Depressive symptoms, brain volumes and subclinical cerebrovascular disease in postmenopausal women: The Women's Health Initiative MRI Study

Goveas, Joseph S.; Espeland, Mark A.; Hogan, Patricia; Dotson, Vonetta; Tarima, Sergey; Coker, Laura H.; Ockene, Judith; Brunner, Robert; Woods, Nancy F.; Wassertheil-Smoller, Sylvia; Kotchen, Jane M.; Resnick, Susan

doi:10.1016/j.jad.2011.01.020

« Previous Next »Journal of Affective Disorders
Volume 132, Issue 1 , Pages 275-284, July 2011

Depressive symptoms, brain volumes and subclinical cerebrovascular disease in postmenopausal women: The Women's Health Initiative MRI Study

Joseph S. Goveas
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Corresponding author at: Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI 53226, USA. Tel.: +1 414 955 8983; fax: +1 414 955 6299.
Mark A. Espeland
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
Patricia Hogan
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
Vonetta Dotson
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
Sergey Tarima
- Department of Population Health, Medical College of Wisconsin, Milwaukee, WI, USA
Laura H. Coker
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
Judith Ockene
- Department of Preventive and Behavioral Medicine, University of Massachusetts, Amherst, MA, USA
Robert Brunner
- Department of Family and Community Medicine, University of Nevada School of Medicine, Reno, NV, USA, USA
Nancy F. Woods
- Family and Child Nursing, University of Washington, Seattle, WA, USA, USA
Sylvia Wassertheil-Smoller
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY, USA
Jane M. Kotchen
- Department of Population Health, Medical College of Wisconsin, Milwaukee, WI, USA
Susan Resnick
- Laboratory of Personality and Cognition, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA

Received 22 June 2010; accepted 29 January 2011.

Abstract

Objective

Late-life depressive symptoms (DS) increase the risk of incident mild cognitive impairment and probable dementia in the elderly. Our objectives were to examine the relationship between elevated DS and regional brain volumes including frontal lobe subregions, hippocampus and amygdala, and to determine whether elevated DS were associated with increased subclinical cerebrovascular disease in postmenopausal women.

Methods

DS were assessed an average of 8years prior to structural brain MRI in 1372 women. The 8-item Burnam regression algorithm was used to define DS with a cut-point of 0.009. Adjusting for potential confounders, mean differences in total brain, frontal lobe subregions, hippocampus and amygdala volumes and total ischemic lesion volumes in the basal ganglia and the cerebral white and gray matter outside the basal ganglia were compared between women with and without DS.

Results

Depressed women had lower baseline global cognition and were more likely to have prior hormone therapy history. After full adjustment, DS at baseline were associated with smaller superior and middle frontal gyral volumes. Hippocampal and amygdala volumes, and ischemic lesion volumes were similar in depressed and non-depressed women.

Limitations

Depression was not assessed based on semi-structured interview, and MRI scans were obtained cross-sectionally rather than longitudinally. Longitudinal MRI assessments will be necessary to define the temporal relationships between DS and frontal lobe volumes.

Conclusions

Elevated DS were associated with lower volumes in certain frontal lobe subregions but not in the medial temporal lobe structures. Our findings support the role of frontal lobe structures in late-life DS among women.

Keywords: Late-life depression, Regional brain volumes, Subclinical cerebrovascular disease, Structural magnetic resonance imaging