Subcortical hyperintensities on magnetic resonance imaging: clinical correlates and prognostic significance in patients with severe depression.
In 39 hospital inpatients with severe primary depressive disorders, we evaluated the relationships between subcortical hyperintensities on magnetic resonance imaging (MRI) and clinical features, neuropsychological impairment and response to standard therapies. Both white matter and gray nuclei lesions were associated with older age and the absence of a family history of affective disorder. White matter hyperintensities were also associated with onset of first affective episode after the age of 50 years and impaired psychomotor speed. Most importantly, the severity of white matter hyperintensities predicted a poorer response to treatment (r = -0.44, p < .01). Negative correlations of the same order were detected in those (n = 20) who received electroconvulsive therapy (r = -0.42, p = .06) and those (n = 19) who received pharmacotherapy alone (r = -.49, p < .05). This study provides preliminary evidence supporting the clinical and prognostic significance of extensive white matter hyperintensities in patients with severe depression.
Hickie
I
I
Mood Disorders Unit, Prince Henry Hospital, Little Bay, Sydney, NSW, Australia.
Scott
E
E
Mitchell
P
P
Wilhelm
K
K
Austin
M P
MP
Bennett
B
B
D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use; D001479:Basal Ganglia / Q000473:pathology*; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics; D001925:Brain Damage, Chronic / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics; D002540:Cerebral Cortex / Q000473:pathology*; D003866:Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics; D004565:Electroconvulsive Therapy; D005260:Female; D006801:Humans; D008032:Limbic System / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019965:Neurocognitive Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics; D009483:Neuropsychological Tests; D010343:Patient Admission; D016896:Treatment Outcome
D000928:Antidepressive Agents