/09/2016] [Accepted: 02/28/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Chronic kidney disease (CKD) is associated with structural brain damage and with a high prevalence of depression. We therefore investigated structural brain alterations in both gray and white matter in CKD patients, focusing on depression-related (frontal-subcortical) regions. METHOD This cross-sectional MRI study in 24 CKD patients and 24 age- and sex-matched controls first tested whether CKD was associated with regionally lower gray matter (GM) volumes and more severe white matter lesions (WMLs). In exploratory subanalyses, we examined whether differences were more pronounced in CKD patients with depressive symptoms. RESULTS CKD patients showed lower global GM volume (P=.04) and more severe WMLs (P=.04) compared to controls. In addition, we found substantial clusters of lower GM in the bilateral orbitofrontal-cortex for CKD patients, which were however nonsignificant after proper multiple-comparison correction. In exploratory analyses for depressed CKD patients, reduced GM clusters were mainly detected within the frontal lobe. WML severity was unrelated to depression. CONCLUSION CKD was characterized by differences in brain structure. Although subthreshold, lower GM volumes were observed in depression-related brain areas and were more pronounced for depressed patients. There is a need for replication in larger and longitudinal studies to investigate whether WMLs and regional GM reductions may render CKD patients more susceptible for depression.
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Affiliation(s)
- Maaike Meurs
- University of Groningen/University Medical Center Groningen, Department of psychiatry - Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), The Netherlands.
| | - Annelieke M Roest
- University of Groningen/University Medical Center Groningen, Department of psychiatry - Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), The Netherlands.
| | - Nynke A Groenewold
- University of Groningen/University Medical Center Groningen, Department of psychiatry - Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), The Netherlands.
| | - Casper F M Franssen
- University of Groningen/University Medical Center Groningen, Department of Internal Medicine, Division of Nephrology, The Netherlands.
| | | | | | - Bennard Doornbos
- University Medical Center Groningen, department of Psychiatry, the Netherlands, GGZ Drenthe, Assen, the Netherlands.
| | - Lindy Beukema
- University of Groningen/University Medical Center Groningen, Department of psychiatry - Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), The Netherlands.
| | - Hanna Lindmäe
- University of Groningen/University Medical Center Groningen, department of Radiology, The Netherlands.
| | - Jan Cees de Groot
- University of Groningen/University Medical Center Groningen, department of Radiology, The Netherlands.
| | - Marie-José van Tol
- University of Groningen/University Medical Center Groningen, Neuroimaging Center, department of Neuroscience, section Cognitive NeuroPsychiatry, The Netherlands.
| | - Peter de Jonge
- University of Groningen/University Medical Center Groningen, Department of psychiatry - Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), The Netherlands.
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24
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Agudelo C, Aizenstein HJ, Karp JF, Reynolds CF. Applications of magnetic resonance imaging for treatment-resistant late-life depression. DIALOGUES IN CLINICAL NEUROSCIENCE 2016. [PMID: 26246790 PMCID: PMC4518699 DOI: 10.31887/dcns.2015.17.2/cagudelo] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Late-life depression (LLD) is a growing public and global health concern with diverse clinical manifestations and etiology. This literature review summarizes neuroimaging findings associated with depression in older adults and treatment-response variability. LLD has been associated with cerebral atrophy, diminished myelin integrity, and cerebral lesions in frontostriatal-limbic regions. These associations help explain the depression-executive dysfunction syndrome observed in LLD, and support cerebrovascular burden as a pathogenic mechanism. Furthermore, this review suggests that neuroimaging determinants of treatment resistance also reflect cerebrovascular burden. Of the theoretical etiologies of LLD, cerebrovascular burden may mediate treatment resistance. This review proposes that neuroimaging has the potential for clinical translation. Controlled trials may identify neuroimaging biomarkers that may inform treatment by identifying depressed adults likely to remit with pharmacotherapy, identifying individualized therapeutic dose, and facilitating earlier treatment response measures. Neuroimaging also has the potential to similarly inform treatment response variability from treatment with aripiprazole (dopamine modulator) and buprenorphine (opiate modulator).
