Skip to main content Accessibility help
×
Home

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

  • Dan V. Iosifescu (a1), Perry F. Renshaw (a2), In Kyoon Lyoo (a2), Ho Kyu Lee (a3), Roy H. Perlis (a4), George I. Papakostas (a4), Andrew A. Nierenberg (a4) and Maurizio Fava (a4)...

Abstract

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.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

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

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

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

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

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

Copyright

Corresponding author

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

Footnotes

Hide All

Declaration of Interest

None. Funding detailed in Acknowledgements.

Footnotes

References

Hide All
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.
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.
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.
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.
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.
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.
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.
Fazekas, F., Kleinert, R., Offenbacher, H., et al (1993) Pathologic correlates of incidental MRI white matter signal hyperintensities. Neurology, 43, 16831689.
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.
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.
Hamilton, M. (1967) Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology, 6, 278296.
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.
Krishnan, K. R., Hays, J. C. & Blazer, D. G. (1997) MRI-defined vascular depression. American Journal of Psychiatry, 154, 497501.
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.
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.
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.
Nierenberg, A. A., Papakostas, G. I., Petersen, T., et al (2003) Nortriptyline for treatment-resistant depression. Journal of Clinical Psychiatry, 64, 3539.
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.
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.
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.
Shimoda, K. & Robinson, R. G. (1999) The relationship between poststroke depression and lesion location in long-term follow-up. Biological Psychiatry, 45, 187192.
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.
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.
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.
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.
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.
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.
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.
Wilson, P. W., D'Agostino, R. B., Levy, D., et al (1998) Prediction of coronary heart disease using risk factor categories. Circulation, 97, 18371847.

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

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

  • Dan V. Iosifescu (a1), Perry F. Renshaw (a2), In Kyoon Lyoo (a2), Ho Kyu Lee (a3), Roy H. Perlis (a4), George I. Papakostas (a4), Andrew A. Nierenberg (a4) and Maurizio Fava (a4)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *