Applications of magnetic resonance imaging for treatment-resistant late-life depression

Agudelo, Christian; Aizenstein, Howard J.; Jf, Karp; Cf, Reynolds

doi:10.31887/dcns.2015.17.2/cagudelo

Cited by 17 publications

(2 citation statements)

References 154 publications

(182 reference statements)

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“…Moreover, such a vascular etiology may explain the high recurrence and persistence rate of LLD, in addition to high treatment resistance to antidepressant and/or behavioral therapy [ 34 , 35 , 36 ]. Later, the term “MRI-defined VaD” was introduced [ 37 ], with a focus on the presence and severity of either white matter changes or subcortical gray matter lesions (lacunes, microbleeds), supporting the hypothesis that loss of brain volume, diminished white matter integrity, and lesions in the fronto–striatal–limbic regions are associated with depressive symptoms in the elderly [ 38 , 39 , 40 , 41 ], although this was not confirmed by others [ 42 , 43 , 44 , 45 , 46 ].…”

Section: The “Vascular Depression Hypothesis”mentioning

confidence: 99%

Pathomechanisms of Vascular Depression in Older Adults

Jellinger¹

2021

IJMS

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Depression in older individuals is a common complex mood disorder with high comorbidity of both psychiatric and physical diseases, associated with high disability, cognitive decline, and increased mortality The factors predicting the risk of late-life depression (LLD) are incompletely understood. The reciprocal relationship of depressive disorder and age- and disease-related processes has generated pathogenic hypotheses and provided various treatment options. The heterogeneity of depression complicates research into the underlying pathogenic cascade, and factors involved in LLD considerably differ from those involved in early life depression. Evidence suggests that a variety of vascular mechanisms, in particular cerebral small vessel disease, generalized microvascular, and endothelial dysfunction, as well as metabolic risk factors, including diabetes, and inflammation that may induce subcortical white and gray matter lesions by compromising fronto–limbic and other important neuronal networks, may contribute to the development of LLD. The “vascular depression” hypothesis postulates that cerebrovascular disease or vascular risk factors can predispose, precipitate, and perpetuate geriatric depression syndromes, based on their comorbidity with cerebrovascular lesions and the frequent development of depression after stroke. Vascular burden is associated with cognitive deficits and a specific form of LLD, vascular depression, which is marked by decreased white matter integrity, executive dysfunction, functional disability, and poorer response to antidepressive therapy than major depressive disorder without vascular risk factors. Other pathogenic factors of LLD, such as neurodegeneration or neuroimmune regulatory dysmechanisms, are briefly discussed. Treatment planning should consider a modest response of LLD to antidepressants, while vascular and metabolic factors may provide promising targets for its successful prevention and treatment. However, their effectiveness needs further investigation, and intervention studies are needed to assess which interventions are appropriate and effective in clinical practice.

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Section: The “Vascular Depression Hypothesis”mentioning

confidence: 99%

Pathomechanisms of Vascular Depression in Older Adults

Jellinger¹

2021

IJMS

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“…Selective serotonin reuptake inhibitor(SSRIS) are the first-line treatment for LLD, but approximately one-third of the LLD patients experience treatment resistance (Agudelo, Aizenstein, Karp, & Reynolds, 2015). Evidence has shown that the pharmacologic treatment response of LOD is worse than that of EOD (Naismith, Norrie, Mowszowski, & Hickie, 2012).…”

Section: Introductionmentioning

confidence: 99%

Increasing variance of rich-club nodes distribution in early onset depression according to dynamic network

Mai,

Wu,

Zhong

et al. 2024

Brain Imaging and Behavior

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Early onset depression(EOD) and late onset depression(LOD) are thought to have different pathogeneses, but lack of pathological evidence. In the current study we describe the dynamic rich-club properties of patients with EOD and LOD to address this question indirectly.We recruited 82 patients with late life depression (EOD 40, LOD 42) and 90 healthy controls. Memory, executive function and processing speed were measured, and resting-stage functional MRI was performed with all participants. We constructed a dynamic functional connectivity network and carried out rich-club and modularity analyses. Normalized mutual information(NMI) was applied to describe the variance in rich-club nodes distribution and partitioning. The NMI coefficient of rich club nodes distribution among the three groups was the lowest in the EOD patients (F = 4.298; P=0.0151, FDR=0.0231), which was positively correlated with rich-club connectivity (R = 0.886,P<0.001) and negatively correlated with memory(R = -0.347,P = 0.038) in the EOD group. In the LOD patients, non-rich-club connectivity was positively correlated with memory(R = 0.353,P = 0.030 and R = 0.420,P = 0.009). Furthermore, local connectivity was positively correlated with processing speed in the LOD patients (R = 0.374,P = 0.021). The modular partition was different between the EOD patients and the HCs(P=0.0013 < 0.05/3). The temporal instability of rich-club nodes was found in the EOD patients, but not the LOD patients, supporting the hypothesis that EOD and LOD result from different pathogenesis, and showing that the instability of the rich-club nodes across time might disrupt rich-club connectivity.

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Hirnstrukturelle und funktionelle Bildgebung

Wolf

2017

Altersdepression

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Applications of magnetic resonance imaging for treatment-resistant late-life depression

Cited by 17 publications

References 154 publications

Pathomechanisms of Vascular Depression in Older Adults

Pathomechanisms of Vascular Depression in Older Adults

Increasing variance of rich-club nodes distribution in early onset depression according to dynamic network

Hirnstrukturelle und funktionelle Bildgebung

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