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Greater Depression Severity in Elderly Patients With Memory Complaints Is Associated With Decreased Left Temporal-Parietal Dominance Indicated by Dynamic Susceptibility Contrast Magnetic Resonance Imaging Cerebral Blood Volume Measures

From the Division on Aging (HHK), Department of Psychiatry (HHK, JH, PFR, GLG), Harvard Medical School, Boston, MA; Department of Psychiatry, McLean Hospital, Belmont, MA (HHK, JH, PFR); Biostatistics Solutions, Boston, MA (THW); Department of Psychiatry, Brigham and Women's Hospital, Boston, MA (GLG); Department of Psychiatry, Mt. Sinai School of Medicine, New York, NY (JMG).

Objective: To assess the relationships among depressive signs and symptoms and left versus right temporal-parietal cerebral blood volumes (CBVs) in elderly patients with a primary complaint of memory loss.

Methods: Total Geriatric Depression Scale Short Form (GDS-SF) scores, left and right temporal-parietal cerebral blood volume values, and other prospectively recorded data were obtained via chart review of 24 patients aged 65 years, evaluated between 1995 and 2000 at McLean Hospital for a primary complaint of memory loss. Multivariate regression analyses were carried out with GDS-SF total scores as outcome variables, with CBV values as explanatory factors and with several patient characteristics as covariates.

Results: Depressive symptoms, as measured by the GDS-SF, were significantly associated with decreased left/right temporal-parietal CBV ratios (ß regression coefficient = –20.7; t [df = 22] = –2.96, p = 0.007). These findings remained statistically significant after controlling for age, sex, Mini-Mental State Exam (MMSE) score, years of education, years of memory loss, and handedness (ß regression coefficient = –16.7; t [df = 16] = –2.67, p = 0.017).

Conclusion: In this study, severity of depressive symptoms as measured by the GDS-SF in patients 65 years old who presented with a primary complaint of memory loss was associated with decreased left/right temporal-parietal CBV ratios, independently of age, sex, MMSE score, years of education, years of memory loss, and handedness. These findings suggest that in the presence of cognitive decline, increased depressive signs and symptoms may be associated with decreased left/right temporal-parietal CBV ratios.

Key Words: Depression • functional neuroimaging • elderly • laterality