title: Correlation between Motor Cortex Excitability Changes and Cognitive Impairment in Vascular Depression: Pathophysiological Insights from a Longitudinal TMS Study.
abstract: Background. Transcranial magnetic stimulation (TMS) highlighted functional changes in dementia, whereas there are few data in patients with vascular cognitive impairment-no dementia (VCI-ND). Similarly, little is known about the neurophysiological impact of vascular depression (VD) on deterioration of cognitive functions. We test whether depression might affect not only cognition but also specific cortical circuits in subcortical vascular disease. Methods. Sixteen VCI-ND and 11 VD patients, age-matched with 15 controls, underwent a clinical-cognitive, neuroimaging, and TMS assessment. After approximately two years, all participants were prospectively reevaluated. Results. At baseline, a significant more pronounced intracortical facilitation (ICF) was found in VCI-ND patients. Reevaluation revealed an increase of the global excitability in both VCI-ND and VD subjects. At follow-up, the ICF of VCI-ND becomes similar to the other groups. Only VD patients showed cognitive deterioration. Conclusions. Unlike VD, the hyperfacilitation found at baseline in VCI-ND patients suggests enhanced glutamatergic neurotransmission that might contribute to the preservation of cognitive functioning. The hyperexcitability observed at follow-up in both groups of patients also indicates functional changes in glutamatergic neurotransmission. The mechanisms enhancing the risk of dementia in VD might be related either to subcortical vascular lesions or to the lack of compensatory functional cortical changes.
authors.affiliation: Spinal Unit, Emergency Hospital "Cannizzaro", 95126 Catania, Italy.
authors.forename: Manuela
authors.identifier: 0000-0003-0776-1411
authors.initials: M
authors.lastname: Pennisi
authors.affiliation: Department of Neurology I.C., "Oasi" Institute for Research on Mental Retardation and Brain Aging (I.R.C.C.S.), 94018 Troina, Italy.
authors.forename: Giuseppe
authors.identifier: 0000-0002-5659-662X
authors.initials: G
authors.lastname: Lanza
authors.affiliation: Department of Neurology I.C., "Oasi" Institute for Research on Mental Retardation and Brain Aging (I.R.C.C.S.), 94018 Troina, Italy.
authors.forename: Mariagiovanna
authors.initials: M
authors.lastname: Cantone
authors.affiliation: Department of Medical and Surgical Sciences and Advanced Technologies, Section of Neurosciences, University of Catania, 95125 Catania, Italy.
authors.forename: Riccardo
authors.identifier: 0000-0001-9751-4478
authors.initials: R
authors.lastname: Ricceri
authors.affiliation: Department of Electrical, Electronics and Informatics Engineering, University of Catania, 95125 Catania, Italy.
authors.forename: Concetto
authors.initials: C
authors.lastname: Spampinato
authors.affiliation: Department of Surgery and Medical-Surgical Specialties, University of Catania, 95125 Catania, Italy.
authors.forename: Giovanni
authors.identifier: 0000-0002-0911-2370
authors.initials: G
authors.lastname: Pennisi
authors.affiliation: Department of Medicine, Unit of Neurology, Neurophysiology, Neurobiology, Campus Bio-Medico University of Rome, 00128 Rome, Italy.
authors.forename: Vincenzo
authors.identifier: 0000-0002-9113-5925
authors.initials: V
authors.lastname: Di Lazzaro
authors.affiliation: Department of Medical and Surgical Sciences and Advanced Technologies, Section of Neurosciences, University of Catania, 95125 Catania, Italy.
authors.forename: Rita
authors.identifier: 0000-0001-8332-6863
authors.initials: R
authors.lastname: Bella
mesh_terms: D000368:Aged; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging / Q000503:physiopathology*; D060825:Cognitive Dysfunction / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D003866:Depressive Disorder / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000639:trends; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011446:Prospective Studies; D050781:Transcranial Magnetic Stimulation / Q000639:trends*