TY - JOUR
T1 - The impact of vascular burden on late-life depression
AU - Santos, Micaela
AU - Kövari, Enikö
AU - Hof, Patrick R.
AU - Gold, Gabriel
AU - Bouras, Constantin
AU - Giannakopoulos, Panteleimon
N1 - Funding Information:
This work was supported by NIH grants AG05138 and AG02219 (P.R.H.) and the Foundation Jérôme Tissières (P.G.).
PY - 2009/12/11
Y1 - 2009/12/11
N2 - Small vessel pathology and microvascular lesions are no longer considered as minor players in the fields of cognitive impairment and mood regulation. Although frequently found in cognitively intact elders, both neuroimaging and neuropathological data revealed the negative impact on cognitive performances of their presence within neocortical association areas, thalamus and basal ganglia. Unlike cognition, the relationship between these lesions and mood dysregulation is still a matter of intense debate. Early studies focusing on the role of macroinfarct location in the occurrence of post-stroke depression (PSD) led to conflicting data. Later on, the concept of vascular depression proposed a deleterious effect of subcortical lacunes and deep white matter demyelination on mood regulation in elders who experienced the first depressive episode. More recently, the chronic accumulation of lacunes in thalamus, basal ganglia and deep white matter has been considered as a strong correlate of PSD. We provide here a critical overview of neuroimaging and neuropathological sets of evidence regarding the affective repercussions of vascular burden in the aging brain and discuss their conceptual and methodological limitations. Based on these observations, we propose that the accumulation of small vascular and microvascular lesions constitutes a common neuropathological platform for both cognitive decline and depressive episodes in old age.
AB - Small vessel pathology and microvascular lesions are no longer considered as minor players in the fields of cognitive impairment and mood regulation. Although frequently found in cognitively intact elders, both neuroimaging and neuropathological data revealed the negative impact on cognitive performances of their presence within neocortical association areas, thalamus and basal ganglia. Unlike cognition, the relationship between these lesions and mood dysregulation is still a matter of intense debate. Early studies focusing on the role of macroinfarct location in the occurrence of post-stroke depression (PSD) led to conflicting data. Later on, the concept of vascular depression proposed a deleterious effect of subcortical lacunes and deep white matter demyelination on mood regulation in elders who experienced the first depressive episode. More recently, the chronic accumulation of lacunes in thalamus, basal ganglia and deep white matter has been considered as a strong correlate of PSD. We provide here a critical overview of neuroimaging and neuropathological sets of evidence regarding the affective repercussions of vascular burden in the aging brain and discuss their conceptual and methodological limitations. Based on these observations, we propose that the accumulation of small vascular and microvascular lesions constitutes a common neuropathological platform for both cognitive decline and depressive episodes in old age.
KW - Aging
KW - Cognitive impairment
KW - Lacunes
KW - Microvascular pathology
KW - Mood
KW - Vascular burden
UR - http://www.scopus.com/inward/record.url?scp=70449624835&partnerID=8YFLogxK
U2 - 10.1016/j.brainresrev.2009.08.003
DO - 10.1016/j.brainresrev.2009.08.003
M3 - Review article
C2 - 19744522
AN - SCOPUS:70449624835
SN - 0165-0173
VL - 62
SP - 19
EP - 32
JO - Brain Research Reviews
JF - Brain Research Reviews
IS - 1
ER -