Hippocampal Morphology and Distinguishing Late-Onset From Early-Onset Elderly Depression

Università degli Studi di Brescia, Brescia, Lombardy, Italy
American Journal of Psychiatry (Impact Factor: 12.3). 03/2008; 165(2):229-37. DOI: 10.1176/appi.ajp.2007.07030506
Source: PubMed


Despite evidence for hippocampal abnormalities in elderly depression, it is unknown whether these changes are regionally specific. This study used three-dimensional mapping techniques to identify regional hippocampal abnormalities in early- and late-onset depression. Neuropsychological correlates of hippocampal morphology were also investigated.
With high-resolution magnetic resonance imaging, hippocampal morphology was compared among elderly patients with early- (N=24) and late-onset (N=22) depression and comparison subjects (N=34). Regional structural abnormalities were identified by comparing distances, measured from homologous hippocampal surface points to the central core of each individual's hippocampal surface model, between groups.
Hippocampal volumes differed between depressed patients and comparison subjects but not between patients with early- and late-onset depression. However, statistical mapping results showed that regional surface contractions were significantly pronounced in late- compared to early-onset depression in the anterior of the subiculum and lateral posterior of the CA1 subfield in the left hemisphere. Significant shape differences were observed bilaterally in anterior CA1-CA3 subfields and the subiculum in patients in relation to comparison subjects. These results were similar when each disease group was separately compared to comparison subjects. Hippocampal surface contractions significantly correlated with memory measures among late- but not early-onset depressed patients or comparison subjects.
More pronounced regional volume deficits and their associations with memory in late-onset depression may suggest that these patients are more likely to develop cognitive impairment over time than individuals with early-onset depression. Mapping regional hippocampal abnormalities and their cognitive correlates may help guide research in defining risk profiles and treatment strategies.

