Factors associated with brain volume in major depression in older adults without dementia: results from a large autopsy study

Nunes, Paula; Suemoto, Cláudia Kimie; Leite, Renata Elaine Paraízo; Ferretti‐Rebustini, Renata Eloah de Lucena; Pasqualucci, Carlos Augusto; Nitrini, Ricardo; Farfel, José Marcelo; Oliveira, Kátia C.; Grinberg, Lea T.; Costa, Nicole Rezende da; Nascimento, Camila; Salmasi, Faraz; Kim, Helena Kyunghee; Young, L. Trevor; Jacob‐Filho, Wilson; Lafer, Beny

doi:10.1002/gps.4649

Cited by 8 publications

(7 citation statements)

References 49 publications

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“…Further, it should be noted that the depressive symptoms used in this study are not a clinical diagnosis, but a self-reported symptom in a questionnaire. In our analyses, subjects with depressive symptoms showed less BPV at baseline (very weak effect size), which is consistent with previous studies ( Espinoza Oyarce et al, 2020 , Kumar et al, 1998 , Lebedeva et al, 2018 , Nunes et al, 2018 ). On the other hand, our subjects with depressive symptoms showed a decrease in dWMH over time (weak effect size), while several other previous studies have, in a clinical context, associated depression with higher WMH load ( Krishnan et al, 2006 , Nebes et al, 2002 , Teodorczuk et al, 2007 ).…”

Section: Discussionsupporting

confidence: 92%

Associations of subclinical cerebral small vessel disease and processing speed in non-demented subjects: A 7-year study

Hotz

Deschwanden

Mérillat

et al. 2021

NeuroImage: Clinical

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Markers of cerebral small vessel disease (CSVD) have previously been associated with age-related cognitive decline. Using longitudinal data of cognitively healthy, older adults ( N = 216, mean age at baseline = 70.9 years), we investigated baseline status and change in white matter hyperintensities (WMH) (total, periventricular, deep), normal appearing white matter (NAWM), brain parenchyma volume (BPV) and processing speed over seven years as well as the impact of different covariates by applying latent growth curve (LGC) models. Generally, we revealed a complex pattern of associations between the different CSVD markers. More specifically, we observed that changes of deep WMH (dWMH), as compared to periventricular WMH (pWMH), were more strongly related to the changes of other CSVD markers and also to baseline processing speed performance. Further, the number of lacunes rather than their volume reflected the severity of CSVD. With respect to the studied covariates, we revealed that higher education had a protective effect on subsequent total WMH, pWMH, lacunar number, NAWM volume, and processing speed performance. The indication of antihypertensive drugs was associated with lower lacunar number and volume at baseline and the indication of antihypercholesterolemic drugs came along with higher processing speed performance at baseline. In summary, our results confirm previous findings, and extend them by providing information on true within-person changes, relationships between the different CSVD markers and brain-behavior associations. The moderate to strong associations between changes of the different CSVD markers indicate a common pathological relationship and, thus, support multidimensional treatment strategies.

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Section: Discussionsupporting

confidence: 92%

Associations of subclinical cerebral small vessel disease and processing speed in non-demented subjects: A 7-year study

Hotz

Deschwanden

Mérillat

et al. 2021

NeuroImage: Clinical

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“…Another limitation of the present study was that we could not examine the effect of informant’s distress on NPI scores because the NPI Distress (NPI-D) scale was not available for all the sample. Despite these limitations, other studies with the same methodology for collecting information have been published [4, 13,39, 40].…”

Section: Discussionmentioning

confidence: 99%

Neuropsychiatric Inventory in Community-Dwelling Older Adults with Mild Cognitive Impairment and Dementia

