Blood pressure and white matter integrity in geriatric depression.
BACKGROUND
Cerebrovascular disease may increase vulnerability to geriatric depression, a syndrome often accompanied by frontal-subcortical lesions. High blood pressure is a risk factor for cerebrovascular disease and white matter changes. This study examined whether and in which brain regions blood pressure is associated with compromised white matter integrity in elderly depressed patients.


METHODS
We studied the association between blood pressure and white matter integrity assessed by diffusion tensor imaging (fractional anisotropy, FA) in 41 older patients with major depression. Correlations between FA and blood pressure, after controlling for age, were examined with a voxelwise analysis.


RESULTS
Significant associations between FA and blood pressure were detected throughout the anterior cingulate and in multiple frontostriatal and frontotemporal regions.


CONCLUSIONS
This study did not employ a healthy control group. Moreover, the relatively small sample size precluded a comparison of patients with and without hypertension.


CONCLUSIONS
Compromised frontal-striatal white matter integrity may be the anatomical background through which blood pressure confers vulnerability to depression.
Hoptman
Matthew J
MJ
Division of Clinical Research, Nathan Kline Institute, United States. hoptman@nki.rfmh.org
Gunning-Dixon
Faith M
FM
Murphy
Christopher F
CF
Ardekani
Babak A
BA
Hrabe
Jan
J
Lim
Kelvin O
KO
Etwaroo
Glenda R
GR
Kanellopoulos
Dora
D
Alexopoulos
George S
GS
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology*; D001921:Brain / Q000473:pathology*; D015283:Citalopram / Q000627:therapeutic use; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging; D004292:Dominance, Cerebral / Q000502:physiology; D005260:Female; D005625:Frontal Lobe / Q000473:pathology; D006179:Gyrus Cinguli / Q000473:pathology; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000473:pathology; D007091:Image Processing, Computer-Assisted; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D010555:Personality Inventory; D012016:Reference Values; D012307:Risk Factors; D013702:Temporal Lobe / Q000473:pathology
D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram