Late-onset Depression in the Absence of Stroke: Associated with Silent Brain Infarctions, Microbleeds and Lesion Locations

Abstract

Background: Late-onset depression (LOD) is a frequent mood disorder among elderly. Previous studies have proved that LOD is associated with cerebral silent lesions especially white matter lesions (WML) and yielded the “vascular depression” hypothesis to explain the pathogenesis of LOD. However, there were relatively few studies about the association between silent brain infarctions (SBIs), microbleeds (MBs) and the prevalence of LOD. In this study we sought to evaluate the presence, accumulation and locations of SBIs and MBs, and explore the possible association between them and LOD.Methods: 65 patients of LOD diagnosed according to DSM-IV and 270 subjects of control group were enrolled and scanned by MRI to analyze the presence, numbers and locations of SBIs and MBs. Clinical and radiological characteristics were compared between LOD patients and control group. Logistic regression models were constructed to identify the independent risk factors for LOD.Results: LOD patients had higher prevalence and numbers of both SBIs and MBs. SBIs and MBs in the left hemisphere, SBIs in basal ganglia and lobar MBs were all independent risk factors for LOD.Conclusion: The presence of both SBIs and MBs were associated with a higher rate LOD. Lesions in some specific locations might be critical for the presence of LOD.

White matter microstructural damage and depressive symptoms in patients with mild cognitive impairment and cerebral small vessel disease: the VMCI‐Tuscany Study

“…Indeed, other studies with similar sample sizes and using both conventional neuroimaging sequences and DTI found results similar to ours (Lamar et al ., ). Considering other SVD lesions, one study found an association between microbleeds and depressive symptoms (Wu et al ., ). A recent meta‐analysis including 12 studies showed that lacunar stroke patients had a non‐significant higher prevalence of depression compared with patients with non‐lacunar cerebrovascular diseases (Egeto et al ., ).…”

Neuroanatomical correlates of late-life depression and associated cognitive changes

“…LLD can be further divided into early-onset depression (EOD) (onset before 60e65 years) and late-onset depression (LOD) (Mackin et al, 2014;Sachs-Ericsson et al, 2012;Wu et al, 2014).…”

Cerebral embolization, silent cerebral infarction and neurocognitive decline after thoracic endovascular aortic repair

“…This is evidence of cerebral infarction on imaging without acute neurological dysfunction attributable to the lesion 11 , and is commonly investigated using MRI. Studies 12,13 have shown that silent cerebral infarction is associated with an increased risk of future stroke, dementia, depression, cognitive impairment and early death independent of other vascular risk factors. It is well recognized following other catheter-based procedures (cerebral 14,15 and coronary 16 angiography, carotid stenting 17 and transcatheter aortic valve implantation 18 ), and a recent study 19 of 19 patients reported an incidence of 63 per cent following TEVAR.…”