The clinical profile of late life depression is frequently associated with cognitive impairment, aging-related brain changes and somatic comorbidity. This two-site naturalistic longitudinal study aimed to explore differences in clinical and brain characteristics and response to electroconvulsive therapy (ECT) in early (EOD) versus late onset (LOD) late life depression (respectively onset < and ≥ 55 years). Methods Between January 2011 and December 2013, 110 patients aged 55 years and older with ECT treated unipolar depression were included in Mood Disorders in Elderly treated with ECT study (MODECT). Clinical profile and somatic health were assessed. MRI scans were performed before the first ECT and visually rated. Results Response rate was 78.2%, and similar between the two sites, but significantly higher in LOD compared to EOD (86.9 vs. 67.3%, p=0.01). Clinical, somatic and brain characteristics were not different between EOD and LOD. Response to ECT was associated with late age at onset and presence of psychotic symptoms, and not with structural MRI characteristics. There was a trend for medial temporal atrophy to be associated with higher odds for response in EOD, which was reversed in LOD. In EOD only, the odds for a higher response were associated with a shorter index episode. Conclusions The clinical profile, somatic comorbidities and brain characteristics were similar in EOD and LOD. Nevertheless, patients with LOD showed a superior response to ECT compared to patients with EOD. Our results indicate that ECT is very effective in LLD, even in vascular burdened patients.
11C-UCB-J PET offers a unique imaging modality to map synaptic density in the human brain in vivo with high specificity. Here, we investigate its correlation with several diffusion MRI metrics and microstructure model parameters in diffusion-weighted PET-MR. We report moderate negative correlation of 11C-UCB-J uptake with measures of anisotropy, consistent with a hypothesis that higher synaptic density is associated with a more disorganised neurite configuration. We also find weak positive correlation to the intra-axonal signal fraction in cortical grey matter. As such, 11C-UCB-J PET-MR can further the interpretation and in vivo validation of more advanced microstructure models of grey matter.
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