Cerebral volume measurements and subcortical white matter lesions and short-term treatment response in late life depression

Int J Geriatr Psychiatry. 2007 May;22(5):468-74. doi: 10.1002/gps.1790.

Abstract

Background: Late life depression is associated with volumetric reductions of gray matter and increased prevalence of subcortical white matter lesions. Previous studies have shown a poorer treatment outcome in those with more severe structural brain abnormalities. In this study, quantitative and semi-quantitative magnetic resonance imaging (MRI) measures were studied in relation to response to a 12-week controlled antidepressant monotherapy trial.

Methods: MRI (1.5 T) brain scans of 42 elderly inpatients with major depression, of which 23 were non-responder to a controlled 12-week antidepressant monotherapy trial, were acquired. In addition, clinical outcome was assessed after a one year period. Measures were volumes of global cerebral and subcortical structures.

Results: After controlling for confounding, no differences were found between non-responders and responders after 12 weeks and after one year in volumes of cerebral gray and white matter, orbitofrontal cortex, hippocampus and white matter lesions.

Conclusions: Structural brain measures associated with late life depression may not be related to short-term treatment response.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Activities of Daily Living / psychology
  • Aged
  • Aged, 80 and over
  • Antidepressive Agents, Second-Generation / adverse effects
  • Antidepressive Agents, Second-Generation / therapeutic use*
  • Antidepressive Agents, Tricyclic / adverse effects
  • Antidepressive Agents, Tricyclic / therapeutic use*
  • Brain / pathology*
  • Cyclohexanols / adverse effects
  • Cyclohexanols / therapeutic use*
  • Depressive Disorder, Major / diagnosis*
  • Depressive Disorder, Major / drug therapy
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • Humans
  • Image Processing, Computer-Assisted*
  • Leukoaraiosis / diagnosis*
  • Leukoaraiosis / drug therapy
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Nerve Fibers, Myelinated / drug effects
  • Nerve Fibers, Myelinated / pathology
  • Nortriptyline / adverse effects
  • Nortriptyline / therapeutic use*
  • Venlafaxine Hydrochloride

Substances

  • Antidepressive Agents, Second-Generation
  • Antidepressive Agents, Tricyclic
  • Cyclohexanols
  • Venlafaxine Hydrochloride
  • Nortriptyline