Relationship between regional brain metabolism, illness severity and age in depressed subjects

Konarski, Jakub Z.; Kennedy, Sidney H.; McIntyre, Roger S.; Rafi-Tari, Shahryar; Soczynska, Joanna K.; Mayberg, Helen S.

doi:10.1016/j.pscychresns.2007.02.001

« Previous Next »Psychiatry Research: Neuroimaging
Volume 155, Issue 3 , Pages 203-210, 15 August 2007

Relationship between regional brain metabolism, illness severity and age in depressed subjects

Jakub Z. Konarski
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
Sidney H. Kennedy
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- University Health Network, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Corresponding author. University Health Network, Toronto General Hospital, 200 Elizabeth Street, Eaton North Wing 8-222, Toronto, ON, Canada M5G 2C4. Tel.: +1 416 340 3888; fax: +1 416 340 4190.
Roger S. McIntyre
- University Health Network, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada
Shahryar Rafi-Tari
- Sunnybrook Hospital, University of Toronto, Toronto, ON, Canada
Joanna K. Soczynska
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
Helen S. Mayberg
- Department of Psychiatry and Neurology, Emory University, Atlanta, GA, USA

Received 2 May 2006; received in revised form 30 January 2007; accepted 3 February 2007.

Abstract

We sought to examine the effects of age, depression chronicity, and treatment responsiveness on glucose metabolism in a large well-characterized sample of depressed men and a psychiatrically unaffected control group. The subjects were unmedicated, symptomatic, right-handed males (n=66) who met DSM-IV criteria for a major depressive episode in the context of a major depressive disorder (MDD, n=66) and never depressed, right-handed, healthy control subjects (HC, n=24). Subjects in the MDD group were subsequently classified as responders, or non-responders to a six-week trial of paroxetine monotherapy (20–60 mg). Statistical parametric mapping (SPM) was used to analyze the relationship between age and cerebral glucose metabolism (18-fluorodeoxyglucose positron emission tomography) and the modulation by treatment responsivity and a history of prior depressive episodes. Metabolic activity in the rostral and dorsal anterior cingulate cortex showed a significant negative correlation with age in MDD, but not in HC. Non-response to treatment and previous depressive episodes were associated with a higher degree of age-dependent hypometabolism in the rostral and anterior cingulate cortex. The age-dependent changes documented herein may influence the distinct clinical presentation and treatment response described in older-age depression.