Nunes

Schwarzer

Leite

et al. 2019

JAD

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Background Behavioral and psychological symptoms (BPSD) can be a prodrome of dementia, and the Neuropsychiatric Inventory (NPI) is widely used for BPSD evaluation. Objective To compare the prevalence of BPSD according to cognitive status, and to determine NPI cutoffs that best discern individuals with mild cognitive impairment (MCI) and dementia from those without dementia. Methods We included 1,565 participants (mean age = 72.7 ± 12.2 years, 48% male). BPSD and cognitive status were assessed with the NPI and the Clinical Dementia Rating (CDR). We used multivariable logistic regression models to investigate the association of BPSD with cognitive status. The area under the curve (AUC) was used to assess model discrimination, and to determine the best NPI cutoff for MCI and dementia. Results Participants were cognitively normal (CDR = 0; n = 1,062), MCI (CDR = 0.5; n = 145), or dementia (CDR ≥ 1.0, n = 358). NPI symptoms were more frequent in dementia and MCI when compared to cognitively normal. Higher odds for delusions, hallucinations, disinhibition, and psychomotor alterations were found among participants with dementia and MCI than in those who were cognitively normal. The best NPI cutoff to discern participants with dementia from those cognitively normal was 11 (AUC = 0.755). Poor discrimination (AUC = 0.563) was found for the comparison of MCI and those cognitively normal. Conclusions We found an increase in BPSD frequencies across the continuum of cognitive impairment. BPSD severity and frequency in MCI was more similar to individuals cognitively normal than with dementia. NPI scores ≥ to 11 in individuals with no diagnosis of dementia can support the decision for further investigation of dementia.

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“… 2 , 20 , 21 Several studies have demonstrated that hypertension is an independent risk factor for brain atrophy. 31 – 33 Therefore, our scale included brain atrophy in the total cSVD burden. There are several different rating scales for brain atrophy assessment, including medial temporal lobe atrophy, 34 posterior atrophy, 35 and global cortical atrophy.…”

Section: Discussionmentioning

confidence: 99%

Twenty-four-hour ambulatory blood-pressure variability is associated with total magnetic resonance-imaging burden in cerebral small-vessel disease

Yang¹,

Yuan²,

Qin³

et al. 2018

CIA

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BackgroundLacunae, brain atrophy, white matter hyperintensity, enlarged perivascular space and microbleed are magnetic resonance imaging (MRI) markers of cerebral small-vessel disease (cSVD). Studies have reported that higher blood pressure variability (BPV) predicted cardiovascular risk in hypertensive patients; however, the association between BPV and the total MRI burden of cSVD has not been investigated. In this study, we aimed to explore this relationship between BPV and cSVD MRI burden.MethodsWe prospectively recruited patients who attended our hospital for annual physical examination. Twenty-four-hour ambulatory BP monitoring was performed using an automated system. BPV was quantified by SD, weighted SD, and coefficient of variation. One point was awarded for the presence of each marker, producing a score between 0 and 5. Spearman correlation and ordinal logistic regression analyses were used to test the relationship between BPV and total cSVD MRI burden.ResultsA total of 251 subjects with an average age of 68 years were enrolled in this study, and 52.6% were male; 163 (64.94%) had one or more markers of cSVD. Correlation analysis indicated that higher systolic BP (SBP) levels and BPV metrics of SBP were positively related to higher cSVD burden. Ordinal logistic regression analyses demonstrated that higher SBP levels and SBP variability were independent risk factors for cSVD. There were no significant differences in 24-hour, day and night diastolic BP levels or BPV metrics of diastolic BP among the five subgroups.ConclusionTwenty-four-hour, day and night SBP levels and SBP variability were positively related to cSVD burden. Higher SBP levels and SBP variability were independent risk factors for cSVD.

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Factors associated with brain volume in major depression in older adults without dementia: results from a large autopsy study

Cited by 8 publications

References 49 publications

Associations of subclinical cerebral small vessel disease and processing speed in non-demented subjects: A 7-year study

Associations of subclinical cerebral small vessel disease and processing speed in non-demented subjects: A 7-year study

Neuropsychiatric Inventory in Community-Dwelling Older Adults with Mild Cognitive Impairment and Dementia

Twenty-four-hour ambulatory blood-pressure variability is associated with total magnetic resonance-imaging burden in cerebral small-vessel disease

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