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Affiliation(s)
- Christian Agudelo
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Howard J Aizenstein
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Jordan F Karp
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Charles F Reynolds
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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Lebedeva A, Borza T, Håberg AK, Idland AV, Dalaker TO, Aarsland D, Selbaek G, Beyer MK. Neuroanatomical correlates of late-life depression and associated cognitive changes. Neurobiol Aging 2015; 36:3090-3099. [PMID: 26277679 DOI: 10.1016/j.neurobiolaging.2015.04.020] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 04/25/2015] [Accepted: 04/27/2015] [Indexed: 01/08/2023]
Abstract
We compared cortical thickness between patients with late-life depression (LLD) and healthy controls and between patients with early-onset (EOD) and late-onset (LOD) depression. We also tested age effects on cortical thickness in LLD and controls and if cortical thickness and hippocampal volumes were associated with cognitive performance in LLD. Three-dimensional T1-weighted magnetic resonance images were obtained in 49 LLD and 49 matched hospital controls and processed using FreeSurfer. General linear model analysis was used as a statistical approach. LLD group had thinning in the left parahippocampal, fusiform, and inferior-parietal cortex compared with controls. Age correlated with cortical thinning in controls but not in LLD. Women in the LOD groups had extensive cortical thinning in the lateral prefrontal cortex bilaterally compared with EOD women. Absence of statistically significant changes observed in men should however be treated with caution because of the low number of men in the study. Mini-Mental Status Examination score correlated with lateral prefrontal cortical thickness bilaterally and hippocampal volume in the total group of LLD and in LOD but not EOD. LLD is associated with cortical thinning, which is associated with age at depression onset, gender, and level of cognitive functioning.
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Affiliation(s)
- Aleksandra Lebedeva
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
| | - Tom Borza
- Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway
| | - Asta Kristine Håberg
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway; Department of Medical Imaging, St Olav University Hospital, Trondheim, Norway
| | - Ane-Victoria Idland
- Oslo Delirium Research Group, Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Campus AHUS, University of Oslo, Oslo, Norway
| | - Turi Olene Dalaker
- Department of Radiology, Stavanger University Hospital, Stavanger, Norway
| | - Dag Aarsland
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden; Center for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Geir Selbaek
- Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway; Norwegian National Advisory Unit for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway; Akershus University Hospital, Lørenskog, Norway
| | - Mona K Beyer
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway
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Wisse LEM, Biessels GJ, Stegenga BT, Kooistra M, van der Veen PH, Zwanenburg JJM, van der Graaf Y, Geerlings MI. Major depressive episodes over the course of 7 years and hippocampal subfield volumes at 7 tesla MRI: the PREDICT-MR study. J Affect Disord 2015; 175:1-7. [PMID: 25589378 DOI: 10.1016/j.jad.2014.12.052] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 12/18/2014] [Accepted: 12/20/2014] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Smaller hippocampal volumes have been associated with major depressive disorder (MDD). The hippocampus consists of several subfields that may be differentially related to MDD. We investigated the association of occurrence of major depressive episodes (MDEs), assessed five times over seven years, with hippocampal subfield and entorhinal cortex volumes at 7 tesla MRI. METHODS In this prospective study of randomly selected general practice attendees, MDEs according to DSM-IV-R criteria were assessed at baseline and after 6, 12, 39 and 84 months follow-up. At the last follow-up, a T2 (0.7 mm(3)) 7 tesla MRI scan was obtained in 47 participants (60±10 years). The subiculum, cornu ammonis (CA) 1 to 3, dentate gyrus&CA4 and entorhinal cortex volumes were manually segmented according a published protocol. RESULTS Of the 47 participants, 13 had one MDE and 5 had multiple MDEs. ANCOVAs, adjusted for age, sex, education and intracranial volume, revealed no significant differences in hippocampal subfield or entorhinal cortex volumes between participants with and without an MDE in the preceding 84 months. Multiple episodes were associated with smaller subiculum volumes (B=-0.03 mL/episode; 95% CI -0.06; -0.003), but not with the other hippocampal subfield volumes, entorhinal cortex, or total hippocampal volume. LIMITATIONS A limitation of this study is the small sample size which makes replication necessary. CONCLUSIONS In this exploratory study, we found that an increasing number of major depressive episodes was associated with smaller subiculum volumes in middle-aged and older persons, but not with smaller volumes in other hippocampal subfields or the entorhinal cortex.
