• Am J Geriatr Psychiatry · May 2015

    White matter integrity and depressive symptoms in cerebral small vessel disease: The RUN DMC study.

    • Ingeborg W M van Uden, Anil M Tuladhar, Karlijn F de Laat, Anouk G W van Norden, David G Norris, Ewoud J van Dijk, Indira Tendolkar, and Frank-Erik de Leeuw.
    • Department of Neurology, Radboudumc, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
    • Am J Geriatr Psychiatry. 2015 May 1;23(5):525-35.

    ObjectiveDepressive symptoms are common in elderly with cerebral small vessel disease (SVD). As not every individual with SVD experiences depressive symptoms, other factors might play a role. We therefore investigated the white matter (WM) integrity of the white matter tracts in elderly with depressive symptoms, independent of global cognitive function, by applying the tract-based spatial statistics (TBSS).DesignProspective cohort study with cross-sectional baseline