Improvement of postmenopausal depressive and anxiety symptoms after treatment with isoflavones derived from red clover extracts

Objective

To evaluate the effect of isoflavones derived from red clover extracts (MF11RCE) over anxiety and depressive symptoms among postmenopausal women.

Methods

One hundred and nine postmenopausal women aged 40 or more were randomly assigned to receive two daily capsules of MF11RCE (80 mg red clover isoflavones, Group A) or placebo of equal appearance (Group B) for a 90-day period. After a washout period of 7 days, medication was crossed over and taken for 90 days more. Anxiety and depressive symptoms were measured at baseline, 90 and 187 days with the Hospital Anxiety and Depression Scale (HADS) and Zung's Self Rating Depression Scale (SDS).

Results

After receiving the MF11RCE compound the total HADS (anxiety and depression subscale scores also) and the total SDS scores decreased significantly. This effect was equivalent to a 76.9% reduction in the total HADS score (76% for anxiety and 78.3% for depression) and an 80.6% reduction in the total SDS score. After placebo, total HADS (anxiety and depression subscale also) and total SDS scores also decreased significantly in comparison to baseline but only equivalent to an average 21.7% decline.

Conclusion

Red clover derived isoflavones (MF11RCE) were effective in reducing depressive and anxiety symptoms among postmenopausal women.     

Behavioural and neuropsychological correlates of frontal lobe features in dementia

BACKGROUND: In order to characterize frontal lobe features and their behavioural and cognitive correlates across diagnostic categories, we performed a cross-sectional analysis of behavioural and neuropsychological data from a large, prospective Belgian study on behavioural and psychological signs and symptoms of dementia (BPSD). METHOD: Patients with probable Alzheimer's disease (AD) (n=170), frontotemporal dementia (FTD) (n=28), mixed dementia (MXD) (n=29) and dementia with Lewy bodies (DLB) (n=21) were included and underwent neuropsychological and behavioural assessment by means of a battery of tests and scales. Frontal lobe symptoms were quantified by means of the Middelheim Frontality Score (MFS). RESULTS: In AD (and to a lesser extent in MXD), MFS total scores were negatively correlated with scores on MMSE (Spearman: r=-0.36, p<0.001) and a Verbal Fluency Task (r=-0.38, p<0.001) and were associated with increased severity and frequency of psychosis (r=0.24, p<0.01), activity disturbances (r=0.44, p<0.001) and aggressiveness (r=0.43, p<0.001). In DLB, MFS total scores were negatively correlated with MMSE scores (r=-0.50, p=0.020). No associations were found in FTD patients. CONCLUSIONS: A cross-sectional analysis of frontal lobe features, behavioural characteristics and neuropsychological data demonstrated that, in AD (and to a lesser extent in MXD) patients, frontal lobe symptoms were associated with more pronounced cognitive deficits (of frontal origin), with increased severity and frequency of agitated and aggressive behaviour, and with increased severity of psychosis and depressive symptoms. Given the small sample sizes of the DLB and FTD patient groups, negative findings in these patient groups should be interpreted cautiously.     

Brain single photon emission computed tomography findings in depressive pseudodementia patients

