title: Treatment course with antidepressant therapy in late-life depression.
abstract: OBJECTIVE
  In order to assess the effect of gray matter volumes and cortical thickness on antidepressant treatment response in late-life depression, the authors examined the relationship between brain regions identified a priori and Montgomery-Åsberg Depression Rating Scale (MADRS) scores over the course of an antidepressant treatment trial.
  
  
  METHODS
  In a nonrandomized prospective trial, 168 patients who were at least 60 years of age and met DSM-IV criteria for major depression underwent MRI and were enrolled in a 12-week treatment study. Exclusion criteria included cognitive impairment or severe medical disorders. The volumes or cortical thicknesses of regions of interest that differed between the depressed group and a comparison group (N=50) were determined. These regions of interest were used in analyses of the depressed group to predict antidepressant treatment outcome. Mixed-model analyses adjusting for age, education, age at depression onset, race, baseline MADRS score, scanner, and interaction with time examined predictors of MADRS scores over time.
  
  
  RESULTS
  Smaller hippocampal volumes predicted a slower response to treatment. With the inclusion of white matter hyper-intensity severity and neuropsychological factor scores, the best model included hippocampal volume and cognitive processing speed to predict rate of response over time. A secondary analysis showed that hippocampal volume and frontal pole thickness differed between patients who achieved remission and those who did not.
  
  
  CONCLUSIONS
  These data expand our understanding of the prediction of treatment course in late-life depression. The authors propose that the primary variables of hippocampal volume and cognitive processing speed, subsuming other contributing variables (episodic memory, executive function, language processing) predict antidepressant response.
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA. yvette@npg.wustl.edu
authors.forename: Yvette I
authors.initials: YI
authors.lastname: Sheline
authors.forename: Brianne M
authors.initials: BM
authors.lastname: Disabato
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hranilovich
authors.forename: Carrie
authors.initials: C
authors.lastname: Morris
authors.forename: Gina
authors.initials: G
authors.lastname: D'Angelo
authors.forename: Carl
authors.initials: C
authors.lastname: Pieper
authors.forename: Tommaso
authors.initials: T
authors.lastname: Toffanin
authors.forename: Warren D
authors.initials: WD
authors.lastname: Taylor
authors.forename: James R
authors.initials: JR
authors.lastname: MacFall
authors.forename: Consuelo
authors.initials: C
authors.lastname: Wilkins
authors.forename: Deanna M
authors.initials: DM
authors.lastname: Barch
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Welsh-Bohmer
authors.forename: David C
authors.initials: DC
authors.lastname: Steffens
authors.forename: Ranga R
authors.initials: RR
authors.lastname: Krishnan
authors.forename: P Murali
authors.initials: PM
authors.lastname: Doraiswamy
mesh_terms: D000368:Aged; D000679:Amygdala / Q000187:drug effects / Q000473:pathology; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001921:Brain / Q000187:drug effects* / Q000473:pathology; D002421:Caudate Nucleus / Q000187:drug effects / Q000473:pathology; D002540:Cerebral Cortex / Q000187:drug effects* / Q000473:pathology; D003072:Cognition Disorders / Q000188:drug therapy / Q000473:pathology; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D005625:Frontal Lobe / Q000187:drug effects / Q000473:pathology; D006624:Hippocampus / Q000187:drug effects / Q000473:pathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009434:Neural Pathways / Q000187:drug effects / Q000473:pathology; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D009929:Organ Size / Q000187:drug effects; D020534:Parahippocampal Gyrus / Q000187:drug effects / Q000473:pathology; D010555:Personality Inventory / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011594:Psychometrics; D011930:Reaction Time / Q000187:drug effects; D020280:Sertraline / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D020280:Sertraline