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Attenuated Anterior Cingulate Activation During a Verbal Fluency Task in Elderly Patients With a History of Multiple-Episode Depression

From the Department of Psychiatry and Neurosciences, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University (HT, YO, HY, SY) and Mihara Hospital (GO), Hiroshima, Japan.

Objective: Previous studies have suggested that, in elderly patients, prior depression plays a role in the recurrence of depression. The aim of this study was to investigate cerebral brain function in recovered depressed elderly and investigate the relationship between this brain function and the number of depressive episodes.

Methods: Twenty elderly depressive patients in recovery and 10 healthy volunteers were included in this study. The depressive patients were divided into those who had experienced a single depressive episode and those who had experienced multiple episodes. Functional magnetic resonance imaging was performed in each participant during a verbal fluency task. The data were analyzed using statistical parametric mapping.

Results: Activation in the anterior cingulate cortex was significantly attenuated in patients who had experienced multiple depressive episodes, compared with the other two groups. There were no significant differences in areas of activation between patients with a single depressive episode and healthy volunteers.

Conclusions: These findings suggest that attenuated activation in the anterior cingulate cortex may be associated with multiple episodes of depression in the elderly and with the vulnerability to cycling or recurrence.

Key Words: Elderly depression • recurrence • cycling • anterior cingulate cortex • functional magnetic resonance imaging

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