Accelerated brain aging in major depressive disorder and antidepressant treatment response: A CAN-BIND report

• Published in: NeuroImage clinical Vol. 32; p. 102864
• Main Authors: Ballester, Pedro L., Suh, Jee Su, Nogovitsyn, Nikita, Hassel, Stefanie, Strother, Stephen C., Arnott, Stephen R., Minuzzi, Luciano, Sassi, Roberto B., Lam, Raymond W., Milev, Roumen, Müller, Daniel J., Taylor, Valerie H., Kennedy, Sidney H., Frey, Benicio N.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01-01-2021; Elsevier
• Subjects: Aged; Aging; Antidepressive Agents - therapeutic use; Brain - diagnostic imaging; Brain age; Depressive Disorder, Major - drug therapy; Double-Blind Method; Drug Therapy, Combination; Escitalopram; Humans; Machine learning; Major depressive disorder; Regular; Treatment Outcome; Treatment response; Treatment response; Major depressive disorder; Brain age; Machine learning
• ISSN: 2213-1582; 2213-1582
• DOI: 10.1016/j.nicl.2021.102864

•Depression was associated with a larger brain-age gap in older individuals.•Body mass index was associated with a larger brain-age gap.•Brain-age gap was not associated with an overall antidepressant treatment response.
Previous studies suggest that major depressive disorder (MDD) may be associated with volumetric indications of accelerated brain aging. This study investigated neuroanatomical signs of accelerated aging in MDD and evaluated whether a brain age gap is associated with antidepressant response.
Individuals in a major depressive episode received escitalopram treatment (10–20 mg/d) for 8 weeks. Depression severity was assessed at baseline and at weeks 8 and 16 using the Montgomery-Asberg Depression Rating Scale (MADRS). Response to treatment was characterized by a significant reduction in the MADRS (≥50%). Nonresponders received adjunctive aripiprazole treatment (2–10 mg/d) for a further 8 weeks. The brain-predicted age difference (brain-PAD) at baseline was determined using machine learning methods trained on 3377 healthy individuals from seven publicly available datasets. The model used features from all brain regions extracted from structural magnetic resonance imaging data.
Brain-PAD was significantly higher in older MDD participants compared to younger MDD participants [t(147.35) = -2.35, p < 0.03]. BMI was significantly associated with brain-PAD in the MDD group [r(155) = 0.19, p < 0.03]. Response to treatment was not significantly associated with brain-PAD.
We found an elevated brain age gap in older individuals with MDD. Brain-PAD was not associated with overall treatment response to escitalopram monotherapy or escitalopram plus adjunctive aripiprazole.