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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    • "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.
    Full-text · Article · Apr 2015 · International Journal of Geriatric Psychiatry
    • "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.
    No preview · Article · Dec 2014 · Asian Journal of Psychiatry
    • "Thus, patients with MDD have consistently demonstrated worse performance than healthy controls in verbal memory (Kaymak et al., 2010; MacQueen et al., 2003; Vythilingam et al., 2004; Sheline et al., 1999), recollection memory (Kaymak et al., 2010; MacQueen et al., 2003; Sheline et al., 1999), and in tests of visual memory (Kaymak et al., 2010; Reischies and Neu, 2000; Grant et al., 2001; Neu et al., 2005; van Wingen et al., 2010). Similar deficits have been reported in patients with late-onset depression in some (Hickie et al., 2005), but not all (Ballmaier et al., 2008; Greenberg et al., 2008), studies. The majority of the studies investigating cognitive deficit in MDD have focused on patients with multiple episodes of depression (Lee et al., 2012), rather than those with first onset. "
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    ABSTRACT: Magnetic resonance imaging (MRI) has shown lower hippocampal volume in major depressive disorder (MDD). Patients with MDD have consistently demonstrated worse performance than healthy controls a number of memory tests. Memory functions within the hippocampus in healthy younger subjects appear to be linked to cornu ammonis (CA1-3) and dentate gyrus (DG) subfields. Therefore, the main goal of the present study was to investigate whether memory deficits in MDD patients are related to reduction in hippocampal subfields volumes, particularly DG and CA 1–3.Methods15 MDD patients meeting DSM-IV criteria for MDD with moderate or severe episodes were recruited, together with 15 healthy controls. We used T2-weighted 2D Fast Spin Echo (FSE) and T1-weighted 3D MPRAGE sequences at 4.7 T to compare hippocampal subfield volumes at 0.09 μl voxel volume. Participants were administered the Wechsler Memory Scale.ResultsMDD patients underperformed in several episodic visual memory tasks, as well as in visual working memory, compared to healthy controls. Global hippocampal volumes were similar between groups; however, MDD patients showed significantly reduced DG volumes within the hippocampal body. Duration of depression correlated with MDD patients׳ total volumes in the hippocampal body and CA1-3 and DG subfields within it.LimitationsOur study sample was relatively small and the majority of patients were on antidepressant treatment.Conclusions Our findings suggest that DG volumes in particular may be worthy of further study to further elucidate their precise role in MDD, both by itself as well as in relation to memory.
    No preview · Article · Oct 2014 · Journal of Affective Disorders
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