Structural brain changes as biomarkers and outcome predictors in patients with late-life depression: a cross-sectional and prospective study.
The relationship between structural changes in grey matter and treatment response in patients with late-life depression remains an intriguing area of research. This magnetic resonance imaging (MRI) study compares the baseline grey matter volume of elderly people with and without major depression (according to the DSM-IV-TR criteria) and assesses its association with antidepressant treatment response. Brain MRI scans were processed using statistical parametric mapping and voxel-based morphometry. The sample consisted of 30 patients with depression and 22 healthy controls. We found a significant volumetric reduction in the orbitofrontal cortex bilaterally in patients in comparison with controls. According to their remission status after antidepressant treatment, patients were classified as remitted or not remitted. Compared with controls, remitted patients showed a volumetric reduction in the orbitofrontal cortex bilaterally and in another cluster in the right middle temporal pole. Non-remitted patients showed an even greater volumetric reduction in the orbitofrontal cortex bilaterally compared with controls. To investigate predictive factors of remission after antidepressant treatment, we used a logistic regression. Both baseline Mini Mental State Examination score and baseline left superior lateral orbitofrontal cortex volume (standardized to the total grey matter volume) were associated with remission status. Our findings support the use of regional brain atrophy as a potential biomarker for depression. In addition, baseline cognitive impairment and regional grey matter abnormalities predict antidepressant response in patients with late-life depression.
Old Age Research Group (PROTER), Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil.
Salma R I
SR
Ribeiz
Fabio
F
Duran
Melaine C
MC
Oliveira
Diana
D
Bezerra
Claudio Campi
CC
Castro
David C
DC
Steffens
Geraldo
G
Busatto Filho
Cássio M C
CM
Bottino
D017668:Age of Onset; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000032:analysis; D001921:Brain / Q000187:drug effects / Q000473:pathology* / Q000503:physiopathology; D001931:Brain Mapping; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D000928:Antidepressive Agents; D015415:Biomarkers