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Vascular depression: Recent advances

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Current Psychosis and Therapeutics Reports

Abstract

This manuscript reviews the recent advances in the understanding of depression accompanied by cerebrovascular disease, the “vascular depression” concept, and the approaches to primary and secondary prevention, and treatment. An idea of a cerebrovascular affective-cognitive continuum is also discussed. An improved understanding of the cerebrovascular continuum disorders, underlying pathophysiology, and approaches to management of vascular depression is likely to improve the quality of life of patients and their families, and reduce the cost of care for society.

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References and Recommended Reading

  1. Lebowitz BD, Pearson JL, Schneider LS, et al.: Diagnosis and treatment of depression in late life. Consensus statement update. JAMA 1997, 278:1186–1190.

    Article  PubMed  CAS  Google Scholar 

  2. Schneider LS, Reynolds CF, Lebowitz BD: Diagnosis and Treatment of Depression in Late Life. Washington, DC: American Psychiatric Press; 1994.

    Google Scholar 

  3. Blazer D, Williams CD: Epidemiology of dysphoria and depression in an elderly population. Am J Psychiatry 1980, 137:439–444.

    PubMed  CAS  Google Scholar 

  4. Sharma VK, Copeland JR, Dewey ME, et al.: Outcome of the depressed elderly living in the community in Liverpool: a 5-year follow-up. Psychol Med 1998, 28:1329–1337.

    Article  PubMed  CAS  Google Scholar 

  5. Unutzer J, Patrick DL, Simon G, et al.: Depressive symptoms and the cost of health services in HMO patients aged 65 years and older. A 4-year prospective study. JAMA 1997, 277:1618–1623.

    Article  PubMed  CAS  Google Scholar 

  6. Vaillant GE, Orav J, Meyer SE, et al.: 1995 IPA/Bayer Research Awards in Psychogeriatrics. Late-life consequences of affective spectrum disorder. Int Psychogeriatr 1996, 8:13–32.

    Article  PubMed  CAS  Google Scholar 

  7. Post F: The Significance of Affective Symptoms in Old Age: A Fellow-up Study of One Hundred Patients. London: Oxford University Press; 1962.

    Google Scholar 

  8. Mayer-Gross W, Slater E, Roth M: Clinical Psychiatry. London: Balliere, Tindall & Cassell; 1960.

    Google Scholar 

  9. Kumar A, Cummings J: Depression in neurodegenerative disorders and related conditions in Alzheimer’s disease and related conditions. In Alzheimer’s Disease and Related Disorders. Edited by Gothier S, Cummings J. London: Martin Dunitz; 2001:123–141.

    Google Scholar 

  10. House A, Dennis M, Mogridge L, et al.: Mood disorders in the year after first stroke. Br J Psychiatry 1991, 158:83–92.

    Article  PubMed  CAS  Google Scholar 

  11. Robinson RG, Bolduc PL, Price TR: Two-year longitudinal study of poststroke mood disorders: diagnosis and outcome at one and two years. Stroke 1987, 18:837–843.

    PubMed  CAS  Google Scholar 

  12. Chemerinski E, Robinson RG: The neuropsychiatry of stroke. Psychosomatics 2000, 41:5–14.

    PubMed  CAS  Google Scholar 

  13. Eastwood MR, Rifat SL, Nobbs H, Ruderman J: Mood disorder following cerebrovascular accident. Br J Psychiatry 1989, 154:195–200.

    PubMed  CAS  Google Scholar 

  14. Primeau F: Post-stroke depression: a critical review of the literature. Can J Psychiatry 1988, 33:757–765.

    PubMed  CAS  Google Scholar 

  15. Bowler JV, Hachinski V: Vascular dementia. In Behavioral Neurology and Neuropsychology. Edited by Feinberg TE, Farah MJ. New York: McGraw-Hill; 1997:589–603.

