Relationship between age at onset and magnetic resonance image-defined hyperintensities in mood disorders

Takahashi, Keisuke; Oshima, Akihiro; Ida, Iturou; Kumano, Hiroshi; Yuuki, Naoya; Fukuda, Masato; Amaki, Makoto; Endo, Keigo; Murakami, Masahiko

doi:10.1016/j.jpsychires.2007.05.003

Cited by 27 publications

(24 citation statements)

References 52 publications

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“…The significant increase of periventricular hyperintensities in our LOD group may partly explain the observed cognitive deficits. In fact, recent contributions pointed to a possible vascular origin of episodic memory impairment both in population-based samples and LOD cohorts [5,17]. To our knowledge, this is the only study that compared concomitantly the cognitive profile and the brain structural characteristics of elderly patients who recovered from EOD or LOD.…”

Section: Resultsmentioning

confidence: 94%

“…These discrepancies might be partly explained by age differences relative to the onset of depression among elderly patients. Recent studies suggest that the patterns of both neuropsychological deficits and structural imaging changes vary substantially between late-onset depression (LOD) and early-onset depression (EOD) [1,5,6]. LOD has been traditionally associated with more frequent and rapid cognitive decline as well as more severe structural brain abnormalities compared to age-matched controls and EOD patients [1,6].…”

Section: Introductionmentioning

confidence: 99%

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Neuroanatomical and neuropsychological features of elderly euthymic depressed patients with early- and late-onset

Delaloye

Moy

Bilbao

et al. 2010

Journal of the Neurological Sciences

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Section: Resultsmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Neuroanatomical and neuropsychological features of elderly euthymic depressed patients with early- and late-onset

Delaloye

Moy

Bilbao

et al. 2010

Journal of the Neurological Sciences

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“…Systematic reviews reported a four-fold higher prevalence of deep and periventricular WMHs in LOD/LLD subjects than in those with EOD and healthy controls [98, 116]. Together with a more frequent presence of cardiovascular risk factors (hypertension, dyslipidemia, vascular co-morbidity, diabetes mellitus) [117–120], and a history of CVD, a higher burden of WMHs was proposed to be a diagnostic criterion for VaDep or subcortical ischemic depression [19].…”

Section: Resultsmentioning

confidence: 99%

Vascular depression consensus report – a critical update

Aizenstein

Baskys

Boldrini

et al. 2016

BMC Med

219

145

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BackgroundVascular depression is regarded as a subtype of late-life depression characterized by a distinct clinical presentation and an association with cerebrovascular damage. Although the term is commonly used in research settings, widely accepted diagnostic criteria are lacking and vascular depression is absent from formal psychiatric manuals such as the Diagnostic and Statistical Manual of Mental Disorders, 5th edition – a fact that limits its use in clinical settings. Magnetic resonance imaging (MRI) techniques, showing a variety of cerebrovascular lesions, including extensive white matter hyperintensities, subcortical microvascular lesions, lacunes, and microinfarcts, in patients with late life depression, led to the introduction of the term “MRI-defined vascular depression”.DiscussionThis diagnosis, based on clinical and MRI findings, suggests that vascular lesions lead to depression by disruption of frontal–subcortical–limbic networks involved in mood regulation. However, despite multiple MRI approaches to shed light on the spatiotemporal structural changes associated with late life depression, the causal relationship between brain changes, related lesions, and late life depression remains controversial. While postmortem studies of elderly persons who died from suicide revealed lacunes, small vessel, and Alzheimer-related pathologies, recent autopsy data challenged the role of these lesions in the pathogenesis of vascular depression. Current data propose that the vascular depression connotation should be reserved for depressed older patients with vascular pathology and evident cerebral involvement. Based on current knowledge, the correlations between intra vitam neuroimaging findings and their postmortem validity as well as the role of peripheral markers of vascular disease in late life depression are discussed.ConclusionThe multifold pathogenesis of vascular depression as a possible subtype of late life depression needs further elucidation. There is a need for correlative clinical, intra vitam structural and functional MRI as well as postmortem MRI and neuropathological studies in order to confirm the relationship between clinical symptomatology and changes in specific brain regions related to depression. To elucidate the causal relationship between regional vascular brain changes and vascular depression, animal models could be helpful. Current treatment options include a combination of vasoactive drugs and antidepressants, but the outcomes are still unsatisfying.

