Anterior cingulate dysfunction in geriatric depression

Background Although several brain abnormalities have been identified in geriatric depression, their relationship to the pathophysiological mechanisms leading to the development and perpetuation of this syndrome remain unclear. Methods This paper reviews findings on the anterior cingulate cortex (ACC...

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Bibliographic Details
Published in:International journal of geriatric psychiatry 2008-04, Vol.23 (4), p.347-355
Main Authors: Alexopoulos, George S., Gunning-Dixon, Faith M., Latoussakis, Vassilios, Kanellopoulos, Dora, Murphy, Christopher F.
Format: Article
Language:English
Subjects:
Adult and adolescent clinical studies
Aged
anterior cingulate
Biological and medical sciences
Brain
Brain Mapping - methods
Depression
Depressive Disorder - physiopathology
Evoked Potentials
Fundamental and applied biological sciences. Psychology
geriatric depression
Geriatric psychiatry
Geriatric psychology
Geriatrics
Gyrus Cinguli - physiopathology
Humans
Magnetic Resonance Imaging
Medical sciences
Mental depression
Mood disorders
Positron-Emission Tomography
Psychoanalysis
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
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Summary:Background Although several brain abnormalities have been identified in geriatric depression, their relationship to the pathophysiological mechanisms leading to the development and perpetuation of this syndrome remain unclear. Methods This paper reviews findings on the anterior cingulate cortex (ACC) function and on the relationship of ACC abnormalities to the clinical presentation and the course of geriatric depression in order to elucidate the pathophysiological role of ACC in this disorder. Results The ACC is responsible for conflict detection and emotional evaluation of error and is connected to brain structures that regulate mood, emotional valence of thought and autonomic and visceral responses, which are functions disturbed in depression. Geriatric depression often is accompanied by abnormalities in some executive functions and has a clinical presentation consistent with ACC abnormalities. Indices of ACC dysfunction are associated with adverse outcomes of geriatric depression. Conclusions Converging findings suggest that at least some ACC functions are abnormal in depression and these abnormalities are pathophysiologically meaningful. Indices of ACC dysfunction may be used to identify subgroups of depressed elderly patients with distinct illness course and treatment needs and serve as the theoretical background for novel treatment development. Copyright © 2007 John Wiley & Sons, Ltd.
ISSN:0885-6230
1099-1166
DOI:10.1002/gps.1939