    Google Scholar 

  16. Aharon-Peretz J, Kliot D, Tomer R: Behavioral differences between white matter lacunar dementia and Alzheimer’s disease: a comparison on the neuropsychiatric inventory. Dement Geriatr Cogn Disord 2000, 11:294–298.

    Article  PubMed  CAS  Google Scholar 

  17. Lind K, Edman A, Karlsson I, et al.: Relationship between depressive symptomatology and the subcortical brain syndrome in dementia. Int J Geriatr Psychiatry 2002, 17:774–778.

    Article  PubMed  CAS  Google Scholar 

  18. Ramasubbu R: Relationship between depression and cerebrovascular disease: conceptual issues. J Affect Disord 2000, 57:1–11.

    Article  PubMed  CAS  Google Scholar 

  19. Simonsick EM, Wallace RB, Blazer DG, Berkman LF: Depressive symptomatology and hypertension-associated morbidity and mortality in older adults. Psychosom Med 1995, 57:427–435.

    PubMed  CAS  Google Scholar 

  20. Starkstein SE, Robinson RG, Price TR: Comparison of cortical and subcortical lesions in the production of poststroke mood disorders. Brain 1987, 110:1045–1059.

    Article  PubMed  Google Scholar 

  21. Robinson RG, Price TR: Post-stroke depressive disorders: a follow-up study of 103 patients. Stroke 1982, 13:635–641.

    PubMed  CAS  Google Scholar 

  22. Robinson RG, Szetela B: Mood change following left hemispheric brain injury. Ann Neurol 1981, 9:447–453.

    Article  PubMed  CAS  Google Scholar 

  23. Bolla-Wilson K, Robinson RG, Starkstein SE, et al.: Lateralization of dementia of depression in stroke patients. Am J Psychiatry 1989, 146:627–634.

    PubMed  CAS  Google Scholar 

  24. Herrmann M, Bartels C, Schumacher M, Wallesch CW: Post-stroke depression. Is there a pathoanatomic correlate for depression in the postacute stage of stroke? Stroke 1995, 26:850–856.

    PubMed  CAS  Google Scholar 

  25. Starkstein SE, Robinson RG, Honig MA, et al.: Mood changes after right-hemisphere lesions. Br J Psychiatry 1989, 155:79–85.

    Article  PubMed  CAS  Google Scholar 

  26. Starkstein SE, Robinson RG, Price TR: Comparison of patients with and without poststroke major depression matched for size and location of lesion. Arch Gen Psychiatry 1988, 45:247–252.

    PubMed  CAS  Google Scholar 

  27. Sultzer DL, Mahler ME, Cummings JL, et al.: Cortical abnormalities associated with subcortical lesions in vascular dementia. Clinical and position emission tomographic findings. Arch Neurol 1995, 52:773–780.

    PubMed  CAS  Google Scholar 

  28. Sackheim HI: Brain structure and function in late-life depression. In Advance in Brain Imaging. Edited by Morihisa JM. Washington, DC: American Psychiatric Publishing; 2001:83–122.

    Google Scholar 

  29. Kumar A, Bilker W, Jin Z, Udupa J: Atrophy and high intensity lesions: complementary neurobiological mechanisms in late-life major depression. Neuropsychopharmacology 2000, 22:264–274.

    Article  PubMed  CAS  Google Scholar 

  30. Kumar A, Mintz J, Bilker W, et al.: Autonomous neurobiological pathways to late-life major depressive disorder: clinical and pathophysiological implications. Neuropsychopharmacology 2002, 26:229–236.

    Article  PubMed  Google Scholar 

  31. Fujikawa T, Yokota N, Muraoka M, Yamawaki S: Response of patients with major depression and silent cerebral infarction to antidepressant drug therapy, with emphasis on central nervous system adverse reactions. Stroke 1996, 27:2040–2042.

    PubMed  CAS  Google Scholar 

  32. Coffey CE, Wilkinson WE, Weiner RD, et al.: Quantitative cerebral anatomy in depression. A controlled magnetic resonance imaging study. Arch Gen Psychiatry 1993, 50:7–16.

