Cortical Thickness of the Salience Network and Change in Apathy Following Antidepressant Treatment for Late-Life Depression.

TitleCortical Thickness of the Salience Network and Change in Apathy Following Antidepressant Treatment for Late-Life Depression.
Publication TypeJournal Article
Year of Publication2021
AuthorsPimontel MA, Solomonov N, Oberlin L, Kanellopoulos T, Bress JN, Hoptman MJ, Alexopoulos GS, Gunning FM
JournalAm J Geriatr Psychiatry
Volume29
Issue3
Pagination241-248
Date Published2021 03
ISSN1545-7214
Abstract

OBJECTIVE: Apathy is common in late-life depression and is associated with poor response to antidepressant drugs. In depressed older adults, apathy may be characterized by neuroanatomical abnormalities of the salience network. The current study examined whether cortical thickness of select salience network structures predicted change in apathy following a 12-week treatment with escitalopram.

METHODS: A sample of 46 older adults with major depressive disorder received 12 weeks of escitalopram treatment at a daily target dose of 20 mg. All participants underwent a structural brain MRI scan at baseline, and cortical thickness was estimated in key cortical nodes of the salience network: the caudal anterior cingulate cortex and the insula. We measured baseline and post-treatment symptoms using the Apathy Evaluation Scale and the Hamilton Depression Rating Scale.

RESULTS: A thicker insula at baseline predicted reduction in apathy symptoms following 12 weeks of treatment with escitalopram, even when controlling for age, baseline depression severity and change in depressive symptoms.

CONCLUSION: Reduced insular thickness predicted residual apathetic symptoms following escitalopram treatment. These results converge with our previous findings of abnormal functional connectivity of the insular cortex in older depressed individuals with apathy. Older depressed adults with apathy may benefit from alternative treatment approaches or augmentative interventions that target abnormalities of the salience network.

DOI10.1016/j.jagp.2020.06.007
Alternate JournalAm J Geriatr Psychiatry
PubMed ID32680763
PubMed Central IDPMC7738363
Grant ListK23 MH123864 / MH / NIMH NIH HHS / United States
R01 MH065653 / MH / NIMH NIH HHS / United States
T32 MH019132 / MH / NIMH NIH HHS / United States