title: Brain MRI white matter hyperintensities and one-carbon cycle metabolism in non-geriatric outpatients with major depressive disorder (Part I).
abstract: The objective of the present work was to study the interrelationship between white matter hyperintensities (WMHs), cardiovascular risk factors and elements of the one-carbon cycle including serum folate, vitamin B12, and homocysteine levels in a relatively young sample of outpatients with major depressive disorder (MDD), and to compare the severity of white matter hyperintensities in MDD patients and healthy volunteers. Fifty MDD outpatients (34% women, age 40.6+/-10.3 years), free of psychotropic medications for at least 2 weeks before enrollment, underwent magnetic resonance imaging (MRI) scans of the brain to detect T2 WMHs and also had (1) serum folate, vitamin B12, homocysteine and cholesterol levels measured, and (2) cardiovascular risk factors assessed during the same study visit. Thirty-five healthy comparison subjects (40% women, age 39.2+/-9.8 years) also underwent brain MRI scans. Hypofolatemia, hypertension and age independently predicted a greater severity of total brain WMHs. Separately, the same factors also predicted a greater severity of subcortical WMHs. Hypofolatemic and hypertensive patients had more severe WMHs than normal controls. In light of the adverse impact of WMHs on a number of health-related outcomes later in life, hypofolatemia and hypertension may represent modifiable risk factors to prevent the occurrence of such adverse outcomes.
authors.affiliation: Massachusetts General Hospital, Department of Psychiatry, Depression Clinical and Research Program, Harvard Medical School, 15 Parkman Street, WACC 812, Boston, MA 02114, USA.
authors.forename: Dan V
authors.initials: DV
authors.lastname: Iosifescu
authors.forename: George I
authors.initials: GI
authors.lastname: Papakostas
authors.forename: In Kyoon
authors.initials: IK
authors.lastname: Lyoo
authors.forename: Ho Kyu
authors.initials: HK
authors.lastname: Lee
authors.forename: Perry F
authors.initials: PF
authors.lastname: Renshaw
authors.forename: Jonathan E
authors.initials: JE
authors.lastname: Alpert
authors.forename: Andrew
authors.initials: A
authors.lastname: Nierenberg
authors.forename: Maurizio
authors.initials: M
authors.lastname: Fava
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001921:Brain / Q000378:metabolism* / Q000473:pathology*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005492:Folic Acid / Q000097:blood / Q000378:metabolism*; D006710:Homocysteine / Q000097:blood / Q000378:metabolism*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D014805:Vitamin B 12 / Q000097:blood / Q000378:metabolism*
chemical_list: D006710:Homocysteine; D005492:Folic Acid; D014805:Vitamin B 12