Cerebrovascular reactivity in major depression: a pilot study.
OBJECTIVE
There are a growing number of reports that depression may increase the risk of stroke. Little is known, however, about the pathophysiologic mechanisms underlying this association. Cerebrovascular reactivity (CVR) reflects the compensatory dilatory capacity of cerebral arterioles to a dilatory stimulus and is an important mechanism to provide constant cerebral blood flow. We hypothesized that CVR is reduced in patients with major depression, thus contributing to the association between depression and stroke.


METHODS
We assessed CVR in 33 patients with unipolar depression and 26 healthy controls by calculating the increase in cerebral blood flow velocity after stimulation with acetazolamide. Blood flow velocities were measured by transcranial Doppler ultrasound.


RESULTS
Cerebrovascular reactivity was significantly reduced in depressed patients. Smoking was also associated with a significant reduction in CVR, whereas age and gender had no significant influence.


CONCLUSIONS
Cerebrovascular reactivity appears to be impaired in major depression. Further studies should clarify the mechanisms leading to this reduced CVR.
Neu
Peter
P
Department of Psychiatry, Charité-Hochschulmedizin Berlin, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, Berlin, Germany. peter.neu@medizin.fu-berlin.de
Schlattmann
Peter
P
Schilling
Andreas
A
Hartmann
Andreas
A
D000086:Acetazolamide / Q000494:pharmacology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D001160:Arterioles / Q000187:drug effects / Q000503:physiopathology; D001783:Blood Flow Velocity / Q000187:drug effects; D002560:Cerebrovascular Circulation / Q000187:drug effects; D003866:Depressive Disorder / Q000188:drug therapy / Q000503:physiopathology*; D003920:Diabetes Mellitus / Q000453:epidemiology; D004198:Disease Susceptibility; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012307:Risk Factors; D012907:Smoking / Q000503:physiopathology; D020521:Stroke / Q000453:epidemiology*; D017585:Ultrasonography, Doppler, Transcranial; D014664:Vasodilation / Q000187:drug effects
D000928:Antidepressive Agents; D000086:Acetazolamide