Background: Major depression is associated with activity and connectivity changes of multiple neural networks that correlate to the clinical manifestation. The chronic and recurrent course of late -life depression (LLD) suggests a possible role for structural brain changes in these network alterations. Recent evolutions in brain imaging permits to investigate neural networks in LLD on multiple levels.
Aim: To provide an overview of the structural, functional and molecular changes seen in imaging studies of LLD.
Method: Narrative review.
Results: The neurobiology of LLD includes specific grey and white matter changes and dysfunctions in three neural networks that can be correlated to LLD symptomatology. Some patients show signs of accelerated or pathological brain aging. These provide a possible neurobiological underpinning for poor treatment response.
Conclusion: Imaging studies show various neurobiological changes that contribute to neural network dysfunction in LLD.