Psychological Medicine



Hippocampal/amygdala volumes in geriatric depression


M. ASHTARI a1, B. S. GREENWALD a1c1, E. KRAMER-GINSBERG a1, J. HU a1, H. WU a1, M. PATEL a1, P. AUPPERLE a1 and S. POLLACK a1
a1 Division of Geriatric Psychiatry and the Brain Morphometry and Image Analysis Center, Hillside Hospital, Psychiatric Division and Department of Radiology, Long Island Jewish Medical Center, Glen Oaks and the Albert Einstein College of Medicine, Bronx, New York, USA

Abstract

Background. The hippocampus, amygdala and related functional circuits have been implicated in the regulation of emotional expression and memory processes, which are affected in major depression. Several recent investigations have reported abnormalities in these structures in adult and elderly depressives.

Methods. Elderly DSM-III-R unipolar depressives (N=40) and normal controls (N=46) participated in a magnetic resonance imaging study (1.0T). Brain images were obtained in the coronal plane. Using established anatomical guidelines for structure delineation, volumetric measurements of left and right hippocampus and anterior hippocampus/amygdala complex were completed under blinded conditions using a semi-automated computer mensuration system, with patients and controls in random order.

Results. Medial temporal volumes did not significantly distinguish either elderly depressed and age-similar normal control subjects, or late onset and early onset depressed patients (ANCOVA). Major overlap of measured volumes existed between patient and control groups. In depressives, hippocampal volumes significantly correlated with age, and cognitive and depression ratings, but not with number of prior depressive episodes or age-at-onset of first depression.

Conclusions. Hippocampal volumes do not discriminate a typical clinical population of elderly depressed patients from age-similar normal control subjects. If hippocampal dysfunction contributes to a diagnosis of syndromal depression in the elderly, such dysfunction does not appear to be regularly reflected in structural abnormalities captured by volumetric measurement as conducted. On the other hand, relationships between hippocampal volumes and clinical phenomena in depressives, but not controls, suggest potentially meaningful interactions between hippocampal structure and the expression of major depression in the elderly.


Correspondence:
c1 Address for correspondence: Dr Blaine S. Greenwald, Division of Geriatric Psychiatry, Research Building – Hillside Hospital, 75–59 263rd Street, Glen Oaks, New York 11004, USA.


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