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Brain white-matter hyperintensities and treatment outcome in major depressive disorder

Published online by Cambridge University Press:  02 January 2018

Dan V. Iosifescu*
Affiliation:
Depression Clinical and Research Program, Massachusetts General Hospital
Perry F. Renshaw
Affiliation:
Brain Imaging Center, McLean Hospital, Harvard Medical School, Boston, Massachusetts, USA
In Kyoon Lyoo
Affiliation:
Brain Imaging Center, McLean Hospital, Harvard Medical School, Boston, Massachusetts, USA
Ho Kyu Lee
Affiliation:
Department of Radiology, Sung Kyun Kwan University, Seoul, Korea
Roy H. Perlis
Affiliation:
Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
George I. Papakostas
Affiliation:
Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Andrew A. Nierenberg
Affiliation:
Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Maurizio Fava
Affiliation:
Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
*
Dr Dan V. Iosifescu, Massachusetts General Hospital, 50 Staniford Street, suite 401, Boston, Massachusetts 02114, USA. Tel: +1 617 724 7741; fax: +1 617 724 3028; e-mail: diosifescu@partners.org
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Abstract

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Background

An increased incidence of brain white-matter hyperintensities has been described in major depressive disorder, but the impact of such hyperintensities on treatment outcome is still controversial.

Aims

To investigate the relationship of brain white-matter hyperintensities with cardiovascular risk factors and with treatment outcome in younger people with major depressive disorder.

Method

We assessed brain white-matter hyperintensities and cardiovascular risk factors in 84 people with major depressive disorder prior to initiating antidepressanttreatment. We also assessed hyperintensities in 35 matched controls.

Results

We found no significant difference in the prevalence of white-matter hyperintensities between the depression and the control groups. Left-hemisphere subcortical hyperintensities correlated with lower rates of treatment response. We found no correlation between global hyperintensity measures and clinical outcome. Brain white-matter hyperintensities correlated with hypertension and age and with total cardiovascular risk score.

Conclusions

Subcortical white-matter hyperintensities in the left hemisphere (but not in other brain areas) may be associated with poor response to antidepressant treatment in major depression.

Type
Papers
Copyright
Copyright © 2006 The Royal College of Psychiatrists 

Footnotes

Declaration of Interest

None. Funding detailed in Acknowledgements.

