Abstract
BackgroundIn younger adults, residual alterations in functional neural networks persist during remitted depression. However, there are fewer data for midlife and older adults at risk of recurrence. Such residual network alterations may contribute to vulnerability to recurrence. This study examined intrinsic network functional connectivity in midlife and older women with remitted depression.MethodsA total of 69 women (24 with a history of depression, 45 with no psychiatric history) over 50 years of age completed 3T fMRI with resting-state acquisition. Participants with remitted depression met DSM-IV-TR criteria for an episode in the last 10 years but not the prior year. Whole-brain seed-to-voxel resting-state functional connectivity analyses examined the default mode network (DMN), executive control network (ECN), and salience network (SN), plus bilateral hippocampal seeds. All analyses were adjusted for age and used cluster-level correction for multiple comparisons with FDR < 0.05 and a height threshold of p < 0.001, uncorrected.ResultsWomen with a history of depression exhibited decreased functional connectivity between the SN (right insula seed) and ECN regions, specifically the left superior frontal gyrus. They also exhibited increased functional connectivity between the left hippocampus and the left postcentral gyrus. We did not observe any group differences in functional connectivity for DMN or ECN seeds.ConclusionsRemitted depression in women is associated with connectivity differences between the SN and ECN and between the hippocampus and the postcentral gyrus, a region involved in interoception. Further work is needed to determine whether these findings are related to functional alterations or are predictive of recurrence.
Highlights
Depression, in later life, is associated with high disability, increased risk for cognitive decline and dementia, elevated suicide risk, and greater all-cause mortality rates [1]
Data on network dysfunction is limited in older adults with remitted MDD (rMDD), evidence supports functional alterations in adult populations with rMDD [11]
We focused exclusively on women, as depression is more common in women and women with previous depressive episodes remain at high risk for recurrence [6, 38]
Summary
Depression, in later life, is associated with high disability, increased risk for cognitive decline and dementia, elevated suicide risk, and greater all-cause mortality rates [1]. While antidepressant medications and psychotherapy can effectively treat depressive episodes in older adults [2,3,4], individuals who respond to treatment remain at high risk for future episodes [5, 6]. Despite this increased risk of depression recurrence, little is known about neurobiological factors that increase vulnerability to depression recurrence in midlife or older adults. There are fewer data for midlife and older adults at risk of recurrence Such residual network alterations may contribute to vulnerability to recurrence. This study examined intrinsic network functional connectivity in midlife and older women with remitted depression
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