Blood pressure and white matter integrity in geriatric depression.

BACKGROUND: Cerebrovascular disease may increase vulnerability to geriatric depression, a syndrome often accompanied by frontal-subcortical lesions. High blood pressure is a risk factor for cerebrovascular disease and white matter changes. This study examined whether and in which brain regions blood pressure is associated with compromised white matter integrity in elderly depressed patients. METHODS: We studied the association between blood pressure and white matter integrity assessed by diffusion tensor imaging (fractional anisotropy, FA) in 41 older patients with major depression. Correlations between FA and blood pressure, after controlling for age, were examined with a voxelwise analysis. RESULTS: Significant associations between FA and blood pressure were detected throughout the anterior cingulate and in multiple frontostriatal and frontotemporal regions. LIMITATIONS: This study did not employ a healthy control group. Moreover, the relatively small sample size precluded a comparison of patients with and without hypertension. CONCLUSIONS: Compromised frontal-striatal white matter integrity may be the anatomical background through which blood pressure confers vulnerability to depression.