Change in Alzheimer's Disease Gray Matter Cortical Signature is Associated with Treatment Response in Late-Life Depression

• Published in: The American journal of geriatric psychiatry 2023-03, Vol.31 (3), p.S60-S61
• Main Authors: Faruque, Saurab, Bick, Natalie, Karim, Helmet, Butters, Meryl, Andreescu, Carmen, Aizenstein, Howard
• Format: Article
• Language: English
• ISSN: 1064-7481; 1545-7214
• DOI: 10.1016/j.jagp.2022.12.220

Major depressive disorder is common among older adults and is associated with increased risk for cognitive impairment, including Alzheimer's disease (AD). First line pharmacotherapy for late-life depression (LLD) includes SSRI and SNRIs, but only 50%-75% of individuals respond to treatment and only 30% achieve full remission. The timeline for identifying the right medication and dose for an older adult is often prolonged, especially if multiple medication trials are required. Magnetic Resonance Imaging may offer benefit in optimizing treatment for LLD. Previous work has shown structural anomalies in cortical and subcortical regions, such as overall or localized cortical thickness, to be associated with antidepressant treatment response. Researchers at Massachusetts General Hospital and Harvard Medical School developed the Alzheimer's Disease (AD) cortical signature, which is a novel MR-imaging indicator representing mean cortical thickness of nine regions of interest (ROIs). Decreased AD cortical signature has been associated with onset and progression of dementia, endorsing its value as a biomarker for early neurodegeneration. Dementia and depression in late life often overlap clinically, and cortical atrophy is reported in both. However, no studies report the value of AD cortical signature as a biomarker in depression and its association with treatment response. Thirty-nine patients 60 years old or older currently experiencing major depressive disorder or episode & with a Montgomery-Asberg Depression Rating Scale (MADRS) score ≥15 underwent structural MRI at baseline and after 12 weeks of treatment. Treatment response was defined as a MADRS score ≤10 or reduction in MADRS score ≥50% from baseline to week 12 follow-up visit; treatment non-response was defined as a MADRS score >12 or reduction in MADRS score