TY - JOUR
T1 - Trajectories in cerebral blood flow following antidepressant treatment in late-life depression
T2 - Support for the vascular depression hypothesis
AU - Wei, Wenjing
AU - Karim, Helmet T.
AU - Lin, Chemin
AU - Mizuno, Akiko
AU - Andreescu, Carmen
AU - Karp, Jordan F.
AU - Reynolds, Charles F.
AU - Aizenstein, Howard J.
N1 - Funding Information:
This study was funded by National Institute of Mental Health grants R01 MH076079, 5R01 AG033575, K23 MH086686, P30 MH90333, 5R01 MH083660, and T32 MH019986.
Funding Information:
Submitted: January 2, 2018; accepted April 28, 2018. Published online: October 23, 2018. Potential conflicts of interest: The authors declare no conflicts of interest. Funding/support: This study was funded by National Institute of Mental Health grants R01 MH076079, 5R01 AG033575, K23 MH086686, P30 MH90333, 5R01 MH083660, and T32 MH019986. Role of the sponsor: The sponsors had no role in the design, implementation, analysis, or interpretation of these data. Disclaimer: Dr Karp, JCP Focus on Geriatric Psychiatry Section Editor, was not involved in the editorial review or decision to publish this article. Supplementary material: Available at PSYCHIATRIST.COM.
Publisher Copyright:
© Copyright 2018 Physicians Postgraduate Press, Inc.
PY - 2018/11/1
Y1 - 2018/11/1
N2 - Objective: Studies have identified longitudinally that there exists an association between depression, cerebral blood flow (CBF), and white matter hyperintensities that are thought to be due to vascular pathologies in the brain. However, the changes in CBF, a measure that reflects cerebrovascular integrity, following pharmacotherapy are not well understood. In this study, we investigated the dynamic CBF changes over the course of antidepressant treatment and the association of these changes with depressive symptoms. Methods: We used pseudocontinuous arterial spin labeling to investigate CBF changes in a sample of older patients (≥ 50 years of age; N = 46; 29 female) with a DSM-IV diagnosis of major depressive disorder. Participants had 5 magnetic resonance imaging scans (at baseline, the day after receiving a placebo, the day after receiving a first dose of venlafaxine, a week after starting venlafaxine treatment, and at the end of trial [12 weeks]). Montgomery-Asberg Depression Rating Scale (MADRS) was used to evaluate depression severity and treatment outcome. We investigated the association between changes in depression severity with changes in voxel-wise CBF while adjusting for potential confounding factors. Results: Increased CBF in the middle and posterior cingulate between baseline and end of treatment was significantly associated with percent decrease in MADRS score, independent of sex and Mini-Mental State Examination score (5,000 permutations, cluster forming threshold P < .005, family-wise error P < .05). No significant effects were detected between baseline and other scans (ie, placebo, acute [single dose], or subacute [after a week]). Conclusions: Regional CBF increases were associated with decreases in depressive symptoms. This observation is consistent with the vascular depression hypothesis in late-life depression.
AB - Objective: Studies have identified longitudinally that there exists an association between depression, cerebral blood flow (CBF), and white matter hyperintensities that are thought to be due to vascular pathologies in the brain. However, the changes in CBF, a measure that reflects cerebrovascular integrity, following pharmacotherapy are not well understood. In this study, we investigated the dynamic CBF changes over the course of antidepressant treatment and the association of these changes with depressive symptoms. Methods: We used pseudocontinuous arterial spin labeling to investigate CBF changes in a sample of older patients (≥ 50 years of age; N = 46; 29 female) with a DSM-IV diagnosis of major depressive disorder. Participants had 5 magnetic resonance imaging scans (at baseline, the day after receiving a placebo, the day after receiving a first dose of venlafaxine, a week after starting venlafaxine treatment, and at the end of trial [12 weeks]). Montgomery-Asberg Depression Rating Scale (MADRS) was used to evaluate depression severity and treatment outcome. We investigated the association between changes in depression severity with changes in voxel-wise CBF while adjusting for potential confounding factors. Results: Increased CBF in the middle and posterior cingulate between baseline and end of treatment was significantly associated with percent decrease in MADRS score, independent of sex and Mini-Mental State Examination score (5,000 permutations, cluster forming threshold P < .005, family-wise error P < .05). No significant effects were detected between baseline and other scans (ie, placebo, acute [single dose], or subacute [after a week]). Conclusions: Regional CBF increases were associated with decreases in depressive symptoms. This observation is consistent with the vascular depression hypothesis in late-life depression.
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U2 - 10.4088/JCP.18m12106
DO - 10.4088/JCP.18m12106
M3 - Article
C2 - 30358242
AN - SCOPUS:85055606968
VL - 79
JO - Diseases of the Nervous System
JF - Diseases of the Nervous System
SN - 0160-6689
IS - 6
ER -