Vascular depression consensus report – a critical update

作者：Howard Jay Aizenstein, Andrius Baskys, Maura Boldrini, Meryl A. Butters, Breno Satler Diniz, Manoj K. Jaiswal, K. A. Jellinger, L. S. Kruglov, I. A. Meshandin, Milija D. Mijajlovic, Guenter Niklewski, Sarah Pospos, Keerthy Raju, Kneginja Richter, David C. Steffens, Warren D. Taylor, Oren Tene · 发表于：BMC Medicine · 年份：2016 · DOI：10.1186/s12916-016-0720-5 · 被引用次数：264 · 研究领域：Dementia and Cognitive Impairment Research、Cerebrovascular and Carotid Artery Diseases、Cardiac Health and Mental Health

BACKGROUND: 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 d...