Signal Hyperintensities on Brain Magnetic Resonance Imaging in Elderly Depressed Patients

Abstract

In a retrospective brain magnetic resonance imaging study, we evaluated the prevalence and severity of signal hyperintensities in 30 elderly depressed patients and 30 controls matched for age, sex and cerebrovascular risk factors. A semiquantitative scoring method was used to grade findings in T2-weighted and proton density images. The elderly depressed patients had more extended periventricular hyperintensities, especially in the frontal region (depressed vs. control, 87 vs. 57%, p < 0.05), pons (33 vs. 7%, p < 0.05) as well as hyperintensities in the putamen and globus pallidus (57 vs. 27%, p < 0.05). The third ventricle was more dilated in depressed patients than controls after adjustment for age and cerebrovascular risk factors. The global index for ventricular enlargement was correlated significantly (r = 0.36, p < 0.05) with the severity of the hyperintensity in depressed patients. Our results indicate that these hyperintensities, especially in the frontal region, pons and lenticular nuclei, and the dilatation of the third ventricle play an important role, through the frontal-subcortical circuits, in mood regulation of elderly depressed patients.

Cerebrovascular disease and late life depression: an age old association revisited

“…A similar ®nding of an increased prevalence of WMHI (Iadaka et al, 1996) and subcortical periventricular hyperintensities (Figiel et al, 1991;Salloway et al, 1996) in late-onset cases has emerged.…”

Relationship between periventricular and deep white matter lesions and depressive symptoms in older people. The LADIS Study

“…While some authors have found a correlation between depression and DWML (O'Brien et al, 1996;de Groot et al, 2000;Nebes et al, 2001) others have found a stronger relationship between depression and PVL (Iidaka et al, 1996;Baldwin and O'Brien, 2002), and Jorm et al (2005) found a relationship with both frontoparietal (deep) and periventricular white matter lesions. Other authors have questioned whether there is a real distinction between PVL and DWML (DeCarli et al, 2005).…”

“…The authors found stronger associations between depression and deep rather than periventricular white matter lesions. (de Groot et al, 2000) However, in a community sample aged between 60-64, Jorm and colleagues (2005) found evidence of an association with both frontoparietal (deep) and periventricular white matter lesions and depression, while others have found stronger associations between depression and PVL (Iidaka et al, 1996, Baldwin, 2004.…”

Structural Neuroimaging Studies in Major Depressive Disorder

“…The reported effect sizes in this meta-analysis were smaller than those in 2 earlier meta-analyses 16,187 of depression studies. Our meta-analysis included only studies on patients with MDD; however, both previous metaanalyses included studies that evaluated MDD and BD patients as a single group, [188][189][190] which may have inflated the effect size. Indeed, our study indicates that patients with BD have more than a 2-fold increase in rates of deep white matter hyperintensities compared with MDD patients (Table 5).…”