Late-onset depression in the absence of stroke: associated with silent brain infarctions, microbleeds and lesion locations.
BACKGROUND
Late-onset depression (LOD) is a frequent mood disorder among elderly. Previous studies have proved that LOD is associated with cerebral silent lesions especially white matter lesions (WML) and yielded the "vascular depression" hypothesis to explain the pathogenesis of LOD. However, there were relatively few studies about the association between silent brain infarctions (SBIs), microbleeds (MBs) and the prevalence of LOD. In this study we sought to evaluate the presence, accumulation and locations of SBIs and MBs, and explore the possible association between them and LOD.


METHODS
65 patients of LOD diagnosed according to DSM-IV and 270 subjects of control group were enrolled and scanned by MRI to analyze the presence, numbers and locations of SBIs and MBs. Clinical and radiological characteristics were compared between LOD patients and control group. Logistic regression models were constructed to identify the independent risk factors for LOD.


RESULTS
LOD patients had higher prevalence and numbers of both SBIs and MBs. SBIs and MBs in the left hemisphere, SBIs in basal ganglia and lobar MBs were all independent risk factors for LOD.


CONCLUSIONS
The presence of both SBIs and MBs were associated with a higher rate LOD. Lesions in some specific locations might be critical for the presence of LOD.
1. Department of Neurology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, China;
Ri-Han
RH
Wu
1. Department of Neurology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, China; ; 2. Yiwu Affiliated Hospital of Zhejiang University, School of Medicine, Zhejiang, China;
Chao
C
Feng
3. Department of Radiology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, China.
Yu
Y
Xu
3. Department of Radiology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, China.
Ting
T
Hua
1. Department of Neurology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, China;
Xue-Yuan
XY
Liu
1. Department of Neurology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, China;
Min
M
Fang
D017668:Age of Onset; D000368:Aged; D001479:Basal Ganglia / Q000473:pathology; D020520:Brain Infarction / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D002543:Cerebral Hemorrhage / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D003863:Depression / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011859:Radiography; D012307:Risk Factors; D020521:Stroke / Q000000981:diagnostic imaging / Q000473:pathology
Late-onset depression; microbleeds.; silent brain infarctions; stroke