期刊
JOURNAL OF AFFECTIVE DISORDERS
卷 126, 期 3, 页码 395-401出版社
ELSEVIER
DOI: 10.1016/j.jad.2010.04.004
关键词
Geriatric depression; White matter; MRI; Hyperintensities; Treatment response
资金
- National Institute of Mental Health [P30 MH68638, RO1 MH65653, T32 MH19132, K23 MH074818]
- Sanchez Foundation
- TRU Foundation
- Forest Pharmaceuticals
- Forest Pharmaceuticals, Inc.
- Cephalon
- Forest
- Sanofi-Aventis
- Novartis
- Lilly
- Bristol Meyers Squibb
- Glaxo-Smith Kline
- Pfizer
- Janssen
- ePharmaSolutions
- ProPhase Training Group
- University of Toronto
- Eisai Medical Research Inc.
- Educational Testing and Assessment Systems (ETAS)
Background: White matter abnormalities may interfere with limbic-cortical balance and contribute to chronic depressive syndromes in the elderly. This study sought to clarify the relationship of SH to treatment response. We hypothesized that patients who failed to remit during a 12-week controlled treatment trial of escitalopram would exhibit greater SH burden than patients who remitted. Methods: The participants were 42 non-demented individuals with non-psychotic major depression and 25 elderly comparison subjects. After a 2-week single blind placebo period, subjects who still had a Hamilton Depression Rating Scale (HDRS) of 18 or greater received escitalopram 10 mg daily for 12 weeks. Remission was defined as a HDRS score of 7 or below for 2 consecutive weeks. FLAIR sequences were acquired on a 1.5 T scanner and total SH were quantified using a semi-automated thresholding method. Results: The patient sample consisted of 22 depressed patients who achieved remission during the study and 20 depressed patients who remained symptomatic. ANCOVA, with age and gender as covariates, revealed that depressed subjects had greater total SH burden relative to non-depressed controls. Furthermore, patients who failed to remit following escitalopram treatment had significantly greater SH burden than both patients who remitted and elderly comparison subjects, whereas SH burden did not differ between depressed patients who remitted and elderly comparison subjects. Limitations: Patients were treated with a fixed dose of antidepressants and the index of SH is an overall measure that does not permit examination of the relationship of regional SH to treatment remission. Discussion: SH may contribute to a disconnection state both conferring vulnerability to and perpetuating late-life depression. (C) 2010 Elsevier B.V. All rights reserved.
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