Functional connectivity in apathy of late-life depression: A preliminary study

Alexopoulos, George S.; Hoptman, Matthew J.; Yuen, Genevieve S.; Kanellopoulos, Dora; Seirup, Joanna K.; Lim, Kelvin O.; Gunning, Faith M.

doi:10.1016/j.jad.2012.11.023

Cited by 98 publications

(83 citation statements)

References 70 publications

(76 reference statements)

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“…For example, older adults who suffer from depressive symptoms may be less likely than younger adults to endorse sadness or low mood, or they may present primarily with less common symptoms such as apathy, possibly due to neurological changes (Alexopoulos et al 2013). This phenomenon, known as "depression without sadness" or "masked depression" may lead to misdiagnosis (Covinsky et al 2014).…”

Section: Depressionmentioning

confidence: 99%

Ageism in Mental Health Assessment and Treatment of Older Adults

Bodner

Palgi

Wyman

2018

International Perspectives on Aging

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Section: Depressionmentioning

confidence: 99%

Ageism in Mental Health Assessment and Treatment of Older Adults

Bodner

Palgi

Wyman

2018

International Perspectives on Aging

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“…There is little knowledge of the functional neuroanatomy of apathy in depression despite the abundant geriatric psychiatry literature documenting the phenomenon of apathy syndromes in depression (Alexopoulos et al, 2013, Lavretsky et al, 2007, Lavretsky et al, 2008). Given the malignant effect of comorbid apathy on clinical outcomes and treatment response, apathetic depression appears to not be just a more severe form of depression but possibly a distinctive dimension with a unique neurobiological profile.…”

Section: Introductionmentioning

confidence: 99%

The salience network in the apathy of late‐life depression

Yuen

Gunning-Dixon

Hoptman

et al. 2014

Int J Geriat Psychiatry

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116

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Objective Apathy is prevalent in late-life depression and predicts poor response to antidepressants, chronicity of depression, disability, and greater burden to caregivers. However, little is known about its neurobiology. Salience processing provides motivational context to stimuli. The aim of this study was to examine the salience network (SN) resting-state functional connectivity (rsFC) pattern in elderly depressed subjects with and without apathy. Methods Resting-state functional MRI data were collected from 16 non-demented, non-MCI, elderly depressed subjects and 10 normal elderly subjects who were psychotropic-free for at least two weeks. The depressed group included 7 elderly, depressed subjects with high comorbid apathy and 9 with low apathy. We analyzed the rsFC patterns of the right anterior insular cortex (rAI), a primary node of the SN. Results Relative to non-apathetic depressed elderly, depressed elderly subjects with high apathy had decreased rsFC of the rAI to dorsal anterior cingulate and to subcortical/limbic components of the SN. Depressed elderly subjects with high apathy also exhibited increased rsFC of the rAI to right dorsolateral prefrontal cortex and right posterior cingulate cortex when compared to non-apathetic depressed elderly. Conclusions Elderly depressed subjects with high apathy display decreased intrinsic rsFC of the SN and an altered pattern of SN rsFC to the right DLPFC node of the central executive network when compared to elderly non-apathetic depressed and normal, elderly subjects. These results suggest a unique biological signature of the apathy of late-life depression and may implicate a role for the rAI and SN in motivated behavior.

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“…The prefrontal cortex (PFC) in particular has shown functional changes in older patients with MDD. 1 Dysfunction in the PFC is observed during tasks of executive functioning in general and during working memory in particular. Impairments in working memory are a trait marker in geriatric depression.…”

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confidence: 99%