Xiaofu He1, Elena Pueraro2, Yoojean Kim2, Carolina Montes Garcia2, Ben Maas3, Jongwoo Choi2, Dakota A Egglefield4, Sophie Schiff4, Joel R Sneed5, Patrick J Brown6, Adam M Brickman3, Steven P Roose6, Bret R Rutherford6. 1. Department of Psychiatry (XH, JRS, PJB, SPR, BRR), Vagelos College of Physicians and Surgeons, Columbia University, New York, NY; The New York State Psychiatric Institute (XH, EP, YK, CMG, JC, JRS, PJB, SPR, BRR), New York, NY. Electronic address: xh2170@cumc.columbia.edu. 2. The New York State Psychiatric Institute (XH, EP, YK, CMG, JC, JRS, PJB, SPR, BRR), New York, NY. 3. Department of Neurology ( BM, AMB), Taub Institute for Research on Alzheimer's Disease and the Aging Brain, G.H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY. 4. The Graduate Center, City University of New York (DAE, SS, JRS), New York, NY; Queens College, City University of New York (DAE, SS. JRS), New York, NY. 5. Department of Psychiatry (XH, JRS, PJB, SPR, BRR), Vagelos College of Physicians and Surgeons, Columbia University, New York, NY; The New York State Psychiatric Institute (XH, EP, YK, CMG, JC, JRS, PJB, SPR, BRR), New York, NY; The Graduate Center, City University of New York (DAE, SS, JRS), New York, NY; Queens College, City University of New York (DAE, SS. JRS), New York, NY. 6. Department of Psychiatry (XH, JRS, PJB, SPR, BRR), Vagelos College of Physicians and Surgeons, Columbia University, New York, NY; The New York State Psychiatric Institute (XH, EP, YK, CMG, JC, JRS, PJB, SPR, BRR), New York, NY.
Abstract
OBJECTIVE: While patients with late-life depression (LLD) often exhibit microstructural white matter alterations that can be identified with diffusion tensor imaging (DTI), there is a dearth of information concerning the links between DTI findings and specific cognitive performance, as well as between DTI measures and antidepressant treatment outcomes. DESIGN: Neuroimaging and cognitive tests were conducted at baseline in 71 older adults participating in a larger, 8-week duration antidepressant randomized controlled trial. Correlations between DTI measures of white matter integrity evaluated with tract-based spatial statistics, baseline neurocognitive performance, and prospective antidepressant treatment outcome were evaluated. RESULTS: Fractional anisotropy (FA), an index of white matter integrity, was significantly positively associated with better cognitive function as measured by the Initiation/Perseveration subscale of the Dementia Rating Scale in the bilateral superior longitudinal fasciculus (SLF), bilateral SLF-temporal, and right corticospinal tract (CST). An exploratory analysis limited to these tracts revealed that increased FA in the right CST, right SLF, and right SLF-temporal tracts was correlated with a greater decrease in depressive symptoms. Increased FA in the right CST predicted a greater chance of remission, while increased FA in the right CST and the right SLF predicted a greater chance of treatment response. CONCLUSION: In late-life depression LLD subjects, white matter integrity was positively associated with executive function in white matter tracts which act as key connecting structures underlying the cognitive control network. These tracts may play a role as a positive prognostic factor in antidepressant treatment outcome.
OBJECTIVE: While patients with late-life depression (LLD) often exhibit microstructural white matter alterations that can be identified with diffusion tensor imaging (DTI), there is a dearth of information concerning the links between DTI findings and specific cognitive performance, as well as between DTI measures and antidepressant treatment outcomes. DESIGN: Neuroimaging and cognitive tests were conducted at baseline in 71 older adults participating in a larger, 8-week duration antidepressant randomized controlled trial. Correlations between DTI measures of white matter integrity evaluated with tract-based spatial statistics, baseline neurocognitive performance, and prospective antidepressant treatment outcome were evaluated. RESULTS: Fractional anisotropy (FA), an index of white matter integrity, was significantly positively associated with better cognitive function as measured by the Initiation/Perseveration subscale of the Dementia Rating Scale in the bilateral superior longitudinal fasciculus (SLF), bilateral SLF-temporal, and right corticospinal tract (CST). An exploratory analysis limited to these tracts revealed that increased FA in the right CST, right SLF, and right SLF-temporal tracts was correlated with a greater decrease in depressive symptoms. Increased FA in the right CST predicted a greater chance of remission, while increased FA in the right CST and the right SLF predicted a greater chance of treatment response. CONCLUSION: In late-life depression LLD subjects, white matter integrity was positively associated with executive function in white matter tracts which act as key connecting structures underlying the cognitive control network. These tracts may play a role as a positive prognostic factor in antidepressant treatment outcome.
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