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Affiliation(s)
- L E M Wisse
- Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht, The Netherlands; Department of Neurology, Brain Center Rudolf Magnus, UMC Utrecht, Utrecht, The Netherlands
| | - G J Biessels
- Department of Neurology, Brain Center Rudolf Magnus, UMC Utrecht, Utrecht, The Netherlands
| | - B T Stegenga
- Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht, The Netherlands
| | - M Kooistra
- Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht, The Netherlands; Department of Neurology, Brain Center Rudolf Magnus, UMC Utrecht, Utrecht, The Netherlands
| | - P H van der Veen
- Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht, The Netherlands; Department of Radiology, UMC Utrecht, Utrecht, The Netherlands
| | | | - Y van der Graaf
- Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht, The Netherlands
| | - M I Geerlings
- Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht, The Netherlands.
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Du M, Liu J, Chen Z, Huang X, Li J, Kuang W, Yang Y, Zhang W, Zhou D, Bi F, Kendrick KM, Gong Q. Brain grey matter volume alterations in late-life depression. J Psychiatry Neurosci 2014; 39:397-406. [PMID: 24949867 PMCID: PMC4214874 DOI: 10.1503/jpn.130275] [Citation(s) in RCA: 102] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Voxel-based morphometry (VBM) studies have demonstrated that grey matter abnormalities are involved in the pathophysiology of late-life depression (LLD), but the findings are inconsistent and have not been quantitatively reviewed. The aim of the present study was to conduct a meta-analysis that integrated the reported VBM studies, to determine consistent grey matter alterations in individuals with LLD. METHODS A systematic search was conducted to identify VBM studies that compared patients with LLD and healthy controls. We performed a meta-analysis using the effect size signed differential mapping method to quantitatively estimate regional grey matter abnormalities in patients with LLD. RESULTS We included 9 studies with 11 data sets comprising 292 patients with LLD and 278 healthy controls in our meta-analysis. The pooled and subgroup meta-analyses showed robust grey matter reductions in the right lentiform nucleus extending into the parahippocampus, the hippocampus and the amygdala, the bilateral medial frontal gyrus and the right subcallosal gyrus as well as a grey matter increase in the right lingual gyrus. Meta-regression analyses showed that mean age and the percentage of female patients with LLD were not significantly related to grey matter changes. LIMITATIONS The analysis techniques, patient characteristics and clinical variables of the studies included were heterogeneous, and most participants were medicated. CONCLUSION The present meta-analysis is, to our knowledge, the first to overcome previous inconsistencies in the VBM studies of LLD and provide robust evidence for grey matter alterations within fronto-striatal-limbic networks, thereby implicating them in the pathophysiology of LLD. The mean age and the percentage of female patients with LLD did not appear to have a measurable impact on grey matter changes, although we cannot rule out the contributory effects of medication.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Qiyong Gong
- Correspondence to: Q. Gong, Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, PR China;
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Ashbrook DG, Williams RW, Lu L, Stein JL, Hibar DP, Nichols TE, Medland SE, Thompson PM, Hager R. Joint genetic analysis of hippocampal size in mouse and human identifies a novel gene linked to neurodegenerative disease. BMC Genomics 2014; 15:850. [PMID: 25280473 PMCID: PMC4192369 DOI: 10.1186/1471-2164-15-850] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 09/29/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Variation in hippocampal volume has been linked to significant differences in memory, behavior, and cognition among individuals. To identify genetic variants underlying such differences and associated disease phenotypes, multinational consortia such as ENIGMA have used large magnetic resonance imaging (MRI) data sets in human GWAS studies. In addition, mapping studies in mouse model systems have identified genetic variants for brain structure variation with great power. A key challenge is to understand how genetically based differences in brain structure lead to the propensity to develop specific neurological disorders. RESULTS We combine the largest human GWAS of brain structure with the largest mammalian model system, the BXD recombinant inbred mouse population, to identify novel genetic targets influencing brain structure variation that are linked to increased risk for neurological disorders. We first use a novel cross-species, comparative analysis using mouse and human genetic data to identify a candidate gene, MGST3, associated with adult hippocampus size in both systems. We then establish the coregulation and function of this gene in a comprehensive systems-analysis. CONCLUSIONS We find that MGST3 is associated with hippocampus size and is linked to a group of neurodegenerative disorders, such as Alzheimer's.
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Affiliation(s)
- David G Ashbrook
- Computational and Evolutionary Biology, Faculty of Life Sciences, University of Manchester, Michael Smith Building, Oxford Road, Manchester M13 9PT, UK.
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Lai CH, Wu YT. Alterations in white matter micro-integrity of the superior longitudinal fasciculus and anterior thalamic radiation of young adult patients with depression. Psychol Med 2014; 44:2825-2832. [PMID: 25065445 DOI: 10.1017/s0033291714000440] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND This study surveyed the characteristics of white matter (WM) micro-integrity in patients who were diagnosed with major depressive disorder (MDD) without co-morbidities. METHOD A total of 44 patients with MDD and 27 normal controls were enrolled in our study. Diffusion tensor imaging images of patients and controls were pre-processed and analysed to estimate differences in WM micro-integrity between patients and controls by performing comparisons of the values obtained from fractional anisotropy (FA). FA outputs of patients and controls were compared by a non-parametric permutation-based method with global brain volume, age and gender as covariates. In addition, the between-group differences of radial diffusivity (RD) and axial diffusivity (AD) were assessed to explain the alterations in FA values. Correlations between clinical variables (such as depression severity, anxiety severity, illness duration) and FA values were also estimated in each group and across both groups. RESULTS The patients with MDD had significantly lower FA values than the controls, for the left superior longitudinal fasciculus (SLF) and the right anterior thalamic radiation (ATR). The reductions in FA values occurred in combination with elevated RD values in the bilateral SLF and decreased AD values in the bilateral ATR. FA values were negatively correlated with depression severity in the SLF and with illness duration in the right SLF and ATR. CONCLUSIONS MDD patients had significant alterations in the WM micro-integrity of the left SLF and the right ATR.
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Affiliation(s)
- C H Lai
- Department of Psychiatry,Cheng Hsin General Hospital,Taipei City,Taiwan, ROC
| | - Y T Wu
- Department of Biomedical Imaging and Radiological Sciences,National Yang-Ming University,Taipei,Taiwan, ROC
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Brookes RL, Herbert V, Lawrence AJ, Morris RG, Markus HS. Depression in small-vessel disease relates to white matter ultrastructural damage, not disability. Neurology 2014; 83:1417-23. [PMID: 25230999 PMCID: PMC4206159 DOI: 10.1212/wnl.0000000000000882] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: To determine whether cerebral small-vessel disease (SVD) is a specific risk factor for depression, whether any association is mediated via white matter damage, and to study the role of depressive symptoms and disability on quality of life (QoL) in this patient group. Methods: Using path analyses in cross-sectional data, we modeled the relationships among depression, disability, and QoL in patients with SVD presenting with radiologically confirmed lacunar stroke (n = 100), and replicated results in a second SVD cohort (n = 100). We then compared the same model in a non-SVD stroke cohort (n = 50) and healthy older adults (n = 203). In a further study, to determine the role of white matter damage in mediating the association with depression, a subgroup of patients with SVD (n = 101) underwent diffusion tensor imaging (DTI). Results: Reduced QoL was associated with depression in patients with SVD, but this association was not mediated by disability or cognition; very similar results were found in the replication SVD cohort. In contrast, the non-SVD stroke group and the healthy older adult group showed a direct relationship between disability and depression. The DTI study showed that fractional anisotropy, a marker of white matter damage, was related to depressive symptoms in patients with SVD. Conclusion: These results suggest that in stroke patients without SVD, disability is an important causal factor for depression, whereas in SVD stroke, other factors specific to this stroke subtype have a causal role. White matter damage detected on DTI is one factor that mediates the association between SVD and depression.
