Cortical thickness predicts remission of depression with antidepressants in patients with late-life depression and cognitive impairment.

Journal Article (Journal Article)

BACKGROUND: Depression (DEP) and cognitive impairment (CI) share etiological risk factors, anatomical underpinnings, and interact to produce deleterious treatment outcomes. Both DEP and CI exhibit altered patterns of cortical thickness which may impact the course of antidepressant treatment, though inconsistencies in directionality and affected brain regions have been reported. In this study, we examined the relationship between cortical thickness and treatment outcome in older adults with comorbid DEP-CI. METHODS: 55 patients with DEP-CI received baseline MRI scans as part of a larger clinical trial at NYSPI/Columbia University Medical Center and Duke University Medical Center. Mood was assessed using the Hamilton Depression Rating Scale. Patients received open antidepressant treatment for 8 weeks followed by another 8 weeks of the same medication or switch to another antidepressant for a total of 16 weeks. Cortical thickness was extracted using an automated brain segmentation program (FreeSurfer). Vertex-wise analyses evaluated the relationship between cortical thickness and treatment outcome. RESULTS: Remitters exhibited diffuse clusters of greater cortical thickness and reduced cortical thickness compared to non-remitters. Thicker baseline middle frontal gyrus most consistently predicted greater likelihood and faster rate of remission. White matter hyperintensities and hippocampal volume were not associated with antidepressant treatment outcome. LIMITATIONS: MRI was conducted at baseline only and sample size was small. DISCUSSION: Cortical thickness predicts treatment remission and magnitude of early improvement. Results indicate that individuals with DEP-CI exhibit unique patterns of structural abnormalities compared to their depressed peers without CI that have consequences for their recovery with antidepressant treatment.

Full Text

Duke Authors

Cited Authors

  • Motter, JN; Lee, S; Sneed, JR; Doraiswamy, PM; Pelton, GH; Petrella, JR; Devanand, DP

Published Date

  • December 1, 2021

Published In

Volume / Issue

  • 295 /

Start / End Page

  • 438 - 445

PubMed ID

  • 34507224

Pubmed Central ID

  • PMC8551049

Electronic International Standard Serial Number (EISSN)

  • 1573-2517

Digital Object Identifier (DOI)

  • 10.1016/j.jad.2021.08.062


  • eng

Conference Location

  • Netherlands