Frontal white matter microstructure and treatment response of late-life depression: a preliminary study

Am J Psychiatry. 2002 Nov;159(11):1929-32. doi: 10.1176/appi.ajp.159.11.1929.


Objective: This study tested the hypothesis that microstructural abnormalities in white matter areas of the brain containing frontostriatal tracts are associated with a low rate of remission of geriatric depression.

Method: Thirteen older patients with major depression received open, but controlled, treatment with citalopram at a target daily dose of 40 mg for 12 weeks. Diffusion tensor imaging was used to determine fractional anisotropy in preselected white matter regions.

Results: Survival analysis with Cox's proportional hazards model revealed that lower fractional anisotropy of the right and the left frontal white matter regions 15 mm above the anterior commissure-posterior commissure plane was associated with a low remission rate after age was considered. Remission was not significantly associated with fractional anisotropy of lower frontal regions or a temporal region.

Conclusions: Microstructural white matter abnormalities lateral to the anterior cingulate may be associated with a low rate of remission of geriatric depression.

MeSH terms

  • Aged
  • Anisotropy
  • Citalopram / administration & dosage*
  • Citalopram / adverse effects
  • Corpus Striatum / drug effects
  • Corpus Striatum / pathology*
  • Depressive Disorder, Major / drug therapy
  • Depressive Disorder, Major / pathology*
  • Diffusion Magnetic Resonance Imaging
  • Dominance, Cerebral / drug effects
  • Dominance, Cerebral / physiology*
  • Echo-Planar Imaging
  • Female
  • Frontal Lobe / drug effects
  • Frontal Lobe / pathology*
  • Gyrus Cinguli / drug effects
  • Gyrus Cinguli / pathology
  • Humans
  • Male
  • Middle Aged
  • Neural Pathways / drug effects
  • Neural Pathways / pathology
  • Neuropsychological Tests
  • Treatment Failure
  • Treatment Outcome


  • Citalopram