BACKGROUND: Recently, there have been studies suggesting that depressive pseudodementia would include early-stage dementing disorder. Through the comparison of the 99mTc-HMPAO single photon emission computed tomography (SPECT) image of depressive pseudodementia subjects, healthy comparison subjects, depressed subjects free of cognitive impairment, and dementia of Alzheimer's type (DAT) subjects, we aimed to see part of pathophysiology of the depressive pseudodementia of elderly patients. METHODS: Study subjects consisted of seven patients with depressive pseudodementia, seven healthy comparison subjects, seven patients with depression free of cognitive impairment, and eleven patients with DAT. Depression patients were diagnosed according to DSM-III-R. DAT patients were diagnosed by DSM III-R and NINCDS-ADRDA criteria of DAT. Other measures for assessment include Hamilton Rating Scale for Depression and Mini Mental State Exam. All underwent 99mTc-HMPAO SPECT scan. The images of each group were analyzed using statistical parametric mapping of Friston, which compares the images on voxel-by-voxel basis. RESULTS: The results were as follows (1) The DAT group showed significant decreases of cerebral blood flow (CBF) in the right frontal, right temporal region, and both parietal regions as compared with control group (P < 0.05). (2) The depression group showed a significant decrease of CBF in the left frontal region as compared with control group (P < 0.05). (3) The depressive pseudodementia group showed significant decreases of CBF in both parietal regions as compared with control group (P < 0.05). (4) The depressive pseudodementia group showed significant decreases of CBF in the right temporal region and both parietal regions as compared with depression group (P < 0.05). (5) The DAT group showed significant decreases of CBF in the right temporal region, both frontal regions, and both parietal regions as compared with depressive pseudodementia group (P < 0.05). LIMITATIONS: The small number of subjects may make it difficult to generalize from our results. Because decreased CBF in depressive pseudodementia is found while the subjects were depressed, we cannot tell whether it is a state marker or a trait marker. CONCLUSIONS: The depressive pseudodementia group showed decreased CBF in the temporo-parietal region, similar to that of the DAT group and different from that of the depression group.     

Hot flashes are associated with psychological symptoms of anxiety and depression in peri- and post- but not premenopausal women

OBJECTIVE: To explore the relationship between anxiety, depression, vasomotor symptoms, and menopausal status among middle-aged women. DESIGN: A population-based study involving a rural Taiwanese population. Participants received a structured questionnaire, which included the hospital anxiety and depression scale (HADS), gynecological history and a checklist of menopausal symptoms in the most recent 2 weeks. RESULTS: A total of 1273 women with no history of surgical menopause and hormonal therapy history participated. The mean anxiety, depression, and total HADS scores were 4.3 +/- 3.3, 3.3 +/- 2.8 and 7.6 +/- 5.3, respectively, and did not differ according to menopausal status. A total of 10.5% participants reported hot flashes within the previous 2 weeks. After controlling for educational status and insomnia, anxiety (6.0 +/- 3.8 versus 4.1 +/- 3.1) and depression scores (4.0 +/- 3.3 versus 3.2 +/- 2.7) were significantly higher (p < 0.001) compared with those without hot flashes. These differences were attributed to peri- and postmenopausal subjects. CONCLUSIONS: Hot flashes in peri- and postmenopausal women were associated with anxious and depressive symptoms in East Asian population with low prevalence of vasomotor symptoms.     

抑郁症共病2型糖尿病患者的认知功能及神经内分泌指标

目的:探讨共病糖尿病后抑郁症的认知功能特点及其与神经内分泌的相关性。方法:按照目的抽样的方法,选取符合中国精神障碍分类方案与诊断标准第3版诊断标准的门诊和住院抑郁症患者84例,其中合并2型糖尿病的患者为共病组(n=42);未合并糖尿病的患者为非共病组(n=42)。对两组进行汉密顿抑郁量表(HAMD)、汉密顿焦虑量表(HAMA)、伦敦塔、言语流畅性、言语记忆、Stroop、连线测验、威斯康星卡片(WCST)测查,并测定血浆皮质醇(COR)与促肾上腺皮质激素(ACTH)、促甲状腺激素(TSH)、游离甲状腺素(F4)、游离三碘甲状腺原氨酸(F3)浓度。共病组28例和非共病组25例完成认知功能和血浆测查。结果:共病组HAMD总分和躯体化障碍、认知障碍因子分高于非共病组(均P0.05),ACTH和COR的水平高于非共病组(均P0.05),两组TSH、F4、F3差异无统计学意义。共病组的WCST的完成第一分类所需的应答数、错误应答数、持续应答数、持续性错误数和非持续性错误数均高于非共病组(均P0.05);共病组的伦敦塔因子分评分和认知功能的语言记忆评分方面的评分低于非共病组(P0.05);而WCST完成分类数和连线测验、言语流畅性和Stroop等得分差异无统计学意义(P0.05)。共病组TOL与HAMD得分之间呈负相关(r=-0.53,P0.01);COR水平同WCST持续性错误得分呈正相关(r=0.38,P0.05),与RVR和Stroop得分呈负相关(r=-0.56,-0.55;均P0.01);ACTH水平同WCST持续性错误呈正相关(r=0.528,P0.01),与HVLT-R和Stroop得分呈负相关(r=-0.64,-0.60;均P0.01)。非共病组认知功能和HAMD评分、HAMA评分以及神经内分泌指标之间无统计学相关。结论:共病糖尿病后抑郁程度加重,认知功能受损严重,主要表现在执行功能、注意力和语言记忆方面,可能与皮质醇和促肾上腺皮质激素升高有关。     

