Structural brain changes as biomarkers and outcome predictors in patients with late-life depression: a cross-sectional and prospective study

• Published in: PloS one 2013-11, Vol.8 (11), p.e80049-e80049
• Main Authors: Ribeiz, Salma R I, Duran, Fabio, Oliveira, Melaine C, Bezerra, Diana, Castro, Claudio Campi, Steffens, David C, Busatto Filho, Geraldo, Bottino, Cássio M C
• Format: Article
• Language: English
• Subjects: Abnormalities; Activities of daily living; Age; Age of Onset; Aged; Antidepressants; Antidepressive Agents - therapeutic use; Atrophy; Behavior disorders; Biomarkers; Biomarkers - analysis; Brain; Brain - drug effects; Brain - pathology; Brain - physiopathology; Brain Mapping; Brain research; Case-Control Studies; Clinical outcomes; Cognitive ability; Cortex (temporal); Cross-Sectional Studies; Dementia; Depressive Disorder, Major - drug therapy; Depressive Disorder, Major - pathology; Depressive Disorder, Major - physiopathology; Elderly; Female; Geriatrics; Humans; Laboratories; Logistic Models; Magnetic resonance; Magnetic Resonance Imaging; Male; Medical imaging; Medical research; Medicine; Mental depression; Mental disorders; Middle Aged; Morphometry; Neuroimaging; NMR; Nuclear magnetic resonance; Older people; Patients; Predictive control; Prospective Studies; Psychiatry; Reduction; Remission; Statistical analysis; Studies; Substantia grisea; Systematic review; Young adults
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0080049

The relationship between structural changes in grey matter and treatment response in patients with late-life depression remains an intriguing area of research. This magnetic resonance imaging (MRI) study compares the baseline grey matter volume of elderly people with and without major depression (according to the DSM-IV-TR criteria) and assesses its association with antidepressant treatment response. Brain MRI scans were processed using statistical parametric mapping and voxel-based morphometry. The sample consisted of 30 patients with depression and 22 healthy controls. We found a significant volumetric reduction in the orbitofrontal cortex bilaterally in patients in comparison with controls. According to their remission status after antidepressant treatment, patients were classified as remitted or not remitted. Compared with controls, remitted patients showed a volumetric reduction in the orbitofrontal cortex bilaterally and in another cluster in the right middle temporal pole. Non-remitted patients showed an even greater volumetric reduction in the orbitofrontal cortex bilaterally compared with controls. To investigate predictive factors of remission after antidepressant treatment, we used a logistic regression. Both baseline Mini Mental State Examination score and baseline left superior lateral orbitofrontal cortex volume (standardized to the total grey matter volume) were associated with remission status. Our findings support the use of regional brain atrophy as a potential biomarker for depression. In addition, baseline cognitive impairment and regional grey matter abnormalities predict antidepressant response in patients with late-life depression.