    PubMed  CAS  Google Scholar 

  33. Erkinjuntti T, Gao F, Lee DH, et al.: Lack of difference in brain hyperintensities between patients with early Alzheimer’s disease and control subjects. Arch Neurol 1994, 51:260–268.

    PubMed  CAS  Google Scholar 

  34. Zubenko GS, Sullivan P, Nelson JP, et al.: Brain imaging abnormalities in mental disorders of late life. Arch Neurol 1990, 47:1107–1111.

    PubMed  CAS  Google Scholar 

  35. Alexopoulos GS, Meyers BS, Young RC, et al.: ‘Vascular depression’ hypothesis. Arch Gen Psychiatry 1997, 54:915–922.

    PubMed  CAS  Google Scholar 

  36. Krishnan KR, Hays JC, Blazer DG: MRI-defined vascular depression. Am J Psychiatry 1997, 154:497–501.

    PubMed  CAS  Google Scholar 

  37. Lavretsky H, Kumar A: Depressive disorders and cerebrovascular disease. In Vascular Disease and Affective Disorders. Edited by Chiu E, Ames D, Katona C. London: Martin Dunitz; 2002:127–147.

    Google Scholar 

  38. Robinson RG: Neuropsychiatric consequences of stroke. Annu Rev Med 1997, 48:217–229.

    Article  PubMed  CAS  Google Scholar 

  39. Bush BA: Major life events as risk factors for post-stroke depression. Brain Inj 1999, 13:131–137.

    Article  PubMed  CAS  Google Scholar 

  40. Robinson RG, Starkstein SE: Current research in affective disorders following stroke. J Neuropsychiatry Clin Neurosci 1990, 2:1–14.

    PubMed  CAS  Google Scholar 

  41. Mayberg HS, Parikh RM, Morris PL, Robinson RG: Spontaneous remission of post-stroke depression and temporal changes in cortical S2-serotonin receptors. J Neuropsychiatry Clin Neurosci 1991, 3:80–83.

    PubMed  CAS  Google Scholar 

  42. Ramasubbu R, Flint A, Brown G, et al.: A neuroendocrine study of serotonin function in depressed stroke patients compared to non depressed stroke patients and healthy controls. J Affect Disord 1999, 52:121–133.

    Article  PubMed  CAS  Google Scholar 

  43. Beaulieu M, Coyle JT: Postnatal development of aminergic projections to frontal cortex: effects of cortical lesions. J Neurosci Res 1983, 10:351–361.

    Article  PubMed  CAS  Google Scholar 

  44. Boone KB, Miller BL, Lesser IM, et al.: Neuropsychological correlates of white-matter lesions in healthy elderly subjects. A threshold effect. Arch Neurol 1992, 49:549–554.

    PubMed  CAS  Google Scholar 

  45. Lesser IM, Boone KB, Mehringer CM, et al.: Cognition and white matter hyperintensities in older depressed patients. Am J Psychiatry 1996, 153:1280–1287.

    PubMed  CAS  Google Scholar 

  46. Simpson SW, Jackson A, Baldwin RC, Burns A: 1997 IPA/Bayer Research Awards in Psychogeriatrics. Subcortical hyperintensities in late-life depression: acute response to treatment and neuropsychological impairment. Int Psychogeriatr 1997, 9:257–275.

    Article  PubMed  CAS  Google Scholar 

  47. Alexopoulos GS: New concepts for prevention and treatment of late-life depression. Am J Psychiatry 2001, 158:835–838.

    PubMed  CAS  Google Scholar 

  48. Alexopoulos GS, Vrontou C, Kakuma T, et al.: Disability in geriatric depression. Am J Psychiatry 1996, 153:877–885.

    PubMed  CAS  Google Scholar 

  49. Alexopoulos GS, Meyers BS, Young RC, et al.: Executive dysfunction and long-term outcomes of geriatric depression. Arch Gen Psychiatry 2000, 57:285–290.