References

Awad, I. A., Johnson, P. C., Spetzler, R. F., et al (1986) Incidental subcortical lesions identified on magnetic resonance imaging in the elderly. II: postmortem pathological correlations. Stroke, 17, 10901097.CrossRefGoogle ScholarPubMed
Breteler, M. M., van Swieten, J. C., Bots, M. L., et al (1994) Cerebral white matter lesions, vascular risk factors, and cognitive function in a population-based study: the Rotterdam Study. Neurology, 44, 12461252.CrossRefGoogle Scholar
Coffey, C. E., Wilkinson, W. E., Weiner, R. D., et al (1993) Quantitative cerebral anatomy in depression. A controlled magnetic resonance imaging study. Archives of General Psychiatry, 50, 716.CrossRefGoogle ScholarPubMed
de Groot, J. C., de Leeuw, F. E., Oudkerk, M., et al (2000) Cerebral white matter lesions and depressive symptoms in elderly adults. Archives of General Psychiatry, 57, 10711076.CrossRefGoogle ScholarPubMed
Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (2001) Executive summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in adults (Adult Treatment Panel III). JAMA, 285, 24862497.CrossRefGoogle Scholar
Fava, M., Alpert, J., Nierenberg, A. A., et al (2002) Double-blind study of high-dose fluoxetine versus lithium or desipramine augmentation of fluoxetine in partial responders and nonresponders to fluoxetine. Journal of Clinical Psychopharmacology, 22, 379387.CrossRefGoogle ScholarPubMed
Fazekas, F., Chawluk, J. B., Alavi, A., et al (1987) MR signal abnormalities at 1.5 T in Alzheimer's dementia and normal aging. American Journal of Roentgenology, 149, 351356.CrossRefGoogle Scholar
Fazekas, F., Kleinert, R., Offenbacher, H., et al (1993) Pathologic correlates of incidental MRI white matter signal hyperintensities. Neurology, 43, 16831689.CrossRefGoogle ScholarPubMed
Folstein, M. R., Folstein, S. E. & McHugh, P. R. (1975) ‘Mini-Mental State': a practical method of grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.CrossRefGoogle Scholar
Greenwald, B. S., Kramer-Ginsberg, E., Krishnan, K. R., et al (1998) Neuroanatomic localization of magnetic resonance imaging signal hyperintensities in geriatric depression. Stroke, 29, 613617.CrossRefGoogle ScholarPubMed
Hamilton, M. (1967) Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology, 6, 278296.CrossRefGoogle ScholarPubMed
Hickie, I., Scott, E., Wilhelm, K., et al (1997) Subcortical hyperintensities on magnetic resonance imaging in patients with severe depression – a longitudinal evaluation. Biological Psychiatry, 42, 367374.CrossRefGoogle ScholarPubMed
Krishnan, K. R., Hays, J. C. & Blazer, D. G. (1997) MRI-defined vascular depression. American Journal of Psychiatry, 154, 497501.Google ScholarPubMed
Lenze, E., Cross, D., McKeel, D., et al (1999) White matter hyperintensities and graymatter lesions in physically healthy depressed subjects. American Journal of Psychiatry, 156, 16021607.CrossRefGoogle Scholar
Liao, D., Cooper, L., Cai, J., et al (1997) The prevalence and severity of white matter lesions, their relationship with age, ethnicity, gender and cardiovascular disease risk factors: the ARIC Study. Neuroepidemiology, 16, 149162.CrossRefGoogle ScholarPubMed
Lyoo, I. K., Lee, H. K., Jung, J. H., et al (2002) White matter hyperintensities on magnetic resonance imaging of the brain in children with psychiatric disorders. Comprehensive Psychiatry, 43, 361368.CrossRefGoogle ScholarPubMed
Nierenberg, A. A., Papakostas, G. I., Petersen, T., et al (2003) Nortriptyline for treatment-resistant depression. Journal of Clinical Psychiatry, 64, 3539.CrossRefGoogle ScholarPubMed
O'Brien, J., Ames, D., Chiu, E., et al (1998) Severe deep white matter lesions and outcome in elderly patients with major depressive disorder: follow up study. BMJ, 317, 982984.CrossRefGoogle ScholarPubMed
Robinson, R. G., Starr, L. B., Lipsey, J. R., et al (1985) A two-year longitudinal study of poststroke mood disorders. In-hospital prognostic factors associated with six-month outcome. Journal of Nervous and Mental Disease, 173, 221226.CrossRefGoogle ScholarPubMed
Schmidt, R., Fazekas, F., Hayn, M., et al (1997) Risk factors for microangiopathy-related cerebral damage in the Austrian stroke prevention study. Journal of the Neurological Sciences, 152, 1521.CrossRefGoogle ScholarPubMed
Shimoda, K. & Robinson, R. G. (1999) The relationship between poststroke depression and lesion location in long-term follow-up. Biological Psychiatry, 45, 187192.CrossRefGoogle ScholarPubMed
Simpson, S., Baldwin, R. C., Jackson, A., et al (1998) Is subcortical disease associated with apoor responseto antidepressants? Neurological, neuropsychological and neuroradiological findings in late-life depression. Psychological Medicine, 28, 10151026.CrossRefGoogle Scholar
Spitzer, R. L., Williams, J. B. W., Gibbon, M., et al (1989) Structured Clinical Interview for DSM-III-R Patient edition (SCID—P). New York: Biometrics Research Department, New York State Psychiatric Institute.Google Scholar
Steffens, D. C., Krishnan, K. R., Crump, C., et al (2002) Cerebrovascular disease and evolution of depressive symptoms in the cardiovascular health study. Stroke, 33, 16361644.CrossRefGoogle ScholarPubMed
Taylor, W. D., Macfall, J. R., Steffens, D. C., et al (2003) Localization of age-associated white matter hyperintensities in late-life depression. Progress in Neuropsychopharmacological and Biological Psychiatry, 27, 539544.CrossRefGoogle ScholarPubMed
Thomas, A. J., O'Brien, J. T., Davis, S., et al (2002) Ischemic basis for deep white matter hyperintensities in major depression: a neuropathological study. Archives of General Psychiatry, 59, 785792.CrossRefGoogle ScholarPubMed
Thomas, A. J., O'Brien, J. T., Barber, R., et al (2003) A neuropathological study of periventricular white matter hyperintensities in major depression. Journal of Affective Disorders, 76, 4954.CrossRefGoogle ScholarPubMed
Yanai, I., Fujikawa, T., Horiguchi, J., et al (1998) The 3-year course and outcome of patients with major depression and silent cerebral infarction. Journal of Affective Disorders, 47, 2530.CrossRefGoogle ScholarPubMed
Wilson, P. W., D'Agostino, R. B., Levy, D., et al (1998) Prediction of coronary heart disease using risk factor categories. Circulation, 97, 18371847.CrossRefGoogle ScholarPubMed
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