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“…They reportedly correlate with gait disturbances, 2 cognitive impairment, dementia 3 and mood disorders. 4 These WMLs are likely to result from ischemic injury to the brain. 26 Exposure of vessels to high pressure results in impairment of cerebral autoregulation 27 or microvascular structural damage, 28 and these are potential mechanisms that may lead to cerebral WMHs.…”

Section: Discussionmentioning

confidence: 99%

“…Their presence correlates with gait disturbances, 2 cognitive impairment, dementia 3 and mood disorders. 4 Epidemiological studies have shown that age, hypertension and diabetes, the principal risk factors of cerebrovascular disease (CVD), are associated with white matter hyperintensities (WMHs). This association is suggestive of a vascular mechanism in WMH pathogenesis.…”

Section: Introductionmentioning

confidence: 99%

Association between central systolic blood pressure, white matter lesions in cerebral MRI and carotid atherosclerosis

Shrestha

Takahashi

Nomura³

et al. 2009

Hypertens Res

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White matter hyperintensities (WMHs) observed on cerebral magnetic resonance images (MRIs) are associated with age and hypertension, suggesting a vascular mechanism of pathogenesis. Central systolic blood pressure (cSBP) correlates more closely with measures of cardiovascular disease risk than brachial pressure. We sought to determine whether cSBP correlates with WMHs and if cSBP is predictive of cerebrovascular disease. Radial applanation tonometric measurements for cSBP and augmentation index (AI) were carried out in unselected individuals undergoing carotid ultrasound. WMHs were assessed retrospectively using fluid-attenuated inversion recovery (FLAIR)-MRIs as periventricular (PVH) and deep white matter hyperintensities (DWMH), and they were rated using the Fazekas scale. A total of 179 patients, 94 (53%) men and 85 (47%) women, with a mean age of 66±13 years were included in the study. On MRI, 17, 74, 67 and 21 patients had PVH grades 0, 1, 2 and 3, respectively. Forty-eight, 69, 49 and 13 had DWMH grades 0, 1, 2 and 3, respectively. In our study population, PVH correlated with age, brachial SBP, cSBP and AI (r¼0.49, 0.28, 0.23; Po0.002 and r¼0.13; Po0.05, respectively). DWMH also correlated with age, brachial SBP and cSBP (r¼0.41, 0.30, 0.22; Po0.003, respectively), but not with AI. cSBP values were associated with PVH/DWMH grades 2 and 3, but brachial SBP correlated only with grade 3. Mean carotid intima-media thickness (common carotid arteries (CCA)-IMT) was 0.68 ± 0.13 mm. CCA-IMT and plaque score (PS) correlated with PVH/DWMH. Multivariate regression analysis showed cSBP, age and PS to be independently associated with PVH and DWMH. Correlation of cSBP with PVH and DWMH was independent of PS. Central SBP correlated with PVH and DWMH in FLAIR-MRIs and can better predict WMHs than brachial SBP in earlier stages.

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Relationship between age at onset and magnetic resonance image-defined hyperintensities in mood disorders

Cited by 27 publications

References 52 publications

Neuroanatomical and neuropsychological features of elderly euthymic depressed patients with early- and late-onset

Neuroanatomical and neuropsychological features of elderly euthymic depressed patients with early- and late-onset

Vascular depression consensus report – a critical update

Association between central systolic blood pressure, white matter lesions in cerebral MRI and carotid atherosclerosis

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