title: Depressive symptoms, brain volumes and subclinical cerebrovascular disease in postmenopausal women: the Women's Health Initiative MRI Study.
abstract: OBJECTIVE
  Late-life depressive symptoms (DS) increase the risk of incident mild cognitive impairment and probable dementia in the elderly. Our objectives were to examine the relationship between elevated DS and regional brain volumes including frontal lobe subregions, hippocampus and amygdala, and to determine whether elevated DS were associated with increased subclinical cerebrovascular disease in postmenopausal women.
  
  
  METHODS
  DS were assessed an average of 8years prior to structural brain MRI in 1372 women. The 8-item Burnam regression algorithm was used to define DS with a cut-point of 0.009. Adjusting for potential confounders, mean differences in total brain, frontal lobe subregions, hippocampus and amygdala volumes and total ischemic lesion volumes in the basal ganglia and the cerebral white and gray matter outside the basal ganglia were compared between women with and without DS.
  
  
  RESULTS
  Depressed women had lower baseline global cognition and were more likely to have prior hormone therapy history. After full adjustment, DS at baseline were associated with smaller superior and middle frontal gyral volumes. Hippocampal and amygdala volumes, and ischemic lesion volumes were similar in depressed and non-depressed women.
  
  
  CONCLUSIONS
  Depression was not assessed based on semi-structured interview, and MRI scans were obtained cross-sectionally rather than longitudinally. Longitudinal MRI assessments will be necessary to define the temporal relationships between DS and frontal lobe volumes.
  
  
  CONCLUSIONS
  Elevated DS were associated with lower volumes in certain frontal lobe subregions but not in the medial temporal lobe structures. Our findings support the role of frontal lobe structures in late-life DS among women.
authors.affiliation: Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA. jgoveas@mcw.edu
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Goveas
authors.forename: Mark A
authors.initials: MA
authors.lastname: Espeland
authors.forename: Patricia
authors.initials: P
authors.lastname: Hogan
authors.forename: Vonetta
authors.initials: V
authors.lastname: Dotson
authors.forename: Sergey
authors.initials: S
authors.lastname: Tarima
authors.forename: Laura H
authors.initials: LH
authors.lastname: Coker
authors.forename: Judith
authors.initials: J
authors.lastname: Ockene
authors.forename: Robert
authors.initials: R
authors.lastname: Brunner
authors.forename: Nancy F
authors.initials: NF
authors.lastname: Woods
authors.forename: Sylvia
authors.initials: S
authors.lastname: Wassertheil-Smoller
authors.forename: Jane M
authors.initials: JM
authors.lastname: Kotchen
authors.forename: Susan
authors.initials: S
authors.lastname: Resnick
mesh_terms: D000368:Aged; D001921:Brain / Q000187:drug effects / Q000473:pathology*; D002545:Brain Ischemia / Q000175:diagnosis / Q000188:drug therapy; D003072:Cognition Disorders / Q000175:diagnosis* / Q000188:drug therapy*; D015140:Dementia, Vascular / Q000175:diagnosis* / Q000188:drug therapy*; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy*; D004292:Dominance, Cerebral / Q000502:physiology; D019263:Dysthymic Disorder / Q000175:diagnosis* / Q000188:drug therapy*; D015914:Estrogen Replacement Therapy; D005260:Female; D005625:Frontal Lobe / Q000187:drug effects / Q000473:pathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D002537:Intracranial Arteriosclerosis / Q000175:diagnosis* / Q000188:drug therapy*; D008279:Magnetic Resonance Imaging; D009929:Organ Size / Q000187:drug effects / Q000502:physiology; D017698:Postmenopause; D012307:Risk Factors