Anterior cingulate cortical volumes and treatment remission of geriatric depression.
BACKGROUND
Structural abnormalities of the anterior cingulate cortex (ACC) may interfere with the interaction of cortical and limbic networks involved in emotional regulation and contribute to chronic depressive syndromes in the elderly. This study examined the relationship of regional anterior cingulate cortical volumes with treatment remission of elderly depressed patients. We hypothesized that patients who failed to remit during a 12-week controlled treatment trial of escitalopram would exhibit smaller anterior cingulate gray matter volumes than patients who remitted.


METHODS
The participants were 41 non-demented individuals with non-psychotic major depression. After a 2-week single-blind placebo period, subjects who still had a Hamilton Depression Rating Scale (HDRS) of 18 or greater received escitalopram 10 mg daily for 12 weeks. Remission was defined as a HDRS score of 7 or below for at least 2 consecutive weeks. The patient sample consisted of 22 depressed patients who achieved remission during the study and 19 depressed patients who remained symptomatic. High-resolution magnetization-prepared rapidly acquired gradient echo (MPRAGE) sequences were acquired on a 1.5 T scanner and regional ACC volumes were manually outlined (dorsal, rostral, anterior subgenual, and posterior subgenual).


RESULTS
Repeated measure analyses revealed that patients who failed to remit following escitalopram treatment had smaller dorsal and rostral anterior cingulate gray matter volumes than patients who remitted, whereas subgenual cortical volumes did not differ between the groups.


CONCLUSIONS
Structural abnormalities of the dorsal and rostral anterior cingulate may perpetuate late-life depression.
Gunning
Faith M
FM
Weill Cornell Medical College, Weill Cornell Institute of Geriatric Psychiatry, White Plains, NY, USA. fgd2002@med.cornell.edu
Cheng
Janice
J
Murphy
Christopher F
CF
Kanellopoulos
Dora
D
Acuna
Jessica
J
Hoptman
Matthew J
MJ
Klimstra
Sibel
S
Morimoto
Shizuko
S
Weinberg
James
J
Alexopoulos
George S
GS
D000368:Aged; D000704:Analysis of Variance; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D015283:Citalopram / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000473:pathology*; D006179:Gyrus Cinguli / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009929:Organ Size; D012074:Remission Induction; D012307:Risk Factors; D016037:Single-Blind Method
D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram