One-Year Change in Anterior Cingulate Cortex White Matter Microstructure: Relationship With Late-Life Depression Outcomes

Departments of Psychiatry, Duke University Medical Center, Durham, NC 27710, USA.
The American journal of geriatric psychiatry: official journal of the American Association for Geriatric Psychiatry (Impact Factor: 3.52). 01/2011; 19(1):43-52. DOI: 10.1097/JGP.0b013e3181e70cec
Source: PubMed

ABSTRACT differences in white matter structure measured with diffusion tensor imaging (DTI) are associated with late-life depression, but results examining how these differences relate to antidepressant remission are mixed. To better describe these relationships, the authors examined how 1-year change in DTI measures are related to 1-year course of depression.
one-year cross-sectional follow-up to a 12-week clinical trial of sertraline.
outpatients at an academic medical center.
twenty-nine depressed and 20 never-depressed elderly subjects. Over the 1-year period, 16 depressed subjects achieved and maintained remission, whereas 13 did not.
one-year change in fractional anisotropy (FA) and diffusivity in frontal white matter, as measured by DTI.
contrary to our hypotheses, depressed subjects who did not remit over the study interval exhibited significantly less change in anterior cingulate cortex (ACC) white matter FA than did never-depressed or depressed-remitted subjects. There were no group differences in other frontal or central white matter regions. Moreover, there was a significant positive relationship between change in Montgomery-Asberg Depression Rating Scale (MADRS) and change in ACC FA, wherein greater interval decline in FA was associated with greater interval decline in MADRS.
older depressed individuals who remit exhibit white matter changes comparable with what is observed in never-depressed individuals, whereas nonremitters exhibit significantly less change in ACC FA. Such a finding may be related to either antidepressant effects on brain structure or the effects of chronic stress on brain structure. Further work is needed to better understand this relationship.

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Available from: Warren Taylor, Aug 04, 2015
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    • " inversely correlated with FA ( Versace et al . , 2008 ) . In depressed elderly patients , tricyclic or selective serotonergic antide - pressants increased WM hyperintensities ( Steffens et al . , 2008 ) , and a one - year treatment with sertraline caused a significant decrease of FA which was proportional to the reduction of depression severity ( Taylor et al . , 2011 ) . Antipsychotics reduce the number of glial cells in monkeys , although oligodendrocytes are only marginally affected ( Konopaske et al . , 2008 ) . A study in 13 drug - naı¨ve patients with OCD showed that a three - months treatment with citalopram significantly decreased OCD symptomatology , and also reduced FA in the posterior thal"
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    • "Some studies in late life depression consistently reported reduced FA values in prefrontal brain regions [Bae et al., 2006; Nobuhara et al., 2006b; Li et al., 2007; Murphy et al., 2007; Yang et al., 2007; Shimony et al., 2009]. Reduced FA in the cingulate cortex has been also detected [Murphy et al., 2007; Cullen et al., 2010; Taylor et al., 2010]. In addition, Yang et al. [2007] and Murphy et al. [2007] reported a reduction in FA values in the parahippocampal gyrus. "
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    • "However, a limitation of this review was the significant heterogeneity of acquisition size, analysis methods, and subject properties such as age and medication status. These white matter changes might already exist early in the course of MDD (Zhu et al., 2011), but seem to remit after successful antidepressant therapy (Taylor et al., 2011). These abnormalities of functional and anatomical structures in prefrontal, callosal, and temporal regions support the hypothesis that impaired connectivity is linked to affective dysregulation and seem to characterize MDD. "
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