[Vascular depression, limits of the concept].
The concept of vascular depression has recently been reassessed and more clearly delineated. The diagnostic criteria for vascular depression require a major depression associated with evidence of confluent or diffuse vascular lesions in the subcortical regions on MRI. The clinical symptoms are not specific, but they are often associated with mild cognitive decline. Ischemia is probably the main factor for vascular depression, but the relationship between ischemic lesions and clinical symptoms remains not well explained. The apolipoproteine E genotype is not a risk factor for vascular depression, but it is associated with more severe hyperintensities on MRI. A pharmacological resistance has been described in vascular depression, but, in recent studies, clinical improvement has been observed with antidepressants in more than 80% of cases. A neuropsychological follow-up is recommended, because dementia may appear with 25% of patients.
Lebert
Florence
F
Centre de la mémoire, hôpital Salengro, CHRU Lille. f-lebert@chru-lille.fr
D000368:Aged; D015140:Dementia, Vascular / Q000175:diagnosis / Q000235:genetics / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy; D003866:Depressive Disorder / Q000175:diagnosis / Q000235:genetics / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D012307:Risk Factors