Assessing Anterior Cingulate Brain Activity in People With Late-Life Depression

Weill Cornell Medicine (WCM)

Status

Completed

Conditions

Depression

Treatments

Drug: Escitalopram

Study type

Observational

Funder types

Other

Identifiers

NCT00926653

K23MH074818

DATR AK-TNGP1

Details and patient eligibility

About

This study will examine differences in activity of the anterior cingulate cortex, a brain area involved in emotion and cognitive regulation, between older adults with and without depression.

Full description

Older adults with depression often also suffer from executive dysfunction-problems with planning, impulse control, and reasoning. Executive dysfunction in older adults predicts poor or delayed response to antidepressant treatment and has been associated with early relapse and recurrence of late-life major depression. Functional magnetic resonance imaging (fMRI) is a scan that can measure the activity of someone's brain while that person performs tasks. So far, no fMRI studies investigating cerebral activation patterns in late-life depression have been published. In this study, people will undergo fMRI while they are performing an executive function task. Older adults with late-life depression and older adults without depression will be tested and compared in order to identify the areas and patterns of brain activity underlying executive dysfunction in late-life depression.

Participation in this study will consist of one study visit, during which participants will undergo an fMRI scan that will last 60 to 90 minutes. While being scanned, participants will perform cognitive tasks that involve pressing buttons in response to words viewed on a screen.

Enrollment

76 patients

Sex

All

Ages

60 to 85 years old

Volunteers

Accepts Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria for Depressed Participants:

Diagnosis of major depression by DSM-IV criteria
Mini-Mental State Examination (MMSE) score greater than 24
Severity score of 17 or higher on the 21-item Hamilton Depression Rating Scale score (HDRS) during the index episode
Residence less than a 45-minute drive from New York Hospital-Westchester Division

Exclusion Criteria for Depressed Participants:

Presence of psychotic depression, as defined by Research Diagnostic Criteria and DSM-IV
History of psychiatric disorders other than unipolar major depression (people with bipolar disorder and dysthymia will be excluded)
Presence of dementing disorders
Acute or severe medical illness, such as the following: delirium; metastatic cancer; decompensated cardiac, liver, or kidney failure; major surgery; or cerebrovascular accident or myocardial infarction 3 months prior to study entry
Receiving drugs known to cause depression, including reserpine, alpha-methyl-dopa, and steroids
Requires concomitant treatment with other psychotropics, including antipsychotic medications, lithium salts, stimulants, valproic acid, carbamazepine, or gabapentin
Severe aphasia interfering with communication
Contraindications to magnetic resonance (MR) scanning, such as implanted metal, claustrophobia, or weight greater than or equal to 300 lbs

Inclusion Criteria for Age-Matched Non-Psychiatric Comparison Sample:

MMSE score greater than 24

Exclusion Criteria for Age-Matched Non-Psychiatric Comparison Sample:

History of psychiatric disorder
Presence of dementing disorders
Acute or severe medical illness, such as the following: delirium; metastatic cancer; decompensated cardiac, liver, or kidney failure; major surgery; or cerebrovascular accident or myocardial infarction 3 months prior to study entry
Receiving drugs known to cause depression, including reserpine, alpha-methyl-dopa, and steroids
Current treatment with psychotropics
Severe aphasia interfering with communication
Contraindications to MR scanning, such as implanted metal, claustrophobia, or weight greater than or equal to 300 lbs