One-year change in anterior cingulate cortex white matter microstructure: relationship with late-life depression outcomes.
OBJECTIVE
differences in white matter structure measured with diffusion tensor imaging (DTI) are associated with late-life depression, but results examining how these differences relate to antidepressant remission are mixed. To better describe these relationships, the authors examined how 1-year change in DTI measures are related to 1-year course of depression.


METHODS
one-year cross-sectional follow-up to a 12-week clinical trial of sertraline.


METHODS
outpatients at an academic medical center.


METHODS
twenty-nine depressed and 20 never-depressed elderly subjects. Over the 1-year period, 16 depressed subjects achieved and maintained remission, whereas 13 did not.


METHODS
one-year change in fractional anisotropy (FA) and diffusivity in frontal white matter, as measured by DTI.


RESULTS
contrary to our hypotheses, depressed subjects who did not remit over the study interval exhibited significantly less change in anterior cingulate cortex (ACC) white matter FA than did never-depressed or depressed-remitted subjects. There were no group differences in other frontal or central white matter regions. Moreover, there was a significant positive relationship between change in Montgomery-Asberg Depression Rating Scale (MADRS) and change in ACC FA, wherein greater interval decline in FA was associated with greater interval decline in MADRS.


CONCLUSIONS
older depressed individuals who remit exhibit white matter changes comparable with what is observed in never-depressed individuals, whereas nonremitters exhibit significantly less change in ACC FA. Such a finding may be related to either antidepressant effects on brain structure or the effects of chronic stress on brain structure. Further work is needed to better understand this relationship.
Taylor
Warren D
WD
Departments of Psychiatry, Duke University Medical Center, Durham, NC 27710, USA. taylo066@mc.duke.edu
Macfall
James R
JR
Boyd
Brian
B
Payne
Martha E
ME
Sheline
Yvette I
YI
Krishnan
Ranga R
RR
Murali Doraiswamy
P
P
D000368:Aged; D016880:Anisotropy; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001921:Brain / Q000473:pathology; D002986:Clinical Trials as Topic; D003863:Depression / Q000188:drug therapy* / Q000473:pathology*; D056324:Diffusion Tensor Imaging / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006179:Gyrus Cinguli / Q000473:pathology*; D006801:Humans; D008297:Male; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D011569:Psychiatric Status Rating Scales; D012074:Remission Induction; D020280:Sertraline / Q000627:therapeutic use*
D000928:Antidepressive Agents; D020280:Sertraline
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