title: Markers of cerebral small vessel disease and severity of depression in the general population.
abstract: The vascular depression hypothesis postulates that cerebral small vessel disease can cause or exacerbate depression in elderly persons. Numerous studies explored the association of imaging markers of cerebral small vessel disease including white matter lesions (WMLs) and lacunar infarcts with depressive symptoms or disorders. However, cerebral microbleeds have not been tested in depression. In the current study, we aimed to explore the association of WMLs, lacunar infarcts and cerebral microbleeds with depression continuum in a large population-based sample, the Rotterdam Study. Study population consisted of 3799 participants (aged 45 or over) free of dementia. WML volumes, lacunar infarcts and cerebral microbleeds were measured with brain magnetic resonance imaging. Depressive symptoms, depressive disorders and co-morbid anxiety disorders were assessed with validated questionnaires and clinical interview. WML volumes and lacunar infarcts were associated with depressive symptoms and disorders. Cerebral microbleeds, especially in deep or infratentorial brain regions, were related to depressive disorders only. Our results indicate that WMLs and lacunar infarcts might be non-specific vascular lesions seen in depressive symptoms and disorders. Association of cerebral microbleeds with more severe forms of depression may indicate impaired brain iron homeostasis or minor episodes of cerebrovascular extraversion, which may play a role in depression etiology.
authors.affiliation: Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors.forename: Nese
authors.initials: N
authors.lastname: Direk
authors.affiliation: Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors.forename: Heidi Saavedra
authors.initials: HS
authors.lastname: Perez
authors.affiliation: Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Radiology, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Neurology, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors.forename: Saloua
authors.initials: S
authors.lastname: Akoudad
authors.affiliation: Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Radiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors.forename: Benjamin F J
authors.initials: BF
authors.lastname: Verhaaren
authors.affiliation: Biomedical Imaging Group Rotterdam, Erasmus Medical Centre, Rotterdam, The Netherlands; Faculty of Applied Sciences, Delft University of Technology, Delft, The Netherlands.
authors.forename: Wiro J
authors.initials: WJ
authors.lastname: Niessen
authors.affiliation: Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.affiliation: Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Radiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors.forename: Meike W
authors.initials: MW
authors.lastname: Vernooij
authors.affiliation: Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Radiology, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Neurology, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors.forename: M Arfan
authors.initials: MA
authors.lastname: Ikram
authors.affiliation: Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Psychiatry, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Child and Adolescent Psychiatry, Erasmus Medical Centre, Rotterdam, The Netherlands. Electronic address: h.tiemeier@erasmusmc.nl.
authors.forename: Henning
authors.initials: H
authors.lastname: Tiemeier
mesh_terms: D000368:Aged; D015415:Biomarkers; D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology; D059345:Cerebral Small Vessel Diseases / Q000000981:diagnostic imaging* / Q000473:pathology / Q000523:psychology; D003863:Depression / Q000000981:diagnostic imaging* / Q000473:pathology / Q000523:psychology; D003866:Depressive Disorder / Q000000981:diagnostic imaging* / Q000473:pathology / Q000523:psychology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
chemical_list: D015415:Biomarkers
keywords: Anxiety; Cerebral microbleeds; Depressive iisorders; Depressive symptoms; Lacunar infracts; Vascular depression; White matter lesions