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Affiliation(s)
- Rebecca L Brookes
- From the Stroke and Dementia Research Centre (R.L.B., V.H., A.J.L.), St George's, University of London; University of Cambridge (H.S.M.), Department of Neurology, Cambridge Biomedical Campus; and Department of Psychology (R.G.M.), Institute of Psychiatry, King's College London, UK.
| | - Vanessa Herbert
- From the Stroke and Dementia Research Centre (R.L.B., V.H., A.J.L.), St George's, University of London; University of Cambridge (H.S.M.), Department of Neurology, Cambridge Biomedical Campus; and Department of Psychology (R.G.M.), Institute of Psychiatry, King's College London, UK
| | - Andrew J Lawrence
- From the Stroke and Dementia Research Centre (R.L.B., V.H., A.J.L.), St George's, University of London; University of Cambridge (H.S.M.), Department of Neurology, Cambridge Biomedical Campus; and Department of Psychology (R.G.M.), Institute of Psychiatry, King's College London, UK
| | - Robin G Morris
- From the Stroke and Dementia Research Centre (R.L.B., V.H., A.J.L.), St George's, University of London; University of Cambridge (H.S.M.), Department of Neurology, Cambridge Biomedical Campus; and Department of Psychology (R.G.M.), Institute of Psychiatry, King's College London, UK
| | - Hugh S Markus
- From the Stroke and Dementia Research Centre (R.L.B., V.H., A.J.L.), St George's, University of London; University of Cambridge (H.S.M.), Department of Neurology, Cambridge Biomedical Campus; and Department of Psychology (R.G.M.), Institute of Psychiatry, King's College London, UK
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Cingulum bundle white matter lesions influence antidepressant response in late-life depression: a pilot study. J Affect Disord 2014; 162:8-11. [PMID: 24766997 PMCID: PMC4030539 DOI: 10.1016/j.jad.2014.03.031] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Revised: 03/12/2014] [Accepted: 03/14/2014] [Indexed: 11/23/2022]
Abstract
BACKGROUND Late-life depression is associated with white matter hyperintense lesions (WMLs) occurring in specific fiber tracts. In this study, we sought to determine if greater WML severity in the cingulum bundle or uncinate fasciculus was associated with poor short-term antidepressant response. METHODS Eleven depressed elders completed a baseline cranial 3T MRI and received antidepressant treatment following a medication algorithm. MRIs were analyzed to measure the fraction of each fiber tract׳s volume occupied by WMLs. Statistical analyses examined the effect of dichotomized fiber tract WML severity on three- and six-month depression severity after controlling for age and baseline depression severity. RESULTS Greater WML severity in the left hemispheric cingulum bundle adjacent to the hippocampus was associated with greater post-treatment depression severity at three- (F1,7=6.42, p=0.0390) and six-month assessments (F1,5=9.62, p=0.0268). Other fiber tract WML measures were not significantly associated with outcomes. LIMITATIONS The study had a small sample size and analyses were limited to only a priori fiber tracts. CONCLUSIONS This pilot study supports the hypothesis that focal damage to the cingulum bundle may contribute to poor short-term antidepressant response. These findings warrant further investigation with a larger, more definitive study.
