White Matter Hyperintensity Accumulation During Treatment of Late-Life Depression
White matter hyperintensities (WMHs) have been shown to be associated with the development of late-life depression (LLD) and eventual treatment outcomes. This study sought to investigate longitudinal WMH changes in patients with LLD during a 12-week antidepressant treatment course. Forty-seven depre...
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Veröffentlicht in: | Neuropsychopharmacology (New York, N.Y.) N.Y.), 2015-12, Vol.40 (13), p.3027-3035 |
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description | White matter hyperintensities (WMHs) have been shown to be associated with the development of late-life depression (LLD) and eventual treatment outcomes. This study sought to investigate longitudinal WMH changes in patients with LLD during a 12-week antidepressant treatment course. Forty-seven depressed elderly patients were included in this analysis. All depressed subjects started pharmacological treatment for depression shortly after a baseline magnetic resonance imaging (MRI) scan. At 12 weeks, patients underwent a follow-up MRI scan, and were categorized as either treatment remitters (n=23) or non-remitters (n=24). Among all patients, there was as a significant increase in WMHs over 12 weeks (t(46)=2.36, P=0.02). When patients were stratified by remission status, non-remitters demonstrated a significant increase in WMHs (t(23)=2.17, P=0.04), but this was not observed in remitters (t(22)=1.09, P=0.29). Other markers of brain integrity were also investigated including whole brain gray matter volume, hippocampal volume, and fractional anisotropy. No significant differences were observed in any of these markers during treatment, including when patients were stratified based on remission status. These results add to existing literature showing the association between WMH accumulation and LLD treatment outcomes. Moreover, this is the first study to demonstrate similar findings over a short interval (ie 12 weeks), which corresponds to the typical length of an antidepressant trial. These findings serve to highlight the acute interplay of cerebrovascular ischemic disease and LLD. |
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This study sought to investigate longitudinal WMH changes in patients with LLD during a 12-week antidepressant treatment course. Forty-seven depressed elderly patients were included in this analysis. All depressed subjects started pharmacological treatment for depression shortly after a baseline magnetic resonance imaging (MRI) scan. At 12 weeks, patients underwent a follow-up MRI scan, and were categorized as either treatment remitters (n=23) or non-remitters (n=24). Among all patients, there was as a significant increase in WMHs over 12 weeks (t(46)=2.36, P=0.02). When patients were stratified by remission status, non-remitters demonstrated a significant increase in WMHs (t(23)=2.17, P=0.04), but this was not observed in remitters (t(22)=1.09, P=0.29). Other markers of brain integrity were also investigated including whole brain gray matter volume, hippocampal volume, and fractional anisotropy. No significant differences were observed in any of these markers during treatment, including when patients were stratified based on remission status. These results add to existing literature showing the association between WMH accumulation and LLD treatment outcomes. Moreover, this is the first study to demonstrate similar findings over a short interval (ie 12 weeks), which corresponds to the typical length of an antidepressant trial. These findings serve to highlight the acute interplay of cerebrovascular ischemic disease and LLD.</description><identifier>ISSN: 0893-133X</identifier><identifier>EISSN: 1740-634X</identifier><identifier>DOI: 10.1038/npp.2015.158</identifier><identifier>PMID: 26058663</identifier><identifier>CODEN: NEROEW</identifier><language>eng</language><publisher>England: Nature Publishing Group</publisher><subject>Age of Onset ; Aged ; Anisotropy ; Antidepressants ; Antidepressive Agents - therapeutic use ; Brain - pathology ; Brain research ; Clinical outcomes ; Depressive Disorder - drug therapy ; Depressive Disorder - pathology ; Female ; Follow-Up Studies ; Gray Matter - pathology ; Humans ; Hypotheses ; Ischemia ; Longitudinal Studies ; Magnetic Resonance Imaging ; Male ; Mental depression ; Older people ; Organ Size ; Original ; Remission (Medicine) ; Treatment Outcome ; White Matter - pathology</subject><ispartof>Neuropsychopharmacology (New York, N.Y.), 2015-12, Vol.40 (13), p.3027-3035</ispartof><rights>Copyright Nature Publishing Group Dec 2015</rights><rights>Copyright © 2015 American College of Neuropsychopharmacology 2015 American College of Neuropsychopharmacology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c515t-13b785675eba22cb3edbaa6c673073f97984de069d84d36b855705e4bef85be93</citedby><cites>FETCH-LOGICAL-c515t-13b785675eba22cb3edbaa6c673073f97984de069d84d36b855705e4bef85be93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4864637/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4864637/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26058663$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Khalaf, Alexander</creatorcontrib><creatorcontrib>Edelman, Kathryn</creatorcontrib><creatorcontrib>Tudorascu, Dana</creatorcontrib><creatorcontrib>Andreescu, Carmen</creatorcontrib><creatorcontrib>Reynolds, Charles F</creatorcontrib><creatorcontrib>Aizenstein, Howard</creatorcontrib><title>White Matter Hyperintensity Accumulation During Treatment of Late-Life Depression</title><title>Neuropsychopharmacology (New York, N.Y.)