title: Hippocampus atrophy and the longitudinal course of late-life depression.
abstract: OBJECTIVE
  Smaller hippocampal volumes are observed in depression but it remains unclear how antidepressant response and persistent depression relate to changes in hippocampal volume. We examined the longitudinal relationship between hippocampal atrophy and course of late-life depression.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  Depressed and never-depressed cognitively intact subjects age 60 years or older.
  
  
  METHODS
  Depression severity was measured every three months with the Montgomery-Asberg Depression Rating Scale (MADRS). Participants also completed cranial 1.5-T magnetic resonance imaging every 2 years. We compared 2-year change in hippocampal volume based on remission status, then in expanded analyses examined how hippocampal volumes predicted MADRS score.
  
  
  RESULTS
  In analyses of 92 depressed and 70 never-depressed subjects, over 2 years the cohort whose depression never remitted exhibited greater hippocampal atrophy than the never-depressed cohort. In expanded analyses of a broader sample of 152 depressed elders, depression severity was significantly predicted by a hippocampus × time interaction where smaller hippocampus volumes over time were associated with greater depression severity.
  
  
  CONCLUSIONS
  Hippocampal atrophy is associated with greater and persistent depression severity. Neuropathological studies are needed to determine if this atrophy is related to the toxic effects of persistent depression or related to underlying Alzheimer disease.
authors.affiliation: Department of Psychiatry, Vanderbilt University Medical Center, Nashville, TN. Electronic address: warren.d.taylor@vanderbilt.edu.
authors.forename: Warren D
authors.initials: WD
authors.lastname: Taylor
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC.
authors.forename: Douglas R
authors.initials: DR
authors.lastname: McQuoid
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC.
authors.forename: Martha E
authors.initials: ME
authors.lastname: Payne
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC.
authors.forename: Anthony S
authors.initials: AS
authors.lastname: Zannas
authors.affiliation: Department of Radiology, Duke University Medical Center, Durham, NC.
authors.forename: James R
authors.initials: JR
authors.lastname: MacFall
authors.affiliation: Department of Psychiatry, University of Connecticut Health Center, Farmington, CT.
authors.forename: David C
authors.initials: DC
authors.lastname: Steffens
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use; D001284:Atrophy / Q000473:pathology; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012074:Remission Induction; D012720:Severity of Illness Index
chemical_list: D000928:Antidepressive Agents
keywords: Geriatrics; MRI; depression; hippocampus; longitudinal; neuroimaging