阴性精神分裂症患者局部脑血流与威斯康星卡片分类测验的相关分析

目的：为探讨阴性精神分裂症患者脑结构与认知功能缺陷的关系。方法：运用单光子发射计算机断层扫描（ＳＰＥＣＴ），测定了１２例阴性精神分裂症患者在安静状态与威斯康星卡片分类测验的负荷状态下的局部脑血流。结果：在安静状态下阴性精神分裂症病人的脑局部放射性分布是对称的，但在威斯康星卡片分类测验的刺激状态下左、右侧额叶的局部脑放射性计数是不对称的。结论：提示精神分裂症的阴性症状与左侧额叶的功能状态有关。     

Regional cerebral blood flow in depression: associations with psychopathology

Regional cerebral blood flow (rCBF) was measured during rest and cognitive activation in 21 patients with a major depressive episode and 21 healthy subjects. Depressive patients had significantly lower rCBF during rest in the right global, frontal, parietal, occipital and temporal regions and in the left global and frontal regions. During mental activation patients showed significantly lower values in all right and left parietal regions. rCBF was correlated with the scores of the Brief Psychiatric Rating Scale (BPRS), the parietal regions. rCBF was correlated with the scores of the Brief Psychiatric Rating Scale (BPRS), the Bech-Rafaelsen Melancholia Scale (BRMS), the Hamilton Depression Scale (HAM-D) and the Hamilton Anxiety Scale (HAM-A). The most significant negative correlations were obtained with the BPRS. Correlation analyses between each single item of the BPRS and CBF values revealed the strongest associations between emotional withdrawal and decreased CBF. Patients with 'reactive' features had higher CBF than patients without 'reactive' symptoms. Only patients without 'reactive' symptoms had a lower CBF than controls. 'Endogenous' features had no impact on CBF.     

The importance of continued exercise participation in quality of life and psychological well-being in previously inactive postmenopausal women: a pilot study

OBJECTIVE: Exercise and physical activity provide a wide range of health benefits for postmenopausal women, although the impact of maintained exercise participation on psychological well-being is unclear. An exploration of continued exercise participation in psychological well-being after a moderate-intensity exercise program in previously inactive postmenopausal women was therefore undertaken. DESIGN:: Twenty-three healthy sedentary postmenopausal women (age 56 +/- 4 years) were randomly assigned to two groups. All participants completed the Short Form-36, Hospital Anxiety and Depression Scale (HADS), and Health Anxiety Questionnaire (HAQ) and then began a 6-week walking program at 50% heart rate reserve defined by (.-)V(O(2)) treadmill testing. Post-intervention, all participants underwent (.-)V(O(2)) treadmill testing and questionnaires. Group 1 was then instructed to continue exercising, whereas group 2 was instructed to desist for an additional 6-week period. On completion of the 6-week follow-up, participants completed a final set of questionnaires. RESULTS: Participants performed 97% of the prescribed 15-hour (900 minute) exercise program (875.1 +/- 177.4 minutes) in an average of 26 +/- 5 sessions. Total HAQ (P = 0.001), health worry (P = 0.001), fear of illness (P = 0.037), reassurance seeking behavior (P = 0.037), SF-36 well-being (P = 0.037), total HADS (P = 0.019), and HADS depression (P = 0.015) improved significantly following the exercise program. At follow-up, group 1 had lower HADS anxiety (P = 0.013), total HADS (P = 0.02), total HAQ (P = 0.03), and HAQ interference with life (P = 0.03) and significantly higher SF-36 energy (P = 0.01) than group 2. CONCLUSIONS: Healthy postmenopausal women gain significant psychological benefit from moderate-intensity exercise. However, exercise participation must continue to maintain improvements in psychological well-being and quality of life.     

Mood and thyroid immunity assessed by ultrasonographic imaging in a primary health care

BACKGROUND: Psychiatric morbidity is highly prevalent in the primary health care settings and it may be related to autoimmune thyroid disease (AITD). The aim of this study was to evaluate the impact of thyroid immunity, evident by hypo-echoic thyroid ultrasound pattern, on prevalence of depression and anxiety in a primary care setting. METHODS: In a cross-sectional design, 504 consecutive primary care patients were invited to the study and 474 patients completed the study. They were screened for depression and anxiety using the Hospital Anxiety and Depression Scale (HADS), were interviewed for affective disorders using the Mini International Neuropsychiatric Interview, and were evaluated by ultrasonographic imagining of the thyroid gland. RESULTS: Among patients with hypo-echoic thyroid (n=122) prevailed women and those patients were older than patients with normo-echoic thyroid (n=352). Women, but not men, with hypo-echoic thyroid compared to those with normo-echoic thyroid had higher scores on the anxiety subscale of the HADS (p=0.03). Among women with hypo-echoic thyroid, only those pre-menopause, but not those post-menopause, had greater prevalence of high scores on the depression subscale of the HADS (p=0.02) and a greater likelihood of using psychiatric medications (p=0.001). LIMITATIONS: Lack of cytological evaluation of the thyroid gland; lack of serum thyroid antibodies concentrations; and lack of thyroid hormone concentrations. CONCLUSIONS: Thyroid immunity is related to mood symptoms in primary care patients. These effects are gender specific and in women, they are most evident before menopause.     

抑郁症、强迫症患者大脑额叶执行功能比较研究

目的 :通过对抑郁症、强迫症及大脑额叶肿瘤患者在威斯康星卡片分类测验 (WCST)操作上的比较 ,探讨抑郁症、强迫症患者在大脑额叶执行功能方面损伤的异同 ,并推测两者在发病机制上的联系。方法 :运用WCST对正常对照 74人 ,抑郁症 40例、强迫症 2 2例、额叶肿瘤 48例患者进行测试 ,并对不同组别的各测查指标进行统计分析。结果 :与正常对照组相比 ,抑郁症、强迫症及额叶肿瘤患者均存在不同程度WCST的操作损伤 ,但三个疾病组间 ,在WCST八个常用指标上 ,除完成第一个归类所需应答数外 ,均无显著差异 (P >0 0 5 )。结论 :抑郁症、强迫症患者大脑额叶功能受损明显 ,两者可能存在共同的起病基础。     

No effect of vitamin B-12 treatment on cognitive function and depression: a randomized placebo controlled study

BACKGROUND: Associations between vitamin B-12 deficiency and impaired cognitive function and depression have been reported. METHODS: A randomized placebo controlled study including 140 individuals with an increased plasma methylmalonic acid (0.40-2.00 micromol/l) not previously treated with vitamin B-12. Cognitive function was assessed by the Cambridge Cognitive Examination (CAMCOG), Mini-Mental State Examination (MMSE), and a 12-words learning test. Symptoms of depression were evaluated by the Major Depression Inventory. The main outcome measure was change in cognitive function and depression score from baseline to follow-up 3 months later. RESULTS: At baseline 78 (56%) individuals had cognitive impairment judged from the CAMCOG score and 40 (29%) according to the MMSE; 18 (13%) individuals had symptoms of depression. No improvement was found in cognitive function comparing the treatment and placebo group (total CAMCOG score: P = 0.43), nor among individuals with only slightly impaired cognitive function (n = 44, total CAMCOG score: P = 0.42). The treatment group did not improve in depression score as compared to the placebo group (P = 0.18). LIMITATIONS: The duration of impaired cognitive function was unknown. CONCLUSIONS: A high proportion of individuals with an increased plasma methylmalonic acid had impaired cognitive function, and a rather high prevalence of depression was observed. However, vitamin B-12 treatment did not improve cognitive function or symptoms of depression within the 3-months study period.     

