The 3-year course and outcome of patients with major depression and silent cerebral infarction

Yanai, Ichiro; Fujikawa, Tokumi; Horiguchi, Jun; Yamawaki, Shigeto; Touhouda, Yoshikuni

doi:10.1016/s0165-0327(97)00148-1

Cited by 43 publications

(28 citation statements)

References 19 publications

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“…This was seen in subcortical white matter for any lesion, any large lesion, and to a nearly significant degree (OR, 1.57; 95% CI, 0.86 to 2.88), white-matter grade dichotomized as 0 to 5 versus 6 to 9. This effect is demonstrated in the Figure. Certainly, clinical studies of treatment response indicate that subcortical white-matter lesions are associated with worse outcome, 10,11,39 but this is the first report of actual worsening of symptoms associated with such changes and may provide the best evidence that cerebrovascular disease independently causes depression symptoms.…”

Section: Discussionmentioning

confidence: 87%

Cerebrovascular Disease and Evolution of Depressive Symptoms in the Cardiovascular Health Study

Steffens

Krishnan

Crump

et al. 2002

Stroke

197

113

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Background and Purpose-Previous studies have reported an association between cerebrovascular disease and depressive symptoms. The Cardiovascular Health Study (CHS) provides an opportunity to examine the relationship between vascular brain pathology seen on neuroimaging and changes in depressive symptoms. Methods-The sample included 3236 CHS participants who had an MRI brain scan. Demographic variables, medical history, functional status, and apolipoprotein E genotype were obtained at baseline. Annual scores on a modified version of the Centers for Epidemiologic Studies Depression (CES-D) scale were obtained initially and up to 7 years subsequently. Results-After controlling for important covariates, occurrence of depressive symptoms (defined as modified CES-D score of Ͼ7) was associated with small lesions in the basal ganglia, large cortical white-matter lesions, and severe subcortical white-matter grade. Neuroimaging variables did not predict incident depression among those who were nondepressive at the time of MRI. Persistence of depressive symptoms across 2 consecutive time points was associated with small basal ganglia lesions and large cerebral cortical white-matter lesions. Worsening of depression (increase in CES-D score of Ն5) was associated with subcortical white-matter lesions. Conclusions-These findings suggest that cerebrovascular disease at baseline is related to depression symptoms over time.Further studies are needed to investigate the differential effects of subcortical white-versus gray-matter lesions on mood.

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Section: Discussionmentioning

confidence: 87%

Cerebrovascular Disease and Evolution of Depressive Symptoms in the Cardiovascular Health Study

Steffens

Krishnan

Crump

et al. 2002

Stroke

197

113

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“…SCI generally is detected by MRI, and is thought to be a risk factor for stroke. The presence of SCI frequently is associated with symptomatic stroke (14-18), cognitive dysfunction (24,25), and both psychiatric and neurological disorders (17,26,27). Age, hypertension, smoking, diabetes, and atrial fibrillation are known as SCI risk factors.…”

Section: Discussionmentioning

confidence: 99%

Associations of Brachial-Ankle Pulse Wave Velocity and Carotid Atherosclerotic Lesions with Silent Cerebral Lesions

Matsumoto

Inoue

Moriki³

2007

Hypertens Res

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“…SCI is detectable by MRI and other imaging modalities, but is not associated with either stroke, focal neurological symptoms or dementia. Our findings suggested that SCI is present in most patients exhibiting senile onset major depression [5], that depressed patients with SCI required longer hospital treatment and had more drug-related adverse reactions of the central nervous system [6] and that depressed patients with SCI had a higher rate of readmission due to the recurrence of depression during a 3-year follow-up period [7]. Together, our results suggest that the clinical features and the response to antidepressant pharmacotherapy in depressed patients with SCI are different from those of depressed patients without SCI.…”

Section: Introductionmentioning

confidence: 68%

“…In the present study, as in our previous reports, SCI was defined as the presence of four or more infarcts in the same hemisphere, and these patients were assigned to the SCI(+) group [5][6][7]. Patients with fewer than four infarcts were assigned to the SCI(-) group.…”

Section: Mri Findingsmentioning

confidence: 82%

Clinical Features and Treatment Response of Patients with Major Depression and Silent Cerebral Infarction

et al. 2001

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Previously, we reported a relationship between silent cerebral infarction (SCI), as detected by magnetic resonance imaging (MRI), and late onset major depression. In the present study, we clarify the clinical features of the depressive phase of patients with major depression and SCI, and their response to antidepressant pharmacotherapy. Using clinical charts, we retrospectively examined patients with depression, who were first admitted for antidepressant pharmacotherapy. All patients were classified according to the MRI findings and the age on admission (older or younger than 50 years) into either the young SCI(–) group (n = 23), the elderly SCI(–) group (n = 27) or the elderly SCI(+) group (n = 20).The characteristics of the clinical features were evaluated at the time of admission, after 2 weeks of treatment and at the time of discharge using the Hamilton rating scale for depression (HAMD). These data were compared between each patient group. No differences in the clinical features, as evaluated by HAMD, were observed between the three groups at the time of admission. However, the mean length of treatment was significantly longer and the treatment response, as evaluated by the total HAMD score, was significantly worse in the elderly SCI(+) group than in the other two groups, when examined after 2 weeks of treatment and at the time of discharge. The elderly SCI(+) group demonstrated higher scores in feelings of guilt, suicide, retardation and hypochondriasis than the young SCI(–) group and the elderly SCI(–) group after two weeks of treatment, and higher scores in early insomnia, late insomnia, somatic anxiety and hypochondriasis at the time of discharge. Our findings suggest that while the presence of SCI does not affect the clinical features observed at the time of admission, it does affect the treatment response to antidepressant pharmacotherapy.

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The 3-year course and outcome of patients with major depression and silent cerebral infarction

Cited by 43 publications

References 19 publications

Cerebrovascular Disease and Evolution of Depressive Symptoms in the Cardiovascular Health Study

Cerebrovascular Disease and Evolution of Depressive Symptoms in the Cardiovascular Health Study

Associations of Brachial-Ankle Pulse Wave Velocity and Carotid Atherosclerotic Lesions with Silent Cerebral Lesions

Clinical Features and Treatment Response of Patients with Major Depression and Silent Cerebral Infarction

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