Research output: Contribution to journal › Article › peer-review
Vascular depression consensus report - a critical update. / Aizenstein, Howard J.; Baskys, Andrius; Boldrini, Maura; Butters, Meryl A.; Diniz, Breno S.; Jaiswal, Manoj Kumar; Jellinger, Kurt A.; Kruglov, Lev S.; Meshandin, Ivan A.; Mijajlovic, Milija D.; Niklewski, Guenter; Pospos, Sarah; Raju, Keerthy; Richter, Kneginja; Steffens, David C.; Taylor, Warren D.; Tene, Oren.
In: BMC Medicine, Vol. 14, No. 1, 161, 03.11.2016.Research output: Contribution to journal › Article › peer-review
}
TY - JOUR
T1 - Vascular depression consensus report - a critical update
AU - Aizenstein, Howard J.
AU - Baskys, Andrius
AU - Boldrini, Maura
AU - Butters, Meryl A.
AU - Diniz, Breno S.
AU - Jaiswal, Manoj Kumar
AU - Jellinger, Kurt A.
AU - Kruglov, Lev S.
AU - Meshandin, Ivan A.
AU - Mijajlovic, Milija D.
AU - Niklewski, Guenter
AU - Pospos, Sarah
AU - Raju, Keerthy
AU - Richter, Kneginja
AU - Steffens, David C.
AU - Taylor, Warren D.
AU - Tene, Oren
N1 - 2. Vascular depression consensus report – a critical update// BMC Medicine201614:161 DOI: 10.1186/s12916-016-0720-5
PY - 2016/11/3
Y1 - 2016/11/3
N2 - Background: Vascular depression is regarded as a subtype of late-life depression characterized by a distinct clinical presentation and an association with cerebrovascular damage. Although the term is commonly used in research settings, widely accepted diagnostic criteria are lacking and vascular depression is absent from formal psychiatric manuals such as the Diagnostic and Statistical Manual of Mental Disorders, 5th edition - a fact that limits its use in clinical settings. Magnetic resonance imaging (MRI) techniques, showing a variety of cerebrovascular lesions, including extensive white matter hyperintensities, subcortical microvascular lesions, lacunes, and microinfarcts, in patients with late life depression, led to the introduction of the term "MRI-defined vascular depression". Discussion: This diagnosis, based on clinical and MRI findings, suggests that vascular lesions lead to depression by disruption of frontal-subcortical-limbic networks involved in mood regulation. However, despite multiple MRI approaches to shed light on the spatiotemporal structural changes associated with late life depression, the causal relationship between brain changes, related lesions, and late life depression remains controversial. While postmortem studies of elderly persons who died from suicide revealed lacunes, small vessel, and Alzheimer-related pathologies, recent autopsy data challenged the role of these lesions in the pathogenesis of vascular depression. Current data propose that the vascular depression connotation should be reserved for depressed older patients with vascular pathology and evident cerebral involvement. Based on current knowledge, the correlations between intra vitam neuroimaging findings and their postmortem validity as well as the role of peripheral markers of vascular disease in late life depression are discussed. Conclusion: The multifold pathogenesis of vascular depression as a possible subtype of late life depression needs further elucidation. There is a need for correlative clinical, intra vitam structural and functional MRI as well as postmortem MRI and neuropathological studies in order to confirm the relationship between clinical symptomatology and changes in specific brain regions related to depression. To elucidate the causal relationship between regional vascular brain changes and vascular depression, animal models could be helpful. Current treatment options include a combination of vasoactive drugs and antidepressants, but the outcomes are still unsatisfying.
AB - Background: Vascular depression is regarded as a subtype of late-life depression characterized by a distinct clinical presentation and an association with cerebrovascular damage. Although the term is commonly used in research settings, widely accepted diagnostic criteria are lacking and vascular depression is absent from formal psychiatric manuals such as the Diagnostic and Statistical Manual of Mental Disorders, 5th edition - a fact that limits its use in clinical settings. Magnetic resonance imaging (MRI) techniques, showing a variety of cerebrovascular lesions, including extensive white matter hyperintensities, subcortical microvascular lesions, lacunes, and microinfarcts, in patients with late life depression, led to the introduction of the term "MRI-defined vascular depression". Discussion: This diagnosis, based on clinical and MRI findings, suggests that vascular lesions lead to depression by disruption of frontal-subcortical-limbic networks involved in mood regulation. However, despite multiple MRI approaches to shed light on the spatiotemporal structural changes associated with late life depression, the causal relationship between brain changes, related lesions, and late life depression remains controversial. While postmortem studies of elderly persons who died from suicide revealed lacunes, small vessel, and Alzheimer-related pathologies, recent autopsy data challenged the role of these lesions in the pathogenesis of vascular depression. Current data propose that the vascular depression connotation should be reserved for depressed older patients with vascular pathology and evident cerebral involvement. Based on current knowledge, the correlations between intra vitam neuroimaging findings and their postmortem validity as well as the role of peripheral markers of vascular disease in late life depression are discussed. Conclusion: The multifold pathogenesis of vascular depression as a possible subtype of late life depression needs further elucidation. There is a need for correlative clinical, intra vitam structural and functional MRI as well as postmortem MRI and neuropathological studies in order to confirm the relationship between clinical symptomatology and changes in specific brain regions related to depression. To elucidate the causal relationship between regional vascular brain changes and vascular depression, animal models could be helpful. Current treatment options include a combination of vasoactive drugs and antidepressants, but the outcomes are still unsatisfying.
KW - Cerebrovascular lesions
KW - Clinicopathological correlations
KW - Late-life depression
KW - Neuropathology
KW - Peripheral markers
KW - Structural neuroimaging
KW - Vascular depression
KW - White matter lesions
UR - http://www.scopus.com/inward/record.url?scp=84995743390&partnerID=8YFLogxK
U2 - 10.1186/s12916-016-0720-5
DO - 10.1186/s12916-016-0720-5
M3 - Article
C2 - 27806704
AN - SCOPUS:84995743390
VL - 14
JO - BMC Medicine
JF - BMC Medicine
SN - 1741-7015
IS - 1
M1 - 161
ER -
ID: 37620512