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Available from: Liberty Hamilton, Oct 02, 2015
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    • "In addition, structural and functional alterations associated with the hippocampus have been seen in major depression . Decreased hippocampal volumes have been shown in a number of depressed populations (Sheline et al., 2002), and hippocampal shape deformations have been correlated with memory function in late-life depression (Ballmaier et al., 2008). Although hippocampal volume and memory function have been studied in diabetic populations and depressed populations separately, to our knowledge, this relationship has not been examined in subjects with both disorders. "
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    ABSTRACT: Objective The purpose of this study was to examine the relationship between verbal learning and memory performance and hippocampal volume in subjects with co-morbid type 2 diabetes and major depression compared with healthy control subjects and subjects with type 2 diabetes alone. Methods Twenty four subjects with type 2 diabetes and 20 subjects with type 2 diabetes and major depression were recruited from endocrinology clinics and were compared with 32 healthy control subjects recruited from the community. Subjects were scanned on a 1.5 T GE scanner, and hippocampal volumes were measured using Freesurfer. The California Verbal Learning Test assessed learning and memory. Significant predictors of verbal learning performance (e.g., age, gender, education, blood pressure, stroke risk, hemoglobin A1c, and hippocampal volume) were determined using a stepwise linear regression. ResultsSubjects with diabetes and depression had significantly worse performance on verbal list learning compared with healthy control subjects. Hippocampal volume was a strong predictor of performance in healthy control subjects, and age and hippocampal volume were strong predictors in subjects with type 2 diabetes alone. Age alone was a significant predictor of verbal learning performance in subjects with diabetes and depression. Conclusions The relationship between hippocampal volume and performance on the California Verbal Learning Test is decoupled in subjects with type 2 diabetes and major depression and this decoupling may contribute to poor verbal learning and memory performance in this study population. Copyright (c) 2014 John Wiley & Sons, Ltd.
    International Journal of Geriatric Psychiatry 04/2015; 30(4). DOI:10.1002/gps.4149 · 2.87 Impact Factor
    • "Late onset depression had more volume reduction in the head and tail regions when compared to early onset depression. The correlation of memory scores and hippocampal surface contraction was significant only in late onset depression (Ballmaier et al., 2008). Patients with depression in this study were antidepressant free prior to brain imaging and had moderate depression. "
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    ABSTRACT: While many studies have reported reduced volume of hippocampus in late onset depression (LOD), the status of hippocampus sub-regions (anterior/posterior) is yet to be explored. Evaluating hippocampal sub-regions might facilitate better elucidation of the neurobiological basis of LOD. Twenty five elderly subjects with LOD (mean age=65.28yr, SD=5.73, 15 females) and 20 healthy controls (mean age=65.35yr, SD=5.67, 7 females) were examined using 3-tesla magnetic resonance imaging (MRI). They were also evaluated with Montgomery Asberg Depression Rating Scale (MADRS) and Hindi Mental State Examination (HMSE). We examined the difference in volume of Hippocampal sub-regions between the LOD group and control group controlling for the age, sex and intracranial volume. Left posterior hippocampus volume was significantly smaller in LOD group than the control group (1.01±0.19ml vs 1.16±0.25ml, F=7.50, p=0.009). There was a similar trend for the right posterior hippocampus (1.08±0.19ml vs 1.18±0.27ml, F=3.18, p=0.082). Depression severity (mean MADRS score=20.64±8.99) had a significant negative correlation with volumes of right posterior hippocampus (r=-0.37, p=0.012) and left posterior hippocampus (r=-0.46, p=0.001) in the LOD group. Specific reduction of posterior hippocampus volume and its relationship with depression severity indicates sub region specific hippocampal volumetric abnormalities in LOD. Future studies need to evaluate sub region specific hippocampal volume in LOD longitudinally for better understanding of the pathogenesis of LOD in view of the functional differences between anterior and posterior hippocampus. Copyright © 2014 Elsevier B.V. All rights reserved.
    Asian Journal of Psychiatry 12/2014; 13. DOI:10.1016/j.ajp.2014.11.005
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    • "An early meta-analysis of studies on the hippocampus in MDD found significant associations between number of depressive episodes only on the right [Videbech and Ravnkilde , 2004] but a later meta-analysis did not find evidence for lateralization [McKinnon et al., 2009]. More recent studies using surface renderings found no lateralization [Ballmaier et al., 2008; Posener et al., 2003] or reported the right hippocampus to be more severely affected in MDD [Cole et al., 2010]. Thus, laterality findings might be simply due to chance or depend on the method used. "
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    ABSTRACT: Depression is very common in multiple sclerosis (MS) but the underlying biological mechanisms are poorly understood. The hippocampus plays a key role in mood regulation and is implicated in the pathogenesis of depression. This study utilizes volumetric and shape analyses of the hippocampus to characterize neuroanatomical correlates of depression in MS. A cross-section of 109 female patients with MS was evaluated. Bilateral hippocampi were segmented from MRI scans (volumetric T(1) -weighted, 1 mm(3) ) using automated tools. Shape analysis was performed using surface mesh modeling. Depression was assessed using the Center for Epidemiologic Studies-Depression (CES-D) scale. Eighty-three subjects were classified as low depression (CES-D 0-20) versus 26 subjects with high depression (CES-D ≥ 21). Right hippocampal volumes (P = 0.04) were smaller in the high depression versus the low depression groups, but there was no significant difference in left hippocampal volumes. Surface rendering analysis revealed that hippocampal shape changes in depressed patients with MS were clustered in the right hippocampus. Significant associations were found between right hippocampal shape and affective symptoms but not vegetative symptoms of depression. Our results suggested that regionally clustered reductions in hippocampal thickness can be detected by automated surface mesh modeling and may be a biological substrate of MS depression in female patients. Hum Brain Mapp, 2012. © 2012 Wiley Periodicals, Inc.
    Human Brain Mapping 01/2014; 35(1). DOI:10.1002/hbm.22154 · 5.97 Impact Factor
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