Neuroanatomical Characteristics of Geriatric Apathy and Depression: A Magnetic Resonance Imaging Study

Lavretsky, Helen; Ballmaier, Martina; Pham, Dániel; Toga, Arthur W.; Kumar, Anand

doi:10.1097/jgp.0b013e3180325a16

Cited by 128 publications

(110 citation statements)

References 62 publications

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“…Our study has several strengths, including a relatively large group of participants compared with other structural MRI analyses in late life depression, which typically have samples of 20-50 participants (Ballmaier et al, 2004;Lavretsky et al, 2007). This allowed us to control for agerelated structural changes of the gray matter.…”

Section: Discussionmentioning

confidence: 99%

Gray Matter Changes in Late Life Depression—a Structural MRI Analysis

Andreescu

Butters

Begley

et al. 2007

Neuropsychopharmacol

128

120

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Multiple brain morphometric changes have been reported in late-life depression (LLD), mostly in studies comparing volumes of circumscribed brain areas. The aim of our study is to characterize the volumetric changes of multiple gray matter regions in relation to age of onset/duration of illness. We predicted that the association of gray matter volumes with total duration of illness and age of onset would differ depending on whether the region was susceptible to the toxic effects of chronic exposure to cortisol or to the vascular/ neurodegenerative changes accompanying prodromal dementia. Seventy-one elderly depressed subjects were studied along with thirtytwo comparison subjects. High-resolution T1-weighted brain MRIs were processed using an automated labeling pathway technique. To protect against type-I error, we combined the right and left hemisphere volume data. We sampled 24 regions of interest (ROIs). We used the primary visual cortex volume to normalize for individual variations in brain size. LLD Subjects had smaller volumes than nondepressed subjects in 17 of the 24 examined ROIs. Shorter duration of illness and later age of onset was correlated with smaller volumes of parahippocampal area and parietal inferior area. A later age of onset was also correlated with smaller volumes of several frontal and temporal areas, cingulum, and putamen. Our findings support a dementia prodrome model more strongly than a toxic stress model in this group of subjects. However, it remains likely that both processes as well as other factors contribute to the heterogeneity of volumetric brain changes in LLD.

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Section: Discussionmentioning

confidence: 99%

Gray Matter Changes in Late Life Depression—a Structural MRI Analysis

Andreescu

Butters

Begley

et al. 2007

Neuropsychopharmacol

128

120

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“…Despite positive findings in other limbic regions in patients with MDD (eg, hippocampus; (Sheline et al, 1999)), the relation between treatment with antidepressants and ACC volume has not been systematically examined. While it is notable that in several studies reporting small ACC volumes, patients with MDD were free of medication for periods ranging between 2 and 4 weeks (Drevets et al, 1997;Lavretsky et al, 2007;Caetano et al, 2006;Ballmaier et al, 2004); it is unknown whether the withdrawal of antidepressants influenced the pattern of findings reported. Medication history is an important factor in studies of patients with MDD (Dickstein et al, 2005;Strasser et al, 2005;Frazier et al, 2005;Rajkowska, 2002) and our data further support the notion that even relatively short-term treatment may exert a measurable effect on the volumes of key brain regions.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to Bremner et al (2002) and Pizzagalli et al (2004), who found no differences in BA25 or in BA32 (Bremner et al, 2002) volume between MDD patients and healthy controls, Coryell et al (2005) subsequently reported a reduction in left subcallosal gyrus volume in patients with MDD relative to controls. Finally, a number of studies demonstrate smaller gray (Lavretsky et al, 2007;Caetano et al, 2006;Ballmaier et al, 2004) and white (Ballmaier et al, 2004) matter volume in 'total' and in ventral (Tang et al, 2007) ACC in patients with MDD relative to controls; however, the cingulate regions assayed in these studies varied widely. A small number of studies have relied upon voxel-based morphometry (Pizzagalli et al, 2004;Chen et al, 2007;Tang et al, 2007) as opposed to manual delineation, as is common across the majority of studies.…”

