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
Hauptverfasser: Khalaf, Alexander, Edelman, Kathryn, Tudorascu, Dana, Andreescu, Carmen, Reynolds, Charles F, Aizenstein, Howard
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container_issue 13
container_start_page 3027
container_title Neuropsychopharmacology (New York, N.Y.)
container_volume 40
creator Khalaf, Alexander
Edelman, Kathryn
Tudorascu, Dana
Andreescu, Carmen
Reynolds, Charles F
Aizenstein, Howard
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.
doi_str_mv 10.1038/npp.2015.158
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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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