抑郁症的认知功能和生活事件对照研究

目的 探讨抑郁症患者的认知功能及其与生活事件问的相关.方法 在山西医科大学第一附属医院精神卫生科门诊收集100例抑郁症患者,采用威斯康星卡分类测验(WCST)系统了解其认知功能的情况,同时对其进行生活事件量表(LES)测验,并将测验结果与正常人群对照.结果 ①抑郁症组和对照组的认知功能在威斯康星卡分类测验(WCST)的...     

The prevalence of depression in relation to cerebral atrophy and cognitive performance in 70- and 74-year-old women in Gothenburg. The Women's Health Study

BACKGROUND: Hospital-based studies report that depression in the elderly is associated with brain atrophy. This notion could not be confirmed in a population study on 85-year-olds. We aimed to assess depression in relation to brain atrophy and cognition in 70- and 74-year-old women. METHODS; A representative sample of 70- and 74-year-old women (N = 501) was examined with a psychiatric examination including the Mini-Mental State Examination (MMSE), measuring global cognitive function, and computerized tomography (CT) of the brain (N = 268). Depression was diagnosed according to DSM-III-R. Previous depression was diagnosed by history and by information from previous examinations in this 24-year longitudinal study. RESULTS: The prevalence of depression was 11.6%, including 8.4% with major depression (MDD). Among those who were currently mentally healthy, 43.0% had a history of previous depression. Women with current MDD had lower scores on the MMSE than the mentally healthy women. This association was only found in women with a lower level of education. Current depressives, previous depressives and mentally healthy women without a history of depression did not differ on CT with regard to brain atrophy or white matter lesions. The association between MDD and lower cognitive performance was independent of the association of cognitive performance with structural brain changes on CT. CONCLUSIONS: Brain atrophy on CT is not associated with depression in the general population, despite the fact that individuals with depression have a worse cognitive performance. The finding that cognitive performance was not decreased in individuals with previous depression suggests that cognitive dysfunction is a state phenomenon in depression.     

Estrogen therapy selectively enhances prefrontal cognitive processes: a randomized, double-blind, placebo-controlled study with functional magnetic resonance imaging in perimenopausal and recently postmenopausal women

OBJECTIVE: Estrogen therapy (ET) seems to differentially effect cognitive processes in younger versus older postmenopausal women, suggesting a window of opportunity when ET is most beneficial. Cognitive improvement in younger postmenopausal women has been attributed to ET's influence on hot flushes and sleep, but empiric examination of the mediating role of menopause symptoms versus direct effects of ET on the brain is limited. DESIGN: In a double-blind trial, 52 women were randomly assigned to estradiol 0.05 mg/day (n = 26) or placebo transdermal patches (n = 26) for 12 weeks. Women completed tests of memory, learning, and executive functioning, and hot flush and sleep assessments at baseline and study end. A subset of women (five ET treated, six placebo treated) also underwent blood oxygenation level-dependent (BOLD) functional magnetic resonance imaging (fMRI) studies. RESULTS: Nondepressed perimenopausal and postmenopausal women were studied. The majority had hot flushes and sleep impairment. Compared with placebo, ET selectively reduced errors of perseveration during verbal recall (P = 0.03), a frontal system-mediated function, but did not influence other cognitive processes. Women with baseline hot flushes had greater cognitive benefit with ET (P < 0.05). Cognitive benefit was not associated with sleep problems or its improvement. Measures of fMRI BOLD activation during tests of verbal and spatial working memory showed significant increases in frontal system activity with ET (P < 0.001). CONCLUSIONS: Estrogen therapy selectively improves executive functioning as demonstrated by reduced perseverative errors and prefrontal cortex activation during verbal recall tasks. Cognitive improvement with ET is associated with hot flushes, but not with sleep, suggesting that ET has a direct central nervous system effect, rather than an indirect effect mediated through improvement of sleep.     

