Baseline cerebrovascular disease, including small basal ganglia and large cortical white-matter lesions, was associated with the occurrence, persistence, and worsening of depressive symptoms over 7 years.
Cohort (n=3,236)
Does cerebrovascular disease on neuroimaging predict the evolution of depressive symptoms in CHS participants?
Cerebrovascular disease identified on baseline MRI is associated with the occurrence, persistence, and worsening of depressive symptoms over time, supporting a link between vascular brain pathology and mood disorders.
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 >7) 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 > or =5) 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.
Steffens et al. (Sat,) conducted a cohort in Cerebrovascular disease and depressive symptoms (n=3,236). Vascular brain pathology on neuroimaging was evaluated on Evolution of depressive symptoms (occurrence, persistence, and worsening). Baseline cerebrovascular disease, including small basal ganglia and large cortical white-matter lesions, was associated with the occurrence, persistence, and worsening of depressive symptoms over 7 years.