Successful electroconvulsive therapy for depression in a man with cerebral amyloid angiopathy

Schurgers, Geert; Arts, Baer; Postma, Alida A.; Kort, Anna de

doi:10.1136/bcr-2020-238922

Cited by 1 publication

(1 citation statement)

References 26 publications

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“…Some showed superior efficacy of ECT over pharmacotherapy independent of VRFs [ 217 ], while others reported less response to ECT in patients than in those without VRFs, and the more these increased, the less antidepressive effect was observed [ 218 ]. Successful ECT was reported in a man with “probable” CAA and severe depression [ 219 ] and in a female aged 71 years with subcortical vascular encephalopathy and depression [ 220 ]. Deep transcranial magnetic stimulation was reported to be beneficial in treating VaD [ 221 , 222 , 223 , 224 ].…”

Section: Implications For Clinical Practice and Managementmentioning

confidence: 99%

Pathomechanisms of Vascular Depression in Older Adults

Jellinger¹

2021

IJMS

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Depression in older individuals is a common complex mood disorder with high comorbidity of both psychiatric and physical diseases, associated with high disability, cognitive decline, and increased mortality The factors predicting the risk of late-life depression (LLD) are incompletely understood. The reciprocal relationship of depressive disorder and age- and disease-related processes has generated pathogenic hypotheses and provided various treatment options. The heterogeneity of depression complicates research into the underlying pathogenic cascade, and factors involved in LLD considerably differ from those involved in early life depression. Evidence suggests that a variety of vascular mechanisms, in particular cerebral small vessel disease, generalized microvascular, and endothelial dysfunction, as well as metabolic risk factors, including diabetes, and inflammation that may induce subcortical white and gray matter lesions by compromising fronto–limbic and other important neuronal networks, may contribute to the development of LLD. The “vascular depression” hypothesis postulates that cerebrovascular disease or vascular risk factors can predispose, precipitate, and perpetuate geriatric depression syndromes, based on their comorbidity with cerebrovascular lesions and the frequent development of depression after stroke. Vascular burden is associated with cognitive deficits and a specific form of LLD, vascular depression, which is marked by decreased white matter integrity, executive dysfunction, functional disability, and poorer response to antidepressive therapy than major depressive disorder without vascular risk factors. Other pathogenic factors of LLD, such as neurodegeneration or neuroimmune regulatory dysmechanisms, are briefly discussed. Treatment planning should consider a modest response of LLD to antidepressants, while vascular and metabolic factors may provide promising targets for its successful prevention and treatment. However, their effectiveness needs further investigation, and intervention studies are needed to assess which interventions are appropriate and effective in clinical practice.

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Section: Implications For Clinical Practice and Managementmentioning

confidence: 99%

Pathomechanisms of Vascular Depression in Older Adults

Jellinger¹

2021

IJMS

View full text Add to dashboard Cite

show abstract

Successful electroconvulsive therapy for depression in a man with cerebral amyloid angiopathy

Cited by 1 publication

References 26 publications

Pathomechanisms of Vascular Depression in Older Adults

Pathomechanisms of Vascular Depression in Older Adults

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