The relation of season of birth to severity of menopausal symptoms

OBJECTIVE: Season of birth influences the rate of several psychiatric disorders. In this study, we investigated whether climacteric symptoms and, in particular, psychological and somatic symptoms of postmenopausal women were influenced by their season of birth. DESIGN: This retrospective multicenter study was performed on 2,541 women in natural menopause, free of hormone therapy. The score of the Greene Climacteric Scale and of its vasomotor, psychological (anxiety and depression), and somatization subscales were stratified by season of a woman's birth. Data were controlled for possible confounders, such as age, years since menopause, body mass index, education occupation, smoking habits, and season of evaluation. RESULTS: The Greene Climacteric Scale appeared to be associated with the season of birth, with the lowest scores being observed in women born in autumn and the highest scores in women born in spring (+2.11; 95% CI, 0.67-3.56; P = 0.01), and summer (+2.22; CI, 0.82-3.63; P = 0.01). Lowest scores in autumn and highest scores in spring were also observed for psychological symptoms subscaled as anxiety and depression (+1.43; CI, 0.54-2.32; P = 0.01) and somatic symptoms (+0.59; CI, 0.15-1.04; P = 0.01). CONCLUSIONS: In this study, we found a relationship between season of birth and some menopause-associated symptoms. Further study is needed to confirm these relationships and examine possible mechanisms.     

晚发性抑郁症患者血清神经元特异性烯醇化酶及与认知功能的关系

目的观察晚发性抑郁症(LOD)患者血清神经元特异性烯醇化酶(NSE)的变化情况并探讨其与认知功能的关系。方法分别检测35例晚发性抑郁症患者(LOD组)、35例老年健康者(对照组)血清NSE水平,以简易智能状态检查量表(MMSE)评定LOD患者认知功能,以17项汉密尔顿抑郁量表(HAMD)评定抑郁的严重程度。结果 1LOD组血清NSE水平显著高于对照组,差异有统计学意义(t=4.504,P0.001);2LOD患者MMSE评分显著低于对照组,差异有统计学意义(t=-3.457,P0.01);3LOD患者血清NSE水平与MMSE评分负相关(r=-0.388,P0.05),MMSE评分与HAMD评分负相关(r=-0.413,P0.05)。结论晚发性抑郁患者血清NSE增高,并与其认知功能的改变存在相关性。     

Emotional distress of infertile women in Japan

Although recent papers have suggested that psychological factors are implicated in the experience of infertility, few studies have assessed this relationship in a sample of Japanese infertile women. This study was carried out in order to clarify whether Japanese infertile women experience emotional distress. A cross-sectional questionnaire study was performed to assess the psychological states of 101 infertile women compared to 81 healthy pregnant women. The hospital anxiety and depression scale (HADS) and the profile of mood states (POMS) were administered. These questionnaires produced scores for depression/dejection, anxiety, aggression/hostility, lack of vigour, fatigue, tension anxiety, and confusion. The HADS and the POMS scores of infertile women were significantly higher than those of pregnant women, except for fatigue score. Infertile women with positive HADS indicating emotional disorders (39/101, 38.6%) were significantly (P = 0.0008, chi(2) test) more than those of pregnant women (13/81, 16.0%) when the threshold was set at 12/13 of total HADS scores. The HADS scores were not affected by the women's age, duration of infertility, experience of conception, routine tests, and work states. In this Japanese population, infertile women reported higher levels of emotional distress than pregnant women, suggesting psychological support is needed for infertile women.     

