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The impact of vascular burden on late-life depression

Santos, Micaela
Hof, Patrick R.
Published in Brain Research Reviews. 2009, vol. 62, no. 1, p. 19-32
Abstract 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.
Keywords Aging/*psychologyBlood Vessels/*pathologyBrain/blood supply/*pathologyCognition Disorders/*pathologyDepressive Disorder/*pathologyHumans
PMID: 19744522
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Research groups Groupe Bouras Constantin (neuropsychiatrie) (1)
Groupe Giannakopoulos Panteleimon (psychiatrie générale) (201)
Démence du sujet âgé, troubles cognitifs, la symptomatologie cognitive (577)
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SANTOS, Micaela et al. The impact of vascular burden on late-life depression. In: Brain Research Reviews, 2009, vol. 62, n° 1, p. 19-32. doi: 10.1016/j.brainresrev.2009.08.003 https://archive-ouverte.unige.ch/unige:20072

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Deposited on : 2012-04-23

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