Structural imaging in late-life depression: association with mood and cognitive responses to antidepressant treatment.
OBJECTIVE
Recent positron emission tomography studies of cerebral glucose metabolism have identified the functional neural circuitry associated with mood and cognitive responses to antidepressant treatment in late life depression (LLD). The structural alterations in these networks are not well understood. The present study used magnetic resonance (MR) imaging and voxel-based morphometry to evaluate the association between gray matter volumes and changes in mood symptoms and cognitive function with treatment with the antidepressant citalopram.


METHODS
Open-label trial with baseline brain MR scan. Mood and cognitive assessments performed at baseline and during citalopram treatment.


METHODS
Outpatient clinics of an academic medical center.


METHODS
17 previously unmedicated patients age 55 years or older with a major depressive episode and 17 non-depressed comparison subjects.


METHODS
12-week trial of flexibly dosed citalopram.


METHODS
Gray matter volumes, Hamilton Depression Rating Scale, California Verbal Learning Test, Delis-Kaplan Executive Function System.


RESULTS
In LLD, higher gray matter volumes in the cingulate gyrus, superior and middle frontal gyri, middle temporal gyrus, and precuneus was associated with greater mood improvement. Higher gray matter volumes in primarily frontal areas were associated with greater improvement in verbal memory and verbal fluency performance.


CONCLUSIONS
Associations with antidepressant induced improvements in mood and cognition were observed in several brain regions previously correlated with normalization of glucose metabolism after citalopram treatment in LLD. Future studies will investigate molecular mechanisms underlying these associations (e.g., beta-amyloid, inflammation, glutamate).
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: cmarano1@jhmi.edu.
Christopher M
CM
Marano
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.
Clifford I
CI
Workman
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.
Christopher H
CH
Lyman
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.
Cynthia A
CA
Munro
Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD.
Michael A
MA
Kraut
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.
Gwenn S
GS
Smith
D000339:Affect / Q000187:drug effects*; D000368:Aged; D018687:Antidepressive Agents, Second-Generation / Q000008:administration & dosage / Q000494:pharmacology*; D002540:Cerebral Cortex / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D015283:Citalopram / Q000008:administration & dosage / Q000494:pharmacology*; D003072:Cognition Disorders / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D003865:Major Depressive Disorder / Q000150:complications / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D066128:Gray Matter / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram
Late-life depression; citalopram; cognition; magnetic resonance imaging; voxel-based morphometry