Cingulum bundle white matter lesions influence antidepressant response in late-life depression: A pilot study

JOURNAL OF AFFECTIVE DISORDERS

卷:162

Article

Taylor, Warren D.¹  Kudra, Kami¹  Zhao, Zheen²  Steffens, David C.³  MacFall, James R.² 

[1] Vanderbilt Univ, Dept Psychiat, Med Ctr, Ctr Cognit Med, Nashville, TN 37212 USA

[2] Duke Univ, Dept Radiol, Neuropsychiat Imaging Res Lab, Med Ctr, Durham, NC 27710 USA

[3] Univ Connecticut, Dept Psychiat, Ctr Hlth, Farmington, CT 06030 USA

关键词: Geriatrics;    Depression;    Hyperintense lesions;    Vascular disease;    MRI;    Treatment response;   

DOI  :  10.1016/j.jad.2014.03.031

来源: Elsevier

【 摘 要 】

Background: Late-life depression is associated with white matter hyperintense lesions (WMLs) occurring in specific fiber tracts. In this study, we sought to determine if greater WML severity in the cingulum bundle or uncinate fasciculus was associated with poor short-term antidepressant response. Methods: Eleven depressed elders completed a baseline cranial 3T MRI and received antidepressant treatment following a medication algorithm. MRIs were analyzed to measure the fraction of each fiber tract's volume occupied by WMLs. Statistical analyses examined the effect of dichotomized fiber tract WML severity on three- and six-month depression severity after controlling for age and baseline depression severity. Results: Greater WML severity in the left hemispheric cingulum bundle adjacent to the hippocampus was associated with greater post-treatment depression severity at three- (F-1,F-7=6.42, p =0.0390) and six-month assessments (F-1,F-5 =9.62, p=0.0268). Other fiber tract WML measures were not significantly associated with outcomes. Limitations: The study had a small sample size and analyses were limited to only a priori fiber tracts. Conclusions: This pilot study supports the hypothesis that focal damage to the cingulum bundle may contribute to poor short-term antidepressant response. These findings warrant further investigation with a larger, more definitive study. (C) 2014 Elsevier B.V. All rights reserved.

【 授权许可】

Free