</title><addtitle>Neuropsychopharmacology</addtitle><description>White matter hyperintensities (WMHs) have been shown to be associated with the development of late-life depression (LLD) and eventual treatment outcomes. This study sought to investigate longitudinal WMH changes in patients with LLD during a 12-week antidepressant treatment course. Forty-seven depressed elderly patients were included in this analysis. All depressed subjects started pharmacological treatment for depression shortly after a baseline magnetic resonance imaging (MRI) scan. At 12 weeks, patients underwent a follow-up MRI scan, and were categorized as either treatment remitters (n=23) or non-remitters (n=24). Among all patients, there was as a significant increase in WMHs over 12 weeks (t(46)=2.36, P=0.02). When patients were stratified by remission status, non-remitters demonstrated a significant increase in WMHs (t(23)=2.17, P=0.04), but this was not observed in remitters (t(22)=1.09, P=0.29). Other markers of brain integrity were also investigated including whole brain gray matter volume, hippocampal volume, and fractional anisotropy. No significant differences were observed in any of these markers during treatment, including when patients were stratified based on remission status. These results add to existing literature showing the association between WMH accumulation and LLD treatment outcomes. Moreover, this is the first study to demonstrate similar findings over a short interval (ie 12 weeks), which corresponds to the typical length of an antidepressant trial. These findings serve to highlight the acute interplay of cerebrovascular ischemic disease and LLD.</description><subject>Age of Onset</subject><subject>Aged</subject><subject>Anisotropy</subject><subject>Antidepressants</subject><subject>Antidepressive Agents - therapeutic use</subject><subject>Brain - pathology</subject><subject>Brain research</subject><subject>Clinical outcomes</subject><subject>Depressive Disorder - drug therapy</subject><subject>Depressive Disorder - pathology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gray Matter - pathology</subject><subject>Humans</subject><subject>Hypotheses</subject><subject>Ischemia</subject><subject>Longitudinal Studies</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Mental depression</subject><subject>Older people</subject><subject>Organ Size</subject><subject>Original</subject><subject>Remission (Medicine)</subject><subject>Treatment Outcome</subject><subject>White Matter - pathology</subject><issn>0893-133X</issn><issn>1740-634X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkUtLAzEURoMoWh871zLgxoVTk8nkMRuhtL6gIkJFdyEzvVMj8zLJCP33plSLunJ1F_fw8d17EDomeEgwlRdN1w0TTNiQMLmFBkSkOOY0fdlGAywzGhNKX_bQvnNvOFCCy120l3DMJOd0gB6fX42H6F57Dza6XXZgTeOhccYvo1FR9HVfaW_aJpr0YbOIZha0r6HxUVtGU-0hnpoSogl0FpwL4CHaKXXl4OhrHqCn66vZ-DaePtzcjUfTuGCE-VArF5JxwSDXSVLkFOa51rzggmJBy0xkMp0D5tk8TMpzyZjADNIcSslyyOgBulzndn1ew7wIlayuVGdNre1Stdqo35vGvKpF-6FSyVNORQg4-wqw7XsPzqvauAKqSjfQ9k4RwVkmpcj-g9Ik1OZCBvT0D_rW9rYJn1hRRGQsFUmgztdUYVvnLJSb3gSrlVYVtKqVVhW0Bvzk560b-Nsj_QSXO57L</recordid><startdate>20151201</startdate><enddate>20151201</enddate><creator>Khalaf, Alexander</creator><creator>Edelman, Kathryn</creator><creator>Tudorascu, Dana</creator><creator>Andreescu, Carmen</creator><creator>Reynolds, Charles F</creator><creator>Aizenstein, Howard</creator><general>Nature Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8AO</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20151201</creationdate><title>White Matter Hyperintensity Accumulation During Treatment of Late-Life Depression</title><author>Khalaf, Alexander ; 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This study sought to investigate longitudinal WMH changes in patients with LLD during a 12-week antidepressant treatment course. Forty-seven depressed elderly patients were included in this analysis. All depressed subjects started pharmacological treatment for depression shortly after a baseline magnetic resonance imaging (MRI) scan. At 12 weeks, patients underwent a follow-up MRI scan, and were categorized as either treatment remitters (n=23) or non-remitters (n=24). Among all patients, there was as a significant increase in WMHs over 12 weeks (t(46)=2.36, P=0.02). When patients were stratified by remission status, non-remitters demonstrated a significant increase in WMHs (t(23)=2.17, P=0.04), but this was not observed in remitters (t(22)=1.09, P=0.29). Other markers of brain integrity were also investigated including whole brain gray matter volume, hippocampal volume, and fractional anisotropy. No significant differences were observed in any of these markers during treatment, including when patients were stratified based on remission status. These results add to existing literature showing the association between WMH accumulation and LLD treatment outcomes. Moreover, this is the first study to demonstrate similar findings over a short interval (ie 12 weeks), which corresponds to the typical length of an antidepressant trial. These findings serve to highlight the acute interplay of cerebrovascular ischemic disease and LLD.</abstract><cop>England</cop><pub>Nature Publishing Group</pub><pmid>26058663</pmid><doi>10.1038/npp.2015.158</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Age of Onset Aged Anisotropy Antidepressants Antidepressive Agents - therapeutic use Brain - pathology Brain research Clinical outcomes Depressive Disorder - drug therapy Depressive Disorder - pathology Female Follow-Up Studies Gray Matter - pathology Humans Hypotheses Ischemia Longitudinal Studies Magnetic Resonance Imaging Male Mental depression Older people Organ Size Original Remission (Medicine) Treatment Outcome White Matter - pathology |
title | White Matter Hyperintensity Accumulation During Treatment of Late-Life Depression |
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