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Belvederi Murri M, Pariante C, Mondelli V, Masotti M, Atti AR, Mellacqua Z, Antonioli M, Ghio L, Menchetti M, Zanetidou S, Innamorati M, Amore M. HPA axis and aging in depression: systematic review and meta-analysis. Psychoneuroendocrinology 2014; 41:46-62. [PMID: 24495607 DOI: 10.1016/j.psyneuen.2013.12.004] [Citation(s) in RCA: 219] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 12/01/2013] [Accepted: 12/02/2013] [Indexed: 12/31/2022]
Abstract
One of the most consistent findings in the biology of depression is an altered activity of the hypothalamic-pituitary-adrenal (HPA) axis. However, data concerning this issue have never been examined with a focus on the older population. Here we present a systematic review and meta-analysis, based on studies investigating levels of cortisol, adrenocorticotropic hormone (ACTH) and corticotropin-releasing hormone (CRH) in depressed participants older than 60 and compared with healthy controls. We found 20 studies, for a total of 43 comparisons on different indices of HPA axis functioning. Depression had a significant effect (Hedges' g) on basal cortisol levels measured in the morning (0.89), afternoon (0.83) and night (1.39), but a smaller effect on cortisol measured continuously (0.51). The effect of depression was even higher on post-dexamethasone cortisol levels (3.22), whereas it was non-significant on morning ACTH and CRH levels. Subgroup analyses indicated that various methodological and clinical factors can influence the study results. Overall, older participants suffering from depression show a high degree of dysregulation of HPA axis activity, with differences compared with younger adults. This might depend on several mechanisms, including physical illnesses, alterations in the CNS and immune-endocrinological alterations. Further studies are needed to clarify the implications of altered HPA axis activity in older patients suffering from depression. Novel pharmacological approaches might be effective in targeting this pathophysiological feature, thus improving the clinical outcomes.
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Affiliation(s)
- Martino Belvederi Murri
- Institute of Psychiatry, Department of Psychological Medicine, King's College London, London, UK; Department of Neurosciences Division of Psychiatry, University of Parma, Parma, Italy.
| | - Carmine Pariante
- Institute of Psychiatry, Department of Psychological Medicine, King's College London, London, UK
| | - Valeria Mondelli
- Institute of Psychiatry, Department of Psychological Medicine, King's College London, London, UK
| | - Mattia Masotti
- Section of Psychiatry, Department of Neuroscience, Oftalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy
| | - Anna Rita Atti
- Department of Biomedical and NeuroMotor Sciences - Psychiatry, University of Bologna, Italy
| | - Zefiro Mellacqua
- Institute of Psychiatry, Department of Psychosis Studies, King's College London, London, UK
| | - Marco Antonioli
- Department of Biomedical and NeuroMotor Sciences - Psychiatry, University of Bologna, Italy
| | - Lucio Ghio
- Section of Psychiatry, Department of Neuroscience, Oftalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy
| | - Marco Menchetti
- Section of Psychiatry, Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Italy
| | | | - Marco Innamorati
- Department of Neurosciences Division of Psychiatry, University of Parma, Parma, Italy
| | - Mario Amore
- Section of Psychiatry, Department of Neuroscience, Oftalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy
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Allan CL, Zsoldos E, Ebmeier KP. Imaging and neurobiological changes in late-life depression. Br J Hosp Med (Lond) 2014; 75:25-30. [DOI: 10.12968/hmed.2014.75.1.25] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Charlotte L Allan
- Academic Clinical Lecturer, University of Oxford, Warneford Hospital, Oxford OX3 7JX
| | - Enikő Zsoldos
- Research Assistant, University of Oxford, Warneford Hospital, Oxford OX3 7JX
| | - Klaus P Ebmeier
- Professor of Old Age Psychiatry in the Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX
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Abstract
This article discusses characteristic factors in the presentation of depressive disorders in persons older than age 65 years. Clinical presentation is discussed along with risk and protective factors. Detailed descriptions of tests useful for screening and diagnosis of depression in the elderly are presented. Each test is reviewed according to time to administer, sensitivity and specificity, outcomes, advantages, and disadvantages. The importance of clinical history and the diagnostic interview, as well as the role of laboratory studies and neuroimaging in the clinical evaluation are discussed.
