title: The external validity of MRI-defined vascular depression.
abstract: OBJECTIVE
  Multiple diagnostic criteria have been used to define vascular depression (VD). As a result, there are discrepancies in the clinical characteristics that have been established for the illness. The aim of this study was twofold. First, we used empirically established diagnostic criteria to determine the clinical characteristics of magnetic resonance imaging (MRI)-defined VD. Second, we assessed the agreement between a quantitative and qualitative method for identifying the illness.
  
  
  METHODS
  We examined the baseline clinical and neuropsychological profile of 38 patients from a larger, double-blind, randomized, 12-week clinical trial comparing nortriptyline with sertraline in depressed older adults. Ten patients met quantitative criteria for MRI-defined VD based on the highest quartile of deep white matter hyperintensity (DWMH) volume. Fourteen patients met qualitative criteria for MRI-defined VD based on a DWMH score of 2 or higher on the Fazekas' modified Coffey rating scale.
  
  
  RESULTS
  Age, gender, cumulative illness rating scale-geriatric (CIRS-G) score, two measures of psychomotor retardation [the psychomotor retardation item of the Hamilton Rating Scale for Depression (HRSD) as well as performance on the Purdue Pegboard], and performance on the Stroop Color/Word test (a measure of the response inhibition component of executive functioning) were significantly different between those with VD and non-VD.
  
  
  CONCLUSIONS
  Patients with VD have a distinct clinical and neuropsychological profile that is mostly consistent across different methods for identifying the illness. These findings support the notion that MRI-defined VD represents a unique and valid subtype of late-life depression.
authors: Department of Psychology, The Graduate Center, City University of New York, New York, NY, USA.
authors: Monique A
authors: MA
authors: Pimontel
authors: Michelle E
authors: ME
authors: Reinlieb
authors: Lauren C
authors: LC
authors: Johnert
authors: Ernst
authors: E
authors: Garcon
authors: Joel R
authors: JR
authors: Sneed
authors: Steven P
authors: SP
authors: Roose
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use; D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000503:physiopathology; D003866:Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D004311:Double-Blind Method; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009661:Nortriptyline / Q000627:therapeutic use; D011569:Psychiatric Status Rating Scales; D011597:Psychomotor Performance / Q000502:physiology; D015203:Reproducibility of Results; D020280:Sertraline / Q000627:therapeutic use; D012737:Sex Factors
chemical_list: D000928:Antidepressive Agents; D009661:Nortriptyline; D020280:Sertraline
keywords: MRI; clinical characteristics; external validity; late-life depression; vascular depression