Background: An increase in white matter lesions has been previously described in older depressed subjects. We investigated whether the regional location varied between depressed cases and normal subjects, and determined the relationship of magnetic resonance (MR) signal hyperintensities to known clinical risk factors for vascular disease.
Method: We used automated image processing software to determine volumes of signal hyperintensities from MRI brain scans of older people with depression (n=29, mean age: 76, SD: 6) and normal subjects of similar age(n=32, mean age: 75, SD: 7).
Results: Overall, depressed subjects had a significantly greater frontal lobe white matter (WM) lesion volume than normal subjects (0.35 % vs 0.22 %). However, after excluding those subjects with hypertension, diabetes, or ischaemic heart disease (leaving 14 depressed and 15 normal subjects) we found even greater differences between groups, with a larger volume of MR signal hyperintensities (MRSH) in the frontal region of the depressed group, but no difference in the basal ganglia, or parietal and occipital lobes.
Discussion: The study supports the vascular depression' hypothesis and suggests that those with depression but without traditional vascular risk factors may be much more susceptible to cerebrovascular disease than normal subjects. The mechanism(s) for this increased susceptibility remain to be determined.
Firbank MJ, Lloyd AJ, Ferrier IN, O'Brien JT. A volumetric study of MR signal hyperintensities in old age depression. American Journal of Geriatric Psychiatry 12(6) 606-612.
Dr. M. J. Firbank, NGH Unit, Newcastle upon Tyne. Tel: +44 (0)191-233-6161.
Regional Medical Physics Department, Newcastle General Hospital, Newcastle upon Tyne, NE4 6BE, UK.
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