Applications of magnetic resonance imaging for treatment-resistant late-life depression

Christian Agudelo, Howard J. Aizenstein, Jordan F. Karp, Charles F. Reynolds

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Late-life depression (LLD) is a growing public and global health concern with diverse clinical manifestations and etiology. This literature review summarizes neuroimaging findings associated with depression in older adults and treatment-response variability. LLD has been associated with cerebral atrophy, diminished myelin integrity, and cerebral lesions in frontostriatal-limbic regions. These associations help explain the depression-executive dysfunction syndrome observed in LLD, and support cerebrovascular burden as a pathogenic mechanism. Furthermore, this review suggests that neuroimaging determinants of treatment resistance also reflect cerebrovascular burden. Of the theoretical etiologies of LLD, cerebrovascular burden may mediate treatment resistance. This review proposes that neuroimaging has the potential for clinical translation. Controlled trials may identify neuroimaging biomarkers that may inform treatment by identifying depressed adults likely to remit with pharmacotherapy, identifying individualized therapeutic dose, and facilitating earlier treatment response measures. Neuroimaging also has the potential to similarly inform treatment response variability from treatment with aripiprazole (dopamine modulator) and buprenorphine (opiate modulator).

Original languageEnglish (US)
Pages (from-to)151-169
Number of pages19
JournalDialogues in Clinical Neuroscience
Issue number2
StatePublished - 2015
Externally publishedYes


  • Biomarker
  • DTI
  • Geriatric depression
  • Late-life depression
  • MRI
  • Neuroimaging
  • Review
  • Treatment response
  • fMRI

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry


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