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MRI signal hyperintensities and failure to remit following antidepressant treatment . BACKGROUND MRI signal hyperintensities predict poor remission to antidepressant treatment . Previous studies using volumetrics in outpatient samples have relied on total lesion volume . The purpose of this study was to test whether remission from geriatric depression depends on lesion volume by region of interest ( ROI ) . METHOD Thirty-eight patients received baseline MRIs as part of a larger 12-week , randomized clinical trial comparing sertraline and nortriptyline in the treatment of late-life depression . MRIcro was used to quantify MRI-hyperintensity volume into total hyperintensity , deep white matter hyperintensity ( DWMH ) , and periventricular hyperintensity ( PVH ) volumes . High versus low total , DWMH , and PVH volumes were defined based on the highest quartile of their respective distributions . Remission from depression was defined as a 24-item Hamilton Rating Scale for Depression score ≤ 7 for two consecutive weeks . RESULTS Patients classified as having high DWMH were 7.14 times more likely not to remit following antidepressant treatment compared to patients classified as having low DWMH ( p=0.02 ) . Similar odds ratios were obtained for PVH ( OR=4.17 , p=0.16 ) and total volumes ( OR=5.00 , p=0.05 ) . Importantly , adjusting for age did not change the magnitude of these effects . LIMITATIONS A small and predominantly White sample . CONCLUSIONS This is the first study to test whether remission from geriatric depression depends on lesion volume by ROI in an outpatient sample . The pattern of remission rates and odds ratios was similar when patients were classified as having high DWMH , PVH or total volume suggesting that lesion location may not be critical .
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Intervention_Pharmacological
antidepressant treatment
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Intervention_Pharmacological
antidepressant treatment
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Intervention_Physical
baseline MRIs
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Intervention_Pharmacological
sertraline
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Intervention_Pharmacological
nortriptyline
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Outcome_Physical
MRI signal hyperintensities
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Outcome_Mental
and
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Outcome_Physical
failure to remit
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Outcome_Physical
remission
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Outcome_Physical
total lesion volume
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Outcome_Mental
.
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Outcome_Physical
lesion volume by region of interest ( ROI )
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Outcome_Mental
.
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Outcome_Physical
DWMH
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Outcome_Mental
, and
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Outcome_Physical
PVH volumes
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Outcome_Mental
Remission from depression
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Outcome_Mental
Hamilton Rating Scale for Depression score
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Participant_Condition
geriatric depression
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Participant_Sample-size
Thirty-eight
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Participant_Condition
late-life depression