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A Magnetic Resonance Imaging Study of White Matter Lesions in Depression and Alzheimer's Disease

Published online by Cambridge University Press:  02 January 2018

John O'brien*
Affiliation:
Brighton Clinic, Newcastle General Hospital
Patricia Desmond
Affiliation:
Department of Radiology, University of Melbourne
David Ames
Affiliation:
Department of Psychiatry, University of Melbourne, Royal Melbourne Hospital, Victoria 3050, Australia
Isaac Schweitzer
Affiliation:
Department of Psychiatry, University of Melbourne, Royal Melbourne Hospital, Victoria 3050, Australia
Susan Harrigan
Affiliation:
Department of Psychiatry, University of Melbourne, Royal Melbourne Hospital, Victoria 3050, Australia
Brian Tress
Affiliation:
Department of Radiology, University of Melbourne, c/o The Post Office, Royal Melbourne Hospital, Victoria 3050, Australia
*
Dr John O'brien, Brighton Clinic, Newcastle General Hospital, Westgate Road, Newcastle upon Tyne, NE4 6BE. Fax 0191 272 0816

Abstract

Background

White matter changes, as revealed by magnetic resonance imaging (MRI), may occur in depression and Alzheimer's disease.

Method

T2-weighted MRI scans were performed in 39 control subjects, 61 subjects with NINCDS/ADRDA Alzheimer's disease and 60 subjects with DSM–III–R major depression. Deep white matter lesions (DWML) and periventricular lesions (PVL) were rated on a standard 0–3 scale by two radiologists blind to clinical diagnosis.

Results

After controlling for differences in vascular risk factors and current blood pressure, DWML were significantly more common in depressed subjects and PVL in Alzheimer's disease subjects compared to controls. DWML were most common in those presenting in late life with their first ever depression and 50% of such subjects had severe (grade 3) DWML.

Conclusion

An association between DWML and depression and PVL and Alzheimer's disease is supported. The increase with DWML that occurs with ageing may predispose some elderly subjects to depression.

Type
Papers
Copyright
Copyright © Royal College of Psychiatrists, 1996 

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References

Almkvist, O., Wahlund, L. O., Andersson-Lundman, G., et al (1992) White-matter hyperintensity and neuropsychological functions in dementia and healthy aging. Archives of Neurology, 49, 626632.CrossRefGoogle ScholarPubMed
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Awad, I. A., Spetzler, R. F., Hodak, J. A., et al (1986) Incidental subcortical lesions identified on magnetic resonance imaging in the elderly. I, Correlation with age and cerebrovascular risk factors. Stroke, 17, 10841089.CrossRefGoogle ScholarPubMed
Aylward, E. H., Roberts-Twillie, J. V., Barta, P. E., et al (1994) Basal ganglia volumes and white matter hyperintensities in patients with bipolar disorder. American Journal of Psychiatry, 151, 687693.Google ScholarPubMed
Baldwin, R. C. (1993) Late life depression and structural brain changes: a review of recent magnetic resonance imaging research. International Journal of Geriatric Psychiatry, 8, 115123.CrossRefGoogle Scholar
Bots, M. L., van Sweiten, J. C., Breteler, M. M. B., et al (1993) Cerebral white matter lesions and atherosclerosis in the Rotterdam study. Lancet, 341, 12321237.CrossRefGoogle ScholarPubMed
Brown, E. W., Lewine, R. J., Hudgins, P. A., et al (1992) White matter hyperintensity signals in psychiatric and nonpsychiatric subjects. American Journal of Psychiatry 149, 620625.Google ScholarPubMed
Churchill, C. M., Priolo, C. V., Memeroff, K., et al (1991) Occult subcortical magnetic resonance findings in elderly depressives. International Journal of Geriatric Psychiatry, 6, 213216.CrossRefGoogle Scholar
Coffey, C. E., Figiel, G. S., Djang, W. T., et al (1990) Subcortical hyperintensity on magnetic resonance imaging: a comparison of normal and depressed elderly subjects. American Journal of Psychiatry, 147, 187189.Google ScholarPubMed
Coffey, C. E., Weiner, R. D., Djang, W. T., et al (1991) Brain anatomic effects of electroconvulsive therapy. Archives of General Psychiatry, 48, 10131021.CrossRefGoogle ScholarPubMed
Erkinjuntti, T., Gao, F., Lee, D. H., et al (1994) Lack of difference in brain hyperintensities between patients with early Alzheimer's disease and control subjects. Archives of Neurology, 51, 260268.CrossRefGoogle ScholarPubMed
Fazekas, F., Chawluk, J. B., Alavi, A., et al (1987) MR signal abnormalities at 1.5T in Alzheimer's disease and normal ageing. American Journal of Roentgenology, 149, 351356.CrossRefGoogle Scholar
Fazekas, F., Kleimert, R., Offenbacher, H., et al (1993) Pathologic correlates of incidental MRI white matter hyperintensities. Neurology, 43, 16831689.CrossRefGoogle Scholar
Figiel, G. S., Krishnan, K. R. R., Doraiswamy, P. M., et al (1991) Subcortical hyperintensities on brain magnetic resonance imaging: a comparison between late onset and early onset depressed subjects. Neurobiology of Ageing, 26, 245247.CrossRefGoogle Scholar
Hamilton, M. (1967) Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology, 6, 278296.CrossRefGoogle ScholarPubMed
Kertesz, A., Polk, M. & Carr, T. (1990) Cognition and white matter changes on magnetic resonance imaging in dementia. Archives of Neurology, 47, 387391.CrossRefGoogle ScholarPubMed
Krishnan, K. R. R. (1993) Neuroanatomic substrates of depression in the elderly. Journal of Geriatric Psychiatry and Neurology, 6, 3958.CrossRefGoogle ScholarPubMed
Coffey, C. E., Goli, V., Ellinwood, E. H., et al (1988) Leukoencephalopathy in patients diagnosed as major depressive. Biological Psychiatry, 23, 519522.Google Scholar
Kumar, A., Yousem, E., Souder, E., et al (1992) High-intensity signals in Alzheimer's disease without cerebrovascular risk factors: a magnetic resonance imaging evaluation. American Journal of Psychiatry, 149, 248250.Google ScholarPubMed
McKhann, G., Drachman, D., Folstein, M., et al (1984) Clinical diagnosis of Alzheimer's Disease: report of the NINCDS-ADRDA work group under the auspices of the Department of Health and Human Task Force in Alzheimer's Disease. Neurology, 34, 939944.CrossRefGoogle Scholar
Miller, D. S., Kumar, A., Yousem, D. M., et al (1994) MRI high-intensity signals in depression and Alzheimer's disease. American Journal of Geriatric Psychiatry, 2, 332337.CrossRefGoogle ScholarPubMed
Mirsen, T. R., Lee, D. H., Wong, C. J., et al (1991) Clinical correlates of white-matter changes on magnetic resonance imaging scans of the brain. Archives of Neurology, 48, 10151021.CrossRefGoogle ScholarPubMed
Rabins, P. V., Pearlson, G. D., Aylward, E., et al (1991) Cortical magnetic resonance imaging changes in elderly inpatients with major depression. American Journal of Psychiatry, 148, 617620.Google ScholarPubMed
Roth, M., Tym, E., Mountjoy, C., et al (1986) CAMDEX: a standardised instrument for the diagnosis of mental disorder in the elderly with special reference to the early detection of dementia. British Journal of Psychiatry, 149, 698709.CrossRefGoogle Scholar
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