Hippocampal volume and subcortical white matter lesions in late life depression: comparison of early and late onset depression

Background: Reduced hippocampal volume and increased prevalence of subcortical white matter lesions are associated with both recurrent early onset depression (EOD) and late onset depression (LOD). It is not clear whether these two factors differentially affect the age of onset of first depression. T...

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Veröffentlicht in:Journal of neurology, neurosurgery and psychiatry neurosurgery and psychiatry, 2007-06, Vol.78 (6), p.638-640
Hauptverfasser: Janssen, Joost, Hulshoff Pol, Hilleke E, de Leeuw, Frank-Erik, Schnack, Hugo G, Lampe, Indrag K, Kok, Rob M, Kahn, Rene S, Heeren, Thea J
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container_end_page 640
container_issue 6
container_start_page 638
container_title Journal of neurology, neurosurgery and psychiatry
container_volume 78
creator Janssen, Joost
Hulshoff Pol, Hilleke E
de Leeuw, Frank-Erik
Schnack, Hugo G
Lampe, Indrag K
Kok, Rob M
Kahn, Rene S
Heeren, Thea J
description Background: Reduced hippocampal volume and increased prevalence of subcortical white matter lesions are associated with both recurrent early onset depression (EOD) and late onset depression (LOD). It is not clear whether these two factors differentially affect the age of onset of first depression. Therefore, we wished to investigate the relationship between age of first depression onset and hippocampal volume, with adjustment for subcortical white matter lesions. Methods: MRI brain scans were used to compare hippocampal volumes and white matter lesions between age matched female patients (>60 years) with recurrent EOD and LOD and healthy controls. Results: When comparing the three groups and adjusting for age, the Mini-Mental State Examination score, total brain volume and total hippocampal volume were significantly smaller in patients with EOD compared with controls (5.6 vs 6.1 ml; p = 0.04). The prevalence of larger subcortical white matter lesions was higher in patients with LOD compared with patients with EOD (47% vs 8%; p = 0.002). Patients with LOD did not differ in hippocampal volume from patients with EOD or from controls. Conclusions: In late life depression, age of first depression onset may distinguish between different independent neuropathological mechanisms. A small hippocampus volume may be a neuranatomical marker of EOD depression and larger subcortical white matter lesions could be an intermediate between cerebrovascular disease and LOD.
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It is not clear whether these two factors differentially affect the age of onset of first depression. Therefore, we wished to investigate the relationship between age of first depression onset and hippocampal volume, with adjustment for subcortical white matter lesions. Methods: MRI brain scans were used to compare hippocampal volumes and white matter lesions between age matched female patients (&gt;60 years) with recurrent EOD and LOD and healthy controls. Results: When comparing the three groups and adjusting for age, the Mini-Mental State Examination score, total brain volume and total hippocampal volume were significantly smaller in patients with EOD compared with controls (5.6 vs 6.1 ml; p = 0.04). The prevalence of larger subcortical white matter lesions was higher in patients with LOD compared with patients with EOD (47% vs 8%; p = 0.002). Patients with LOD did not differ in hippocampal volume from patients with EOD or from controls. Conclusions: In late life depression, age of first depression onset may distinguish between different independent neuropathological mechanisms. A small hippocampus volume may be a neuranatomical marker of EOD depression and larger subcortical white matter lesions could be an intermediate between cerebrovascular disease and LOD.</description><identifier>ISSN: 0022-3050</identifier><identifier>EISSN: 1468-330X</identifier><identifier>DOI: 10.1136/jnnp.2006.098087</identifier><identifier>PMID: 17210630</identifier><identifier>CODEN: JNNPAU</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd</publisher><subject>Age ; Age of Onset ; Biological and medical sciences ; Brain Diseases - diagnosis ; Brain Diseases - epidemiology ; Brain Diseases - pathology ; Cerebral Cortex ; Depressive Disorder, Major - diagnosis ; Depressive Disorder, Major - epidemiology ; Depressive Disorder, Major - pathology ; Diabetes ; early onset depression ; EOD ; Female ; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy ; Hippocampus ; Humans ; Hypertension ; Independent sample ; late onset depression ; LOD ; Magnetic Resonance Imaging ; Medical sciences ; Mental depression ; Middle Aged ; Mini-Mental State Examination ; MMSE ; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. 