title: Comparison of brain structural variables, neuropsychological factors, and treatment outcome in early-onset versus late-onset late-life depression.
abstract: OBJECTIVE
  To compare differences in gray matter volumes, white matter and subcortical gray matter hyperintensities, neuropsychological factors, and treatment outcome between early- and late-onset late-life depressed (LLD) subjects.
  
  
  METHODS
  We conducted a prospective, nonrandomized, controlled trial at the outpatient clinics at Washington University and Duke University on 126 subjects, aged 60 years or older, who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for major depression, scored 20 or more on the Montgomery-Asberg Depression Rating Scale (MADRS), and received neuropsychological testing and magnetic resonance imaging. Subjects were excluded for cognitive impairment or severe medical disorders. After 12 weeks of sertraline treatment, subjects' MADRS scores over time and neuropsychological factors were studied.
  
  
  RESULTS
  Left anterior cingulate thickness was significantly smaller in the late-onset depressed group than in the early-onset LLD subjects. The late-onset group also had more hyperintensities than the early-onset LLD subjects. No differences were found in neuropsychological factor scores or treatment outcome between early-onset and late-onset LLD subjects.
  
  
  CONCLUSIONS
  Age at onset of depressive symptoms in LLD subjects are associated with differences in cortical thickness and white matter and subcortical gray matter hyperintensities, but age at onset did not affect neuropsychological factors or treatment outcome.
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, St. Louis, MO.
authors.forename: Brianne M
authors.initials: BM
authors.lastname: Disabato
authors.affiliation: Department of Medicine, Washington University School of Medicine, St. Louis, MO.
authors.forename: Carrie
authors.initials: C
authors.lastname: Morris
authors.affiliation: Department of Medicine, Washington University School of Medicine, St. Louis, MO.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hranilovich
authors.affiliation: Division of Biostatistics, Washington University School of Medicine, St. Louis, MO.
authors.forename: Gina M
authors.initials: GM
authors.lastname: D'Angelo
authors.affiliation: Division of Biostatistics, Washington University School of Medicine, St. Louis, MO.
authors.forename: Gongfu
authors.initials: G
authors.lastname: Zhou
authors.affiliation: Division of Biostatistics, Washington University School of Medicine, St. Louis, MO.
authors.forename: Ningying
authors.initials: N
authors.lastname: Wu
authors.affiliation: Division of Biological Psychiatry, Duke University School of Medicine, Durham, NC.
authors.forename: P Murali
authors.initials: PM
authors.lastname: Doraiswamy
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, St. Louis, MO; Department of Radiology, Washington University School of Medicine, St. Louis, MO; Department of Neurology, Washington University School of Medicine, St. Louis, MO. Electronic address: yvette@npg.wustl.edu.
authors.forename: Yvette I
authors.initials: YI
authors.lastname: Sheline
mesh_terms: D017668:Age of Onset; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology*; D066128:Gray Matter / Q000473:pathology*; D006179:Gyrus Cinguli / Q000473:pathology*; D006801:Humans; D006984:Hypertrophy / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D059906:Neuroimaging; D009483:Neuropsychological Tests; D020280:Sertraline / Q000627:therapeutic use*; D016896:Treatment Outcome; D066127:White Matter / Q000473:pathology*
chemical_list: D000928:Antidepressive Agents; D020280:Sertraline
keywords: Late-life depression; age at onset; amygdala; antidepressant; cognitive deficit; hippocampus; neuropsychological factors; treatment outcome; vascular risk factors; white matter hyperintensities