Brain white-matter hyperintensities and treatment outcome in major depressive disorder.
BACKGROUND
An increased incidence of brain white-matter hyperintensities has been described in major depressive disorder, butthe impact of such hyperintensities on treatment outcome is still controversial.


OBJECTIVE
To investigate the relationship of brain white-matter hyperintensities with cardiovascular risk factors and with treatment outcome in younger people with major depressive disorder.


METHODS
We assessed brain white-matter hyperintensities and cardiovascular risk factors in 84 people with major depressive disorder prior to initiating antidepressant treatment. We also assessed hyperintensities in 35 matched controls.


RESULTS
We found no significant difference in the prevalence of white-matter hyperintensities between the depression and the control groups. Left-hemisphere subcortical hyperintensities correlated with lower rates of treatment response. We found no correlation between global hyperintensity measures and clinical outcome. Brain white-matter hyperintensities correlated with hypertension and age and withtotal cardiovascular risk score.


CONCLUSIONS
Subcortical white-matter hyperintensities in the left hemisphere (but notin other brain areas) maybe associated with poor response to antidepressant treatment in major depression.
Iosifescu
Dan V
DV
Massachusetts General Hospital, 50 Staniford Street, suite 401, Boston, Massachusetts 02114, USA.
Renshaw
Perry F
PF
Lyoo
In Kyoon
IK
Lee
Ho Kyu
HK
Perlis
Roy H
RH
Papakostas
George I
GI
Nierenberg
Andrew A
AA
Fava
Maurizio
M
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D001921:Brain / Q000473:pathology*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000473:pathology; D003865:Major Depressive Disorder / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000928:Antidepressive Agents