    Article  PubMed  CAS  Google Scholar 

  50. Kiosses DN, Alexopoulos GS, Murphy C: Symptoms of striatofrontal dysfunction contribute to disability in geriatric depression. Int J Geriatr Psychiatry 2000, 15:992–999.

    Article  PubMed  CAS  Google Scholar 

  51. Erkinjuntti T, Rockwood K: Vascular cognitive impairment. Psychogeriatrics 2001, 1:27–38.

    Article  Google Scholar 

  52. Cummings JL, Miller B, Hill MA, Neshkes R: Neuropsychiatric aspects of multi-infarct dementia and dementia of the Alzheimer type. Arch Neurol 1987, 44:389–393.

    PubMed  CAS  Google Scholar 

  53. McPherson SE, Cummings JL: Neuropsychological aspects of vascular dementia. Brain Cogn 1996, 31:269–282.

    Article  PubMed  CAS  Google Scholar 

  54. Cummings JL: Frontal-subcortical circuits and human behavior. J Psychosom Res 1998, 44:627–628.

    Article  PubMed  CAS  Google Scholar 

  55. Sachdev P, Looi JCL: Neuropsychological differentiation of Alzheimer’s disease and vascular dementia. In Vascular Cognitive Impairment: Preventable Dementia. Edited by Hachinski V, Bowler JV. London: Oxford University Press; 2003:153–175.

    Google Scholar 

  56. Pantoni L, Inzitari D: New clinical relevance of leukoaraiosis. European task force on age-related white matter-changes. Stroke 1998, 29:543.

    PubMed  CAS  Google Scholar 

  57. Richards M, Meade TW, Peart S, et al.: Is there any evidence for a protective effect of antithrombotic medication on cognitive function in men at risk of cardiovascular disease? Some preliminary findings. J Neurol Neurosurg Psychiatry 1997, 62:269–272.

    PubMed  CAS  Google Scholar 

  58. Lutjohann D, Papassotiropoulos A, Bjorkhem I, et al.: Plasma 24S-hydroxycholesterol (cerebrosterol) is increased in Alzheimer and vascular demented patients. J Lipid Res 2000, 41:195–198.

    PubMed  CAS  Google Scholar 

  59. Jick H, Zornberg GL, Jick SS, et al.: Statins and the risk of dementia. Lancet 2000, 356:1627–1631.

    Article  PubMed  CAS  Google Scholar 

  60. Baldwin RC: Management of affective disorder in cerebrovascular disease. In Vascular Disease and Affective Disorders. Edited by Ames D, Catona C, Chui E. London: Martin Dunitz; 2002:245–265.

    Google Scholar 

  61. Simpson S, Baldwin RC, Jackson A, Burns AS: Is subcortical disease associated with a poor response to antidepressants? Neurological, neuropsychological and neuroradiological findings in late-life depression. Psychol Med 1998, 28:1015–1026.

    Article  PubMed  CAS  Google Scholar 

  62. Roose SP: Treatment of depression in patients with heart disease. Biol Psychiatry 2003, 54:262–268.

    Article  PubMed  CAS  Google Scholar 

  63. Katz IR: Diagnosis and treatment of depression in patients with Alzheimer’s disease and other dementias. J Clin Psychiatry 1998, 59(Suppl 9):38–44.

    PubMed  Google Scholar 

  64. Lavretsky H: Therapy of depression in dementia. Expert Rev Neurotherapeutics 2003, 3:89–97.

    Article  Google Scholar 

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  1. University of California Los Angeles-Neuropsychiatric Institute and Hospital, 760 Westwood Place, 90095, Los Angeles, CA, USA

    Helen Lavretsky MD

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  1. Helen Lavretsky MD
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Lavretsky, H. Vascular depression: Recent advances. Curr psych & therapeutics rep 2, 27–32 (2004). https://doi.org/10.1007/s11922-004-0004-y

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  • DOI: https://doi.org/10.1007/s11922-004-0004-y

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