PDF
ePub
Citation
Print
Abstract
Objectives
This study was done in Korean elderly people in order to examine the relationship of white matter hyperintensity with clinical neuropsychological function and depression symptom severity.
Methods
A total of 148 subjects diagnosed first major depressive episode after age of 60 years were included. Brain magnetic resonance imaging scan was rated with the modified Fazekas White Matter Rating Scale by researcher blinded to clinical information. Cognitive function was evaluated with a comprehensive neurological battery and depression severity was assessed by Hamilton Depression Scale. Subjects were divided into vascular depression group and non vascular group according to the degree of white matter hyperintensity. Independent t-test was used to compare clinical difference between two groups and correlation analysis was used to identify whether white matter hyperintensity severity is correlated with neuropsychological function and depressive symptom.
Results
Vascular depression group was significantly poorer performance in verbal fluency, Boston naming test, Mini-Mental State Examination, trail making test B and stroop test (p<0.05). Furthermore, trail making test B and stroop test performance was correlated with white matter hyperintensity severity. However, Hamilton Depression Scale score was not significantly different between two groups.
Figures and Tables
Table 1
Demographic data and white matter scale of the subjects
* : Hypertension defined according to the Seventh Report of the Joint National Committe on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC 7), † : Diabetes mellitus defined according to International Diabetes Federation Epidemiology Task Force Concensus Group, ‡ : Dyslipidemia defined according to Revised The National Cholesterol Education Program Adult Treatment Panel III Criteria (NCEP ATP III). SD : Standard deviation
References
1. Judd LL, Akiskal HS, Maser JD, Zeller PJ, Endicott J, Coryell W, et al. Major depressive disorder: a prospective study of residual subthreshold depressive symptoms as predictor of rapid relapse. J Affect Disord. 1998. 50:97–108.
2. Alexopoulos GS, Kiosses DN, Heo M, Murphy CF, Shanmugham B, Gunning-Dixon F. Executive dysfunction and the course of geriatric depression. Biol Psychiatry. 2005. 58:204–210.
3. Alexopoulos GS, Gunning-Dixon FM, Latoussakis V, Kanellopoulos D, Murphy CF. Anterior cingulate dysfunction in geriatric depression. Int J Geriatr Psychiatry. 2008. 23:347–355.
4. Taylor WD, Steffens DC, MacFall JR, McQuoid DR, Payne ME, Provenzale JM, et al. White matter hyperintensity progression and late-life depression outcomes. Arch Gen Psychiatry. 2003. 60:1090–1096.
5. Román GC. Vascular depression: An archetypal neuropsychiatric disorder. Biol Psychiatry. 2006. 60:1306–1308.
6. Alexopoulos GS. The vascular depression hypothesis: 10 years later. Biol Psychiatry. 2006. 60:1304–1305.
7. Alexopoulos GS. New concepts for prevention and treatment of late-life depression. Am J Psychiatry. 2001. 158:835–838.
8. Krishnan KR, Hays JC, Blazer DG. MRI-defined vascular depression. Am J Psychiatry. 1997. 154:497–501.
9. Krishnan MS, O'Brien JT, Firbank MJ, Pantoni L, Carlucci G, Erkinjuntti T, et al. Relationship between periventricular and deep white matter lesions and depressive symptoms in older people. The LADIS Study. Int J Geriatr Psychiatry. 2006. 21:983–989.
10. Tupler LA, Krishnan KR, McDonald WM, Dombeck CB, D'Souza S, Steffens DC. Anatomic location and laterality of MRI signal hyperintensities in late-life depression. J Psychosom Res. 2002. 53:665–676.
11. Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960. 23:56–62.
12. Lee JH, Lee KU, Lee DY, Kim KW, Jhoo JH, Kim JH, et al. Development of the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K): clinical and neuropsychological assessment batteries. J Gerontol B Psychol Sci Soc Sci. 2002. 57:P47–P53.
13. Stroop JR. Studies of interference in serial verbal reactions. J Exp Psychol. 1935. 18:643–662.
14. Fazekas F, Chawluk JB, Alavi A, Hurtig HI, Zimmerman RA. MR signal abnormalities at 1.5 T in Alzheimer's dementia and normal aging. AJR Am J Roentgenol. 1987. 149:351–356.
15. Sheline YI, Pieper CF, Barch DM, Welsh-Bohmer K, McKinstry RC, MacFall JR, et al. Support for the vascular depression hypothesis in late-life depression: results of a 2-site, prospective, antidepressant treatment trial. Arch Gen Psychiatry. 2010. 67:277–285.
16. Gunning-Dixon FM, Hoptman MJ, Lim KO, Murphy CF, Klimstra S, Latoussakis V, et al. Macromolecular white matter abnormalities in geriatric depression: a magnetization transfer imaging study. Am J Geriatr Psychiatry. 2008. 16:255–262.
17. Alexopoulos GS, Murphy CF, Gunning-Dixon FM, Latoussakis V, Kanellopoulos D, Klimstra S, et al. Microstructural white matter abnormalities and remission of geriatric depression. Am J Psychiatry. 2008. 165:238–244.
18. Vataja R, Pohjasvaara T, Leppävuori A, Mäntylä R, Aronen HJ, Salonen O, et al. Magnetic resonance imaging correlates of depression after ischemic stroke. Arch Gen Psychiatry. 2001. 58:925–931.
19. Jokinen H, Kalska H, Ylikoski R, Madureira S, Verdelho A, Gouw A, et al. MRI-defined subcortical ischemic vascular disease: baseline clinical and neuropsychological findings. The LADIS Study. Cerebrovasc Dis. 2009. 27:336–344.
20. Kramer-Ginsberg E, Greenwald BS, Krishnan KR, Christiansen B, Hu J, Ashtari M, et al. Neuropsychological functioning and MRI signal hyperintensities in geriatric depression. Am J Psychiatry. 1999. 156:438–444.
XML Download