White-matter tract integrity in late-life depression: associations with severity and cognition

Psychol Med. 2014 May;44(7):1427-37. doi: 10.1017/S0033291713001980. Epub 2013 Sep 16.

Abstract

Background: Although significant changes in both gray and white matter have been noted in late-life depression (LLD), the pathophysiology of implicated white-matter tracts has not been fully described. In this study we examined the integrity of specific white-matter tracts in LLD versus healthy controls (HC).

Method: Participants aged ⩾60 years were recruited from the community. The sample included 23 clinically diagnosed individuals with LLD and 23 HC. White-matter integrity metrics [fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD)] were calculated in the bilateral cingulum and uncinate fasciculus. Depression severity was measured using the Center for Epidemiological Studies Depression Scale (CESD). Composite scores for learning and memory and executive function were created using standardized neuropsychological assessments.

Results: White-matter integrity was lower in LLD versus HC in the bilateral cingulum and right uncinate fasciculus (p⩽0.05). In the whole sample, depression severity correlated with integrity in the bilateral cingulum and right uncinate fasciculus (p ⩽0.05). In patients, depression severity correlated with the integrity of the left uncinate fasciculus (p = 0.03); this tract also correlated with executive function (p = 0.02). Among HC, tract integrity did not correlate with depression scores; however, learning and memory correlated with integrity of the bilateral uncinate fasciculus and bilateral cingulum; executive function correlated with the right uncinate and left cingulum (p ⩽0.05).

Conclusions: White-matter tract integrity was lower in LLD than in HC and was associated with depression severity across all participants. Tract integrity was associated with cognition in both groups but more robustly among HC.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cognition Disorders / pathology*
  • Cognition Disorders / physiopathology
  • Depressive Disorder, Major / pathology*
  • Depressive Disorder, Major / physiopathology
  • Female
  • Gyrus Cinguli / pathology*
  • Gyrus Cinguli / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Neural Pathways / pathology*
  • Neural Pathways / physiopathology
  • Severity of Illness Index
  • White Matter / pathology*
  • White Matter / physiopathology