Greater white matter hyperintensity volume as a predictor of late-life depression relapse
Poster No:
671
Submission Type:
Abstract Submission
Authors:
Leigh Pearcy1, Helmet Karim1, Meryl Butters1, Layla Banihashemi1, Robert Krafty2, Brian Boyd3, Sarah Szymkowicz3, Jason Hassenstab4, Bennett Landman5, Olusola Ajilore6, Warren Taylor3, Carmen Andreescu1
Institutions:
1University of Pittsburgh, Pittsburgh, PA, 2Emory University, Atlanta, GA, 3Vanderbilt University, Nashville, TN, 4Washington University in St. Louis, St. Louis, MO, 5Vanderbilt University Medical Center, Nashville, TN, 6University of Illinois at Chicago, Chicago, IL
First Author:
Co-Author(s):
Introduction:
White matter hyperintensities (WMHs) are lesions characterized by increased signal intensity on MRI. They are strongly associated with age, making them common among older adults. WMHs are prevalent in late-life depression (LLD) and are associated with poorer treatment response. Little is known regarding the role of WMH in LLD relapse risk, with some data describing higher WMH in LLD relapsed participants (Taylor et al., 2003). In this study, we investigated group differences in WMH volume between never depressed older adults and older adults with remitted depression who have or have not relapsed.
Methods:
We assessed WMHs in 145 participants using 3T MRI FLAIR across a multi-site study. We recruited 43 participants with no history of depression (Control) and 102 depressed participants (LLD) who received treatment and were remitted at time of MRI. Of those who were remitted, 21 relapsed within 8 months of the start of the study (LLD relapsed); the rest remained in remission for at least 8 months (LLD remitted). We used regression to compare WMH volumes between groups based on relapse status, while adjusting for intracranial volume and demographic features including age, sex, race, education, and study site.
Results:
The LLD group (n=102) had greater WMH than the control group (n=43) when adjusting for intracranial volume (F(1,139) = 4.66, P= 0.03). Compared to control participants, the LLD relapsed group (n=21) showed greater WMH (F(1,133)=4.94, P=0.03) while the LLD remitted group (n=81) had similar WMH even after adjusting for demographic features.
Conclusions:
Our results showed that compared to the control group, participants with LLD who relapsed had larger WMHs while those who stayed in remission showed no statistical difference in WMH volume, suggesting that individuals who relapse have greater WMH burden than otherwise healthy individuals. This supports the vascular depression hypothesis that individuals with greater WMH burden have worse disease courses, including higher rates of relapse.
Disorders of the Nervous System:
Psychiatric (eg. Depression, Anxiety, Schizophrenia) 1
Neuroanatomy, Physiology, Metabolism and Neurotransmission:
White Matter Anatomy, Fiber Pathways and Connectivity 2
Keywords:
MRI
Psychiatric
White Matter
Other - Depression, Relapse, White matter hyperintensity
1|2Indicates the priority used for review