Neuropathological analysis of lacunes and microvascular lesions in late-onset depression.
Neuropathol Appl Neurobiol
; 36(7): 661-72, 2010 Dec.
Article
em En
| MEDLINE
| ID: mdl-20609111
ABSTRACT
AIMS:
Previous neuropathological studies documented that small vascular and microvascular pathology is associated with cognitive decline. More recently, we showed that thalamic and basal ganglia lacunes are associated with post-stroke depression and may affect emotional regulation. The present study examines whether this is also the case for late-onset depression.METHODS:
We performed a detailed analysis of small macrovascular and microvascular pathology in the post mortem brains of 38 patients with late-onset major depression (LOD) and 29 healthy elderly controls. A clinical diagnosis of LOD was established while the subjects were alive using the DSM-IV criteria. Additionally, we retrospectively reviewed all charts for the presence of clinical criteria of vascular depression. Neuropathological evaluation included bilateral semi-quantitative assessment of lacunes, deep white matter and periventricular demyelination, cortical microinfarcts and both focal and diffuse gliosis. The association between vascular burden and LOD was investigated using Fisher's exact test and univariate and multivariate logistic regression models.RESULTS:
Neither the existence of lacunes nor the presence of microvascular ischaemic lesions was related to occurrence of LOD. Similarly, there was no relationship between vascular lesion scores and LOD. This was also the case within the subgroup of LOD patients fulfilling the clinical criteria for vascular depression.CONCLUSIONS:
Our results challenge the vascular depression hypothesis by showing that neither deep white matter nor periventricular demyelination is associated with LOD. In conjunction with our previous observations in stroke patients, they also imply that the impact of lacunes on mood may be significant solely in the presence of acute brain compromise.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Encéfalo
/
Capilares
/
Transtorno Depressivo
Tipo de estudo:
Prognostic_studies
Limite:
Aged
/
Aged80
/
Female
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Humans
/
Male
Idioma:
En
Revista:
Neuropathol Appl Neurobiol
Ano de publicação:
2010
Tipo de documento:
Article
País de afiliação:
Suíça