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Markers of cerebral small vessel disease progression could indicate depression in elderly

Certain markers of cerebral small vessel disease, such as lower total brain parenchyma volume and subcortical infarcts, could indicate incident depressive symptoms in elderly patients, according to recent research.

“[T]he present study shows that most markers of progression of [cerebral small vessel disease] over time and only some markers of baseline [cerebral small vessel disease]  are independently associated with a concurrent development of higher incident depressive symptoms,” Thomas T. van Sloten, MD, and colleagues wrote in their study. “From a clinical point of view, this association is important because it suggests that [cerebral small vessel disease]  is a target for treatment and prevention strategies of late-life depression.”

Van Sloten and colleagues analyzed 1,752 participants (mean age = 74.6 years) without dementia and symptoms of depression from the Age, Gene/Environment Susceptibility-Reykjavik Study. They evaluated markers of cerebral small vessel disease (CSVD) on MRI measured at baseline between 2002 and 2006, and again at follow-up between 2007 and 2011. The researchers measured progression of CSVD by analyzing cerebral microbleeds, white matter hyperintensity volume, Virchow-Robin spaces, subcortical infarcts and total brain parenchyma volume on MRI.

They found that subcortical infarcts and lower total brain parenchyma volume were significantly associated with incident depressive symptoms when measuring baseline CSVD markers, and these associations remained after adjusting for baseline Geriatric Depression Scale scores.

When measuring progressive CSVD markers, subcortical infarcts, white matter volume hyperintensity volume, decrease in total brain parenchyma volume, and Virchow-Robin spaces were significantly associated with symptoms of depression.

The study was the first conducted to show a link between brain region-specific composite scores and depressive symptoms, according to the researchers.

“Further study is therefore needed to confirm the present findings (eg, using voxel-based morphometric analysis),” they wrote.

Disclosure: The researchers report no relevant financial disclosures.