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It is not clear whether these two factors differentially affect the age of onset of first depression. Therefore, we wished to investigate the relationship between age of first depression onset and hippocampal volume, with adjustment for subcortical white matter lesions. Methods: MRI brain scans were used to compare hippocampal volumes and white matter lesions between age matched female patients (&gt;60 years) with recurrent EOD and LOD and healthy controls. Results: When comparing the three groups and adjusting for age, the Mini-Mental State Examination score, total brain volume and total hippocampal volume were significantly smaller in patients with EOD compared with controls (5.6 vs 6.1 ml; p = 0.04). The prevalence of larger subcortical white matter lesions was higher in patients with LOD compared with patients with EOD (47% vs 8%; p = 0.002). Patients with LOD did not differ in hippocampal volume from patients with EOD or from controls. Conclusions: In late life depression, age of first depression onset may distinguish between different independent neuropathological mechanisms. A small hippocampus volume may be a neuranatomical marker of EOD depression and larger subcortical white matter lesions could be an intermediate between cerebrovascular disease and LOD.</description><subject>Age</subject><subject>Age of Onset</subject><subject>Biological and medical sciences</subject><subject>Brain Diseases - diagnosis</subject><subject>Brain Diseases - epidemiology</subject><subject>Brain Diseases - pathology</subject><subject>Cerebral Cortex</subject><subject>Depressive Disorder, Major - diagnosis</subject><subject>Depressive Disorder, Major - epidemiology</subject><subject>Depressive Disorder, Major - pathology</subject><subject>Diabetes</subject><subject>early onset depression</subject><subject>EOD</subject><subject>Female</subject><subject>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. 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It is not clear whether these two factors differentially affect the age of onset of first depression. Therefore, we wished to investigate the relationship between age of first depression onset and hippocampal volume, with adjustment for subcortical white matter lesions. Methods: MRI brain scans were used to compare hippocampal volumes and white matter lesions between age matched female patients (&gt;60 years) with recurrent EOD and LOD and healthy controls. Results: When comparing the three groups and adjusting for age, the Mini-Mental State Examination score, total brain volume and total hippocampal volume were significantly smaller in patients with EOD compared with controls (5.6 vs 6.1 ml; p = 0.04). The prevalence of larger subcortical white matter lesions was higher in patients with LOD compared with patients with EOD (47% vs 8%; p = 0.002). Patients with LOD did not differ in hippocampal volume from patients with EOD or from controls. Conclusions: In late life depression, age of first depression onset may distinguish between different independent neuropathological mechanisms. A small hippocampus volume may be a neuranatomical marker of EOD depression and larger subcortical white matter lesions could be an intermediate between cerebrovascular disease and LOD.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd</pub><pmid>17210630</pmid><doi>10.1136/jnnp.2006.098087</doi><tpages>3</tpages><oa>free_for_read</oa></addata></record>
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subjects Age
Age of Onset
Biological and medical sciences
Brain Diseases - diagnosis
Brain Diseases - epidemiology
Brain Diseases - pathology
Cerebral Cortex
Depressive Disorder, Major - diagnosis
Depressive Disorder, Major - epidemiology
Depressive Disorder, Major - pathology
Diabetes
early onset depression
EOD
Female
Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy
Hippocampus
Humans
Hypertension
Independent sample
late onset depression
LOD
Magnetic Resonance Imaging
Medical sciences
Mental depression
Middle Aged
Mini-Mental State Examination
MMSE
Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis
Nervous system (semeiology, syndromes)
Neurology
Organ Size
Recurrence
Short Report
Time Factors
Variance analysis
title Hippocampal volume and subcortical white matter lesions in late life depression: comparison of early and late onset depression
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