Late-onset major depression is associated with age-related white matter lesions in the brainstem

2016 ◽  
Vol 32 (4) ◽  
pp. 446-454 ◽  
Author(s):  
Johannes Schwichtenberg ◽  
Mansour Al-Zghloul ◽  
Hans U. Kerl ◽  
Holger Wenz ◽  
Lucrezia Hausner ◽  
...  
Keyword(s):  
White Matter ◽  
Major Depression ◽  
Late Onset ◽  
White Matter Lesions ◽  
Age Related

scholarly journals Localization of white-matter lesions and effect of vascular risk factors in late-onset major depression

2009 ◽  
Vol 40 (8) ◽  
pp. 1389-1399 ◽  
Author(s):  
R. B. Dalby ◽  
M. M. Chakravarty ◽  
J. Ahdidan ◽  
L. Sørensen ◽  
J. Frandsen ◽  
...  
Keyword(s):  
Risk Factors ◽  
White Matter ◽  
Major Depression ◽  
Late Onset ◽  
Brain Magnetic Resonance Imaging ◽  
White Matter Lesions ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Lesion Load ◽  
Significant Difference

BackgroundSeveral studies suggest that patients with late-onset major depression (MD) have an increased load of cerebral white-matter lesions (WMLs) compared with age-matched controls. Vascular risk factors such as hypertension and smoking may confound such findings. Our aim was to investigate the association between the localization and load of WMLs in late-onset MD with respect to vascular risk factors.MethodWe examined 22 consecutive patients with late-onset first-episode MD and 22 age- and gender-matched controls using whole-brain magnetic resonance imaging (MRI). The localization, number and volume of WMLs were compared between patients and controls, while testing the effect of vascular risk factors.ResultsAmong subjects with one or more WMLs, patients displayed a significantly higher WML density in two white-matter tracts: the left superior longitudinal fasciculus and the right frontal projections of the corpus callosum. These tracts are part of circuitries essential for cognitive and emotional functions. Analyses revealed no significant difference in the total number and volume of WMLs between groups. Patients and controls showed no difference in vascular risk factors, except for smoking. Lesion load was highly correlated with smoking.ConclusionsOur results indicate that lesion localization rather than lesion load differs between patients with late-onset MD and controls. Increased lesion density in regions associated with cognitive and emotional functions may be crucial in late-onset MD, and vascular risk factors such as smoking may play an important role in the pathophysiology of late-onset MD, consistent with the vascular depression hypothesis.

Treatment response in late-onset depression: relationship to neuropsychological, neuroradiological and vascular risk factors

2004 ◽  
Vol 34 (1) ◽  
pp. 125-136 ◽  
Author(s):  
R. BALDWIN ◽  
S. JEFFRIES ◽  
A. JACKSON ◽  
C. SUTCLIFFE ◽  
N. THACKER ◽  
...  
Keyword(s):  
Risk Factors ◽  
Executive Function ◽  
White Matter ◽  
Depressive Disorder ◽  
Late Onset ◽  
White Matter Lesions ◽  
Vascular Risk Factors ◽  
Group Differences ◽  
Vascular Risk ◽  
Control Subjects

Background. Late-onset depressive disorder is associated with white matter lesions and neuropsychological deficits that in some studies are linked to a poorer outcome for depression. Some white matter lesions may be vascular in origin. This study investigated the relationship between response or non-response to antidepressant monotherapy and neuropsychological function, structural brain measures and vascular factors.Method. This was a case–control study. Fifty patients with late-onset major depressive disorder (29 who were responders to antidepressant monotherapy and 21 who were not) were compared with 35 non-depressed control subjects. Measures included assessment of vascular risk factors, neuropsychological testing and a magnetic resonance imaging (MRI) scan.Results. After adjustment for depressed mood and medication at evaluation, both patient groups had significantly more impairment compared to control subjects on verbal learning tasks involving immediate or delayed recall. Patients who did not respond to antidepressant monotherapy had significantly poorer performance than controls on tests involving visuospatial ability, language, word recognition and tests of executive function, whereas there were no differences between control subjects and responders. On two tests of executive function (verbal fluency and the Stroop test) non-responders scored significantly worse than responders. There were no significant group differences on MRI measures of atrophy or of white matter lesions apart from a higher periventricular hyperintensity score in non-responders compared to controls. There were no group differences on measures of vascular disease.Conclusion. The results lend support to the emerging evidence that resistance to treatment in late-onset depression may be associated with impaired executive function. Subtle cerebrovascular mechanisms may be involved.

