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Localization of white-matter lesions and effect of vascular risk factors in late-onset major depression

Published online by Cambridge University Press:  09 November 2009

R. B. Dalby ,
M. M. Chakravarty ,
J. Ahdidan ,
L. Sørensen ,
J. Frandsen ,
K. Y. Jonsdottir ,
E. Tehrani ,
R. Rosenberg ,
L. Østergaard  and
P. Videbech
R. B. Dalby*
Affiliation:
Center for Psychiatric Research, Aarhus University Hospital, Risskov, Denmark
M. M. Chakravarty
Affiliation:
Allen Institute for Brain Science, Seattle, WA, USA PET Center, Aarhus University Hospital, Aarhus Sygehus, Aarhus, Denmark Center of Functionally Integrative Neuroscience (CFIN), Aarhus University, Aarhus, Denmark
J. Ahdidan
Affiliation:
Center for Psychiatric Research, Aarhus University Hospital, Risskov, Denmark
L. Sørensen
Affiliation:
Department of Neuroradiology, Aarhus University Hospital, Aarhus Sygehus, Aarhus, Denmark
J. Frandsen
Affiliation:
Center of Functionally Integrative Neuroscience (CFIN), Aarhus University, Aarhus, Denmark
K. Y. Jonsdottir
Affiliation:
Center of Functionally Integrative Neuroscience (CFIN), Aarhus University, Aarhus, Denmark
E. Tehrani
Affiliation:
Center for Psychiatric Research, Aarhus University Hospital, Risskov, Denmark
R. Rosenberg
Affiliation:
Center for Psychiatric Research, Aarhus University Hospital, Risskov, Denmark
L. Østergaard
Affiliation:
Center of Functionally Integrative Neuroscience (CFIN), Aarhus University, Aarhus, Denmark
P. Videbech
Affiliation:
Center for Psychiatric Research, Aarhus University Hospital, Risskov, Denmark
*
*Address for correspondence: Dr R. B. Dalby, Center for Psychiatric Research, Aarhus University Hospital, Skovagervej 2, DK-8240 Risskov, Denmark. (Email: [email protected])
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Abstract

Background

Several studies suggest that patients with late-onset major depression (MD) have an increased load of cerebral white-matter lesions (WMLs) compared with age-matched controls. Vascular risk factors such as hypertension and smoking may confound such findings. Our aim was to investigate the association between the localization and load of WMLs in late-onset MD with respect to vascular risk factors.

Method

We examined 22 consecutive patients with late-onset first-episode MD and 22 age- and gender-matched controls using whole-brain magnetic resonance imaging (MRI). The localization, number and volume of WMLs were compared between patients and controls, while testing the effect of vascular risk factors.

Results

Among subjects with one or more WMLs, patients displayed a significantly higher WML density in two white-matter tracts: the left superior longitudinal fasciculus and the right frontal projections of the corpus callosum. These tracts are part of circuitries essential for cognitive and emotional functions. Analyses revealed no significant difference in the total number and volume of WMLs between groups. Patients and controls showed no difference in vascular risk factors, except for smoking. Lesion load was highly correlated with smoking.

Conclusions

Our results indicate that lesion localization rather than lesion load differs between patients with late-onset MD and controls. Increased lesion density in regions associated with cognitive and emotional functions may be crucial in late-onset MD, and vascular risk factors such as smoking may play an important role in the pathophysiology of late-onset MD, consistent with the vascular depression hypothesis.

Keywords

Late-onset major depressionmagnetic resonance imagingwhite-matter hyperintensitieswhite-matter lesionssmokingvascular risk factors
Type
Original Articles
Information
Psychological Medicine , Volume 40 , Issue 8 , August 2010 , pp. 1389 - 1399
Copyright
Copyright © Cambridge University Press 2009

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