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Brain white-matter hyperintensities and treatment outcome in major depressive disorder

Published online by Cambridge University Press:  02 January 2018

Dan V. Iosifescu ,
Perry F. Renshaw ,
In Kyoon Lyoo ,
Ho Kyu Lee ,
Roy H. Perlis ,
George I. Papakostas ,
Andrew A. Nierenberg  and
Maurizio Fava
Dan V. Iosifescu*
Affiliation:
Depression Clinical and Research Program, Massachusetts General Hospital
Perry F. Renshaw
Affiliation:
Brain Imaging Center, McLean Hospital, Harvard Medical School, Boston, Massachusetts, USA
In Kyoon Lyoo
Affiliation:
Brain Imaging Center, McLean Hospital, Harvard Medical School, Boston, Massachusetts, USA
Ho Kyu Lee
Affiliation:
Department of Radiology, Sung Kyun Kwan University, Seoul, Korea
Roy H. Perlis
Affiliation:
Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
George I. Papakostas
Affiliation:
Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Andrew A. Nierenberg
Affiliation:
Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Maurizio Fava
Affiliation:
Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
*
Dr Dan V. Iosifescu, Massachusetts General Hospital, 50 Staniford Street, suite 401, Boston, Massachusetts 02114, USA. Tel: +1 617 724 7741; fax: +1 617 724 3028; e-mail: [email protected]
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Abstract

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Background

An increased incidence of brain white-matter hyperintensities has been described in major depressive disorder, but the impact of such hyperintensities on treatment outcome is still controversial.

Aims

To investigate the relationship of brain white-matter hyperintensities with cardiovascular risk factors and with treatment outcome in younger people with major depressive disorder.

Method

We assessed brain white-matter hyperintensities and cardiovascular risk factors in 84 people with major depressive disorder prior to initiating antidepressanttreatment. We also assessed hyperintensities in 35 matched controls.

Results

We found no significant difference in the prevalence of white-matter hyperintensities between the depression and the control groups. Left-hemisphere subcortical hyperintensities correlated with lower rates of treatment response. We found no correlation between global hyperintensity measures and clinical outcome. Brain white-matter hyperintensities correlated with hypertension and age and with total cardiovascular risk score.

Conclusions

Subcortical white-matter hyperintensities in the left hemisphere (but not in other brain areas) may be associated with poor response to antidepressant treatment in major depression.

Type
Papers
Information
The British Journal of Psychiatry , Volume 188 , Issue 2 , February 2006 , pp. 180 - 185
Copyright
Copyright © 2006 The Royal College of Psychiatrists 

Footnotes

Declaration of Interest

None. Funding detailed in Acknowledgements.

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