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Affiliation(s)
- Juliet Glover
- Geriatric Psychiatry Fellowship Program, Palmetto Health, University of South Carolina School of Medicine, 3555 Harden Street, Suite 301, Columbia, SC 29203, USA
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Taylor WD, Aizenstein HJ, Alexopoulos GS. The vascular depression hypothesis: mechanisms linking vascular disease with depression. Mol Psychiatry 2013; 18:963-74. [PMID: 23439482 PMCID: PMC3674224 DOI: 10.1038/mp.2013.20] [Citation(s) in RCA: 555] [Impact Index Per Article: 50.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 01/09/2013] [Accepted: 01/18/2013] [Indexed: 02/07/2023]
Abstract
The 'Vascular Depression' hypothesis posits that cerebrovascular disease may predispose, precipitate or perpetuate some geriatric depressive syndromes. This hypothesis stimulated much research that has improved our understanding of the complex relationships between late-life depression (LLD), vascular risk factors, and cognition. Succinctly, there are well-established relationships between LLD, vascular risk factors and cerebral hyperintensities, the radiological hallmark of vascular depression. Cognitive dysfunction is common in LLD, particularly executive dysfunction, a finding predictive of poor antidepressant response. Over time, progression of hyperintensities and cognitive deficits predicts a poor course of depression and may reflect underlying worsening of vascular disease. This work laid the foundation for examining the mechanisms by which vascular disease influences brain circuits and influences the development and course of depression. We review data testing the vascular depression hypothesis with a focus on identifying potential underlying vascular mechanisms. We propose a disconnection hypothesis, wherein focal vascular damage and white matter lesion location is a crucial factor, influencing neural connectivity that contributes to clinical symptomatology. We also propose inflammatory and hypoperfusion hypotheses, concepts that link underlying vascular processes with adverse effects on brain function that influence the development of depression. Testing such hypotheses will not only inform the relationship between vascular disease and depression, but also provide guidance on the potential repurposing of pharmacological agents that may improve LLD outcomes.
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Affiliation(s)
- W D Taylor
- Center for Cognitive Medicine, Department of Psychiatry, Vanderbilt University, Nashville, TN 37212, 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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Functional role of adult hippocampal neurogenesis as a therapeutic strategy for mental disorders. Neural Plast 2012; 2012:854285. [PMID: 23346419 PMCID: PMC3549353 DOI: 10.1155/2012/854285] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2012] [Revised: 11/30/2012] [Accepted: 11/30/2012] [Indexed: 02/07/2023] Open
Abstract
Adult neurogenesis, the process of generating new neurons from neural stem cells, plays significant roles in synaptic plasticity, memory, and mood regulation. In the mammalian brain, it continues to occur well into adulthood in discrete regions, namely, the hippocampus and olfactory bulb. During the past decade, significant progress has been made in understanding the mechanisms regulating adult hippocampal neurogenesis and its role in the etiology of mental disorders. In addition, adult hippocampal neurogenesis is highly correlated with the remission of the antidepressant effect. In this paper, we discuss three major psychiatric disorders, depression, schizophrenia, and drug addiction, in light of preclinical evidence used in establishing the neurobiological significance of adult neurogenesis. We interpret the significance of these results and pose questions that remain unanswered. Potential treatments which include electroconvulsive therapy, deep brain stimulation, chemical antidepressants, and exercise therapy are discussed. While consensus lacks on specific mechanisms, we highlight evidence which indicates that these treatments may function via an increase in neural progenitor proliferation and changes to the hippocampal circuitry. Establishing a significant role of adult neurogenesis in the pathogenicity of psychiatric disorders may hold the key to potential strategies toward effective treatment.
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