Late-Onset Depression With White Matter Lesions

1993 ◽  
Vol 34 (4) ◽  
pp. 364-367 ◽  
Author(s):  
Ira M. Lesser ◽  
Elizabeth Hill-Gutierrez ◽  
Bruce L. Miller ◽  
Kyle B. Boone
Keyword(s):  
White Matter ◽  
Late Onset ◽  
White Matter Lesions

scholarly journals White Matter Lesion Assessment in Patients with Cognitive Impairment and Healthy Controls: Reliability Comparisons between Visual Rating, a Manual, and an Automatic Volumetrical MRI Method—The Gothenburg MCI Study

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Erik Olsson ◽  
Niklas Klasson ◽  
Josef Berge ◽  
Carl Eckerström ◽  
Åke Edman ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
White Matter ◽  
Rating Scale ◽  
Intensity Variation ◽  
White Matter Lesions ◽  
Volumetric Method ◽  
Visual Rating ◽  
Flair Sequence ◽  
Age Related ◽  
Mri Scans

Age-related white matter lesions (WML) are a risk factor for stroke, cognitive decline, and dementia. Different requirements are imposed on methods for the assessment of WML in clinical settings and for research purposes, but reliability analysis is of major importance. In this study, WML assessment with three different methods was evaluated. In the Gothenburg mild cognitive impairment study, MRI scans from 152 participants were used to assess WML with the Fazekas visual rating scale on T2 images, a manual volumetric method on FLAIR images, and FreeSurfer volumetry on T1 images. Reliability was acceptable for all three methods. For low WML volumes (2/3 of the patients), reliability was overall lower and nonsignificant for the manual volumetric method. Unreliability in the assessment of patients with low WML with manual volumetry may mainly be due to intensity variation in the FLAIR sequence used; hence, intensity standardization and normalization methods must be used for more accurate assessments. The FreeSurfer segmentations resulted in smaller WML volumes than the volumes acquired with the manual method and showed deviations from visible hypointensities in the T1 images, which quite likely reduces validity.

scholarly journals Anti-MOG autoantibody–associated schizophreniform psychosis

2021 ◽  
pp. 1-21
Author(s):  
Katharina von Zedtwitz ◽  
Isabelle Matteit ◽  
Maike Michel ◽  
Bernd Feige ◽  
Kimon Runge ◽  
...  
Keyword(s):  
White Matter ◽  
Alpha Rhythm ◽  
Late Onset ◽  
White Matter Lesions ◽  
Igg Antibodies ◽  
Antibody Titers ◽  
Mog Antibodies ◽  
Fixed Cell ◽  
Confusional States ◽  
Cerebrospinal Fluid Protein

Abstract Objective: Autoimmune mechanisms are related to disease development in a subgroup of patients with psychosis. The contribution of immunoglobulin G (IgG) antibodies against myelin oligodendrocyte glycoprotein (MOG) is mainly unclear in this context. Methods: Therefore, two patients with psychosis and anti-MOG antibodies—detected in fixed cell-based and live cell-based assays—are presented. Results: Patient 1 suffered from late-onset psychosis with singular white matter lesions in MRI and intermittent EEG slowing. Patient 2 suffered from a chronic paranoid-hallucinatory disorder with intermittent confusional states, non-specific white matter alterations on MRI, a disorganized alpha rhythm on EEG and elevated cerebrospinal-fluid protein. Both patients had anti-MOG antibody titers of 1:320 in serum (reference<1:20). Conclusion: The arguments for and against a causal role for anti-MOG antibodies are discussed. The antibodies could be relevant, but due to moderate titers, they may have caused a rather “subtle clinical picture” consisting of psychosis instead of “classical” MOG encephalomyelitis.

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