Advances in neuroimaging have allowed for the demonstration of a high incidence of white matter abnormalities among older depressed patients referred for electroconvulsive therapy. This finding suggesting an association between structural deficits and pharmacotherapy resistance in late-life depression has been expanded by more focused studies of neuropsychological functioning and responses to systematic treatment. Parallel findings from the neurological and psychiatric literature demonstrate that vascular disease occurring without overt evidence of strokes is associated with specific cognitive deficits and diminished responsiveness to antidepressants. Prospective studies assessing relationships between these factors and responses to acute and maintenance treatments are reviewed. Recent evidence demonstrating that disruption of specific central pathways, which may result from aging-related vascular damage, is associated with poor treatment response is described. Relationships between treatment studies of patients with brain damage due to small vessel disease and studies of post-stroke depression are discussed.
Back to S075 Neurobiological Factors in Late-life Depression
Back to The Eleventh International Congress