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Treatment Course With Antidepressant Therapy in Late-Life Depression
- Publication Year :
- 2012
-
Abstract
- In order to assess the effect of gray matter volumes and cortical thickness on antidepressant treatment response in late-life depression, the authors examined the relationship between brain regions identified a priori and Montgomery-Åsberg Depression Rating Scale (MADRS) scores over the course of an antidepressant treatment trial.In a nonrandomized prospective trial, 168 patients who were at least 60 years of age and met DSM-IV criteria for major depression underwent MRI and were enrolled in a 12-week treatment study. Exclusion criteria included cognitive impairment or severe medical disorders. The volumes or cortical thicknesses of regions of interest that differed between the depressed group and a comparison group (N=50) were determined. These regions of interest were used in analyses of the depressed group to predict antidepressant treatment outcome. Mixed-model analyses adjusting for age, education, age at depression onset, race, baseline MADRS score, scanner, and interaction with time examined predictors of MADRS scores over time.Smaller hippocampal volumes predicted a slower response to treatment. With the inclusion of white matter hyper-intensity severity and neuropsychological factor scores, the best model included hippocampal volume and cognitive processing speed to predict rate of response over time. A secondary analysis showed that hippocampal volume and frontal pole thickness differed between patients who achieved remission and those who did not.These data expand our understanding of the prediction of treatment course in late-life depression. The authors propose that the primary variables of hippocampal volume and cognitive processing speed, subsuming other contributing variables (episodic memory, executive function, language processing) predict antidepressant response.
- Subjects :
- Male
medicine.medical_specialty
Psychometrics
Personality Inventory
Neuropsychological Tests
Hippocampus
Article
NO
Rating scale
Sertraline
Internal medicine
Image Interpretation, Computer-Assisted
Neural Pathways
Reaction Time
medicine
Humans
Prospective Studies
Psychiatry
Prospective cohort study
Aged
Cerebral Cortex
Depressive Disorder, Major
Brain
Organ Size
Middle Aged
Late life depression
Amygdala
Magnetic Resonance Imaging
Antidepressive Agents
Frontal Lobe
Psychiatry and Mental health
Treatment Outcome
medicine.anatomical_structure
Parahippocampal Gyrus
Antidepressant
Female
Caudate Nucleus
Personality Assessment Inventory
Cognition Disorders
Psychology
Parahippocampal gyrus
medicine.drug
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....fb25a65ce93f57a9e53abad32095b14a