title: Hippocampal volume and the course of depressive symptoms over eight years of follow-up.
abstract: OBJECTIVE
  To estimate the association between hippocampal and total brain volume and the course of depressive symptoms over eight years of follow-up in patients with a history of vascular disease.
  
  
  METHODS
  Within the SMART-Medea study, 636 participants (62 ± 10 years) had a 1.5-tesla brain MRI obtaining hippocampal and total brain volumes. Depressive symptoms were assessed with the Patient Health Questionnaire-9 biannually during eight-year follow-up. Generalized estimating equation models with robust standard errors were used to assess the associations of hippocampal and total brain volumes with depressive symptoms during follow-up adjusting for age, sex, education, and intracranial volume. An interaction term between volume and time (6-month intervals) was included to examine whether the course of depressive symptoms differed according to hippocampal and total brain volume.
  
  
  RESULTS
  The mean PHQ-9 score was 2.8 ± 3.5. Smaller hippocampal volumes were associated with an increasing course of depressive symptom levels, while larger volumes were associated with decreasing levels (P-value interaction = 0.07). Smaller total brain volume was associated with consistently higher levels of depressive symptoms, but not with change in course of depressive symptoms (P-value interaction = 0.45).
  
  
  CONCLUSIONS
  Smaller hippocampal volume but not total brain volume is associated with poorer course of depressive symptoms over eight years of follow-up.
authors: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors: J
authors: J
authors: Buddeke
authors: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.|Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
authors: M
authors: M
authors: Kooistra
authors: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors: N P A
authors: NP
authors: Zuithoff
authors: Department of Psychiatry, VU Medical Center Amsterdam, Amsterdam, The Netherlands.|Department of Medical Epidemiology and Biostatistics, Karolinska Institute Stockholm, Stockholm, Sweden.
authors: L
authors: L
authors: Gerritsen
authors: Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
authors: G J
authors: GJ
authors: Biessels
authors: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors: Y
authors: Y
authors: van der Graaf
authors: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors: M I
authors: MI
authors: Geerlings
mesh_terms: D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging; D003863:Depression / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D006624:Hippocampus / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging / Q000379:methods; D011569:Psychiatric Status Rating Scales
keywords: MRI; cardiovascular; depressive symptoms; epidemiology; hippocampus