抑郁症患者认知功能与脑源性神经营养因子相关性研究

目的探讨抑郁症患者认知功能及血清脑源性神经营养因子BDNF及其与抑郁严重程度的关系,为防治疾病提供重要依据。方法采用酶联免疫吸附法、汉密尔顿抑郁量表(HAMD)和威斯康星卡片分类(WCST)测验分别测定40例抑郁症患者的血清BDNF水平、抑郁严重程度及认知功能,并与49名正常对照组进行对比分析。结果研究组治疗前总应答数、非持续性错误数均明显增加,正确应答数明显减少,血清BDNF水平明显降低,与对照组比较有显著性差异(P<0.01)。研究组治疗8周末总应答数、持续性错误数、非持续性错误数减少,完成分类数和正确应答数增加,血清BDNF水平明显升高,HAMD总分明显降低,与治疗前比较有显著差异(P<0.05或P<0.01)。治疗前,患者组WCST非持续性错误与血清BDNF水平呈负相关(r=-0.34,P<0.05),血清BDNF水平与HAMD总分无相关(r=-0.10,P>0.05)。治疗后,WCST上述5个指标与血清BDNF水平及HAMD总分均无相关(P>0.05)。结论抑郁症患者存在认知功能受损及血清BDNF水平的下降,抗抑郁治疗可改善认知功能,并显著提高血清BDNF水平。     

Gray matter reduction associated with psychopathology and cognitive dysfunction in unipolar depression: a voxel-based morphometry study

BACKGROUND: Functional neuroimaging studies on both cognitive processing and psychopathology in patients with major depression have reported several functionally aberrant brain areas within limbic-cortical circuits. However, less is known about the relationship between psychopathology, cognitive deficits and regional volume alterations in this patient population. METHODS: By means of voxel-based morphometry (VBM) and a standardized neuropsychological test battery, we examined 15 patients meeting DSM-IV criteria for major depression disorder and 14 healthy controls in order to investigate the relationship between affective symptoms, cognitive deficits and structural abnormalities. RESULTS: Patients with depression showed reduced gray matter concentration (GMC) in the left inferior temporal cortex (BA 20), the right orbitofrontal (BA 11) and the dorsolateral prefrontal cortex (BA 46). Reduced gray matter volume (GMV) was found in the left hippocampal gyrus, the cingulate gyrus (BA 24/32) and the thalamus. Structure-cognition correlation analyses revealed that decreased GMC of the right medial and inferior frontal gyrus was associated with both depressive psychopathology and worse executive performance as measured by the Wisconsin Card Sorting Test (WCST). Furthermore, depressive psychopathology and worse performance during the WCST were associated with decreased GMV of the hippocampus. Decreased GMV of the cingulate cortex was associated with worse executive performance. LIMITATIONS: Moderate illness severity, medication effects, and the relatively small patient sample size should be taken into consideration when reviewing the implications of these results. CONCLUSIONS: The volumetric results indicate that regional abnormalities in gray matter volume and concentration may be associated with both psychopathological changes and cognitive deficits in depression.     

Choline acetyltransferase activity and cognitive domain scores of Alzheimer's patients

Choline acetyltransferase activity and cognitive domain scores of Alzheimer's patients. Item scores from the Mattis Dementia Rating Scale (MDRS) and the Mini-Mental State Examination (MMSE) from 389 patients with probable Alzheimer's disease were submitted to principal component analysis with orthogonal rotation. The optimal solution identified four factors that reflected the cognitive domains of attention/registration, verbal fluency/reasoning, graphomotor/praxis and recent memory. A subgroup of patients was identified for whom both the MDRS and the MMSE had been administered within the 12 months before death. Scores were assigned to these patients for the four factors. These cognitive-domain scores were then correlated with postmortem choline acetyltransferase (ChAT) activity in the medial frontal cortex, inferior parietal cortex, and hippocampus. ChAT activity in both the medial frontal and the inferior parietal cortex significantly correlated with scores on the graphomotor/praxis factor. Medial frontal ChAT also correlated significantly with the attention/registration scores. Hippocampal ChAT correlated significantly only with recent memory scores. These results are consistent with current animal research regarding the effect of selective cholinergic lesions on behavior.