Abstract
Late-life depression (LLD) is an important public health problem among the aging population. Recent studies found that mindfulness-based cognitive therapy (MBCT) can effectively alleviate depressive symptoms in major depressive disorder. The present study explored the clinical effect and potential neuroimaging mechanism of MBCT in the treatment of LLD. We enrolled 60 participants with LLD in an 8-week, randomized, controlled trial (ChiCTR1800017725). Patients were randomized to the treatment-as-usual (TAU) group or a MBCT+TAU group. The Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) were used to evaluate symptoms. Magnetic resonance imaging (MRI) was used to measure changes in resting-state functional connectivity and structural connectivity. We also measured the relationship between changes in brain connectivity and improvements in clinical symptoms. HAMD total scores in the MBCT+TAU group were significantly lower than in the TAU group after 8 weeks of treatment (p < 0.001) and at the end of the 3-month follow-up (p < 0.001). The increase in functional connections between the amygdala and middle frontal gyrus (MFG) correlated with decreases in HAMA and HAMD scores in the MBCT+TAU group. Diffusion tensor imaging analyses showed that fractional anisotropy of the MFG-amygdala significantly increased in the MBCT+TAU group after 8-week treatment compared with the TAU group. Our study suggested that MBCT improves depression and anxiety symptoms that are associated with LLD. MBCT strengthened functional and structural connections between the amygdala and MFG, and this increase in communication correlated with improvements in clinical symptoms.Randomized Controlled Trial; Follow-Up Study; fMRI; Brain Connectivity
Highlights
Depression that occurs after 60–65 years of age is typically referred to as late-life depression (LLD), with a lifetime prevalence of 16% [1, 2]
The results showed that changes in functional connectivity of the right middle frontal gyrus (MFG)-right amygdala in the mindfulness-based cognitive therapy (MBCT)+TAU group significantly positively correlated with changes in Hamilton Depression Scale (HAMD) scores (r = 0.52, p = 0.004 after false discovery rate (FDR) corrected) and changes in Hamilton Anxiety Scale (HAMA) scores (r = 0.49, p = 0.006 after FDR corrected), whereas no significant correlations were found in the TAU group (Figure 3B)
The results showed that fractional anisotropy (FA) of the MFG-amygdala in the MBCT+TAU group increased more than in the TAU group after 8 weeks of treatment, especially in the right hemisphere
Summary
Depression that occurs after 60–65 years of age is typically referred to as late-life depression (LLD), with a lifetime prevalence of 16% [1, 2]. Late-life depression is an important public health concern among the aging population, severely affecting psychological, social, and biological functions [3]. The most common treatments for LLD are antidepressants, but side effects and other limitations can hamper their efficacy. Older adults are considered a vulnerable population because they are more likely to suffer from chronic medical conditions and are sensitive to adverse effects of antidepressants [5]. Older patients with depression require extra care from clinical professionals because of high rates of relapse and recurrence [6]. The combination of psychotherapy and pharmacotherapy was shown to be an effective approach to treat the acute phase of depression and preventing relapse and recurrence [7]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