Section: Introductionmentioning

confidence: 99%

“…ACC volume in MDD has been further examined in relation to clinical and demographic variables, including age (Lavretsky et al, 2007), family history of illness (Drevets et al, 1997), treatment response (Coryell et al, 2005), and current mood state (Caetano et al, 2006). Patients included in these studies were heterogeneous with respect to illness history and medication status, however; rendering the conclusions of these reports equivocal.…”

Section: Introductionmentioning

confidence: 99%

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Anterior Cingulate Volumes in Never-Treated Patients with Major Depressive Disorder

Yücel

McKinnon

Chahal

et al. 2008

Neuropsychopharmacol

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The anterior cingulate cortex (ACC) is implicated in the cognitive and affective abnormalities observed in mood disorders. Bilateral ACC volume reductions have been reported in patients with major depressive disorder (MDD) when compared to healthy controls. We compared regional brain volumes in the subgenual prefrontal cortex (SGPFC; Brodmann area (BA) 24 sg ), subcallosal gyrus (BA25), and paracingulate gyrus (BA32) in 65 patients receiving a first course of treatment for MDD and 93 healthy control subjects. Patients with more than three episodes of untreated MDD had smaller subcallosal gyrus volumes than healthy controls, while those with three or fewer past untreated episodes did not differ from controls. We also found preliminary evidence that medication-exposed patients had smaller SGPFC volumes than patients with no exposure to medication and healthy controls. There was no evidence that these effects related to mood state, duration of untreated illness, or to patient age. No differences were apparent in paracingulate gyrus volumes between patients and controls. These findings confirm the presence of ACC volume reductions in untreated patients with MDD and suggest that illness burden and short-term medication exposure mediate this change.

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“…Nevertheless, existing studies suggest that the frontal and striatal areas are most robustly implicated in PD patients with symptoms of depression, anxiety or apathy. The frontostriatal pathway has been demonstrated to be the significant neural system affected by geriatric depression, anxiety and apathy 70, 71, 72. Arguably this pathway (Fig.…”

Section: Methodsmentioning

confidence: 99%

Depression, anxiety, and apathy in Parkinson's disease: insights from neuroimaging studies

Wen

Chan

Tan

et al. 2016

Euro J of Neurology

150

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Depression, anxiety and apathy are common mood disturbances in Parkinson's disease (PD) but their pathophysiology is unclear. Advanced neuroimaging has been increasingly used to unravel neural substrates linked to these disturbances. A systematic review is provided of neuroimaging findings in depression, anxiety and apathy in PD. A PubMed, MEDLINE and EMBASE search of peer‐reviewed original research articles on these mood disturbances in PD identified 38 studies on depression, eight on anxiety and 14 on apathy in PD. Most of the imaging studies used either position emission tomography or single‐photon emission computed tomography techniques. These studies generally suggest increased neural activity in the prefrontal regions and decreased functional connectivity between the prefrontal−limbic networks in depressed patients. Functional imaging studies revealed an inverse correlation between dopaminergic density in the caudate and putamen with the severity of anxiety in PD. There was no consistent correlation between dopaminergic density of thalamus and anxiety. Studies demonstrated both positive and inverse correlations between apathy and metabolism or activity in the striatum, amygdalar, prefrontal, temporal and parietal regions. The clinical variability of study subjects and differences in image pre‐processing and analytical strategies may contribute to discrepant findings in these studies. Both nigrostriatal and extra‐nigrostriatal pathways (in particular the frontal region and its connecting areas) are affected in mood disorders in PD. Identifying the relative contributions of these neural pathways in PD patients with overlapping motor and mood symptoms could provide new pathophysiological clues for the development of better therapeutic targets for affected patients.

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Neuroanatomical Characteristics of Geriatric Apathy and Depression: A Magnetic Resonance Imaging Study

Cited by 128 publications

References 62 publications

Gray Matter Changes in Late Life Depression—a Structural MRI Analysis

Gray Matter Changes in Late Life Depression—a Structural MRI Analysis

Anterior Cingulate Volumes in Never-Treated Patients with Major Depressive Disorder

Depression, anxiety, and apathy in Parkinson's disease: insights from neuroimaging studies

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