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Is the Clinical Expression of Late-Life Depression Influenced by Brain Changes? MRI Subcortical Neuroanatomical Correlates of Depressive Symptoms

Published online by Cambridge University Press:  10 January 2005

Steve Simpson
Affiliation:
Forston Clinic, Herrison, Dorchester, Dorset, UK.
Robert C. Baldwin
Affiliation:
Department of Old Age Psychiatry, York House, Manchester Royal Infirmary, Centeral Manchester, UK
Alan Jackson
Affiliation:
University Department of Diagnostic Radiology, Medical School, Central Manchester, UK
Alistair Burns
Affiliation:
University Department of Old Age Psychiatry in South Manchester, Withington Hospital, West Didsbury, Manchester, UK
Peter Thomas
Affiliation:
RDSU, Bournemouth University, Royal, London House, Bournemouth, UK

Abstract

Background: “Vascular depression” has recently been proposed. It is characterized by magnetic resonance imaging (MRI) T2-weighted subcortical lesions, a late onset of first episode of depression, and reduced heritability; a cerebrovascular etiology is suggested. The validity of “vascular depression” might be strengthened if an association was found between the subcortical lesions used to define it and particular depressive symptoms. Methods: A blinded cross-sectional examination of DSM-III-R depressive symptoms (American Psychiatric Association, 1987) and MRI T2-weighted subcortical lesions in 44 patients with late-life depression. Results: Many associations were found; however, because of multiple comparisons, their significance is viewed with caution. The most robust finding was that psychomotor retardation was independently related to total white-matter score. The odds of showing psychomotor retardation was increased 1.9 times for every point increase in severity of white-matter change. Conclusion: In late-life depression the clinical expression of the depression is influenced by the pattern of MRI T2-weighted subcorticallesions. This gives some validity to the concept of an MRI-defined “vascular” subtype of late-life depression and strengthens the argument for including neuroimaging in the classification of late-life depression.

Type
Articles
Copyright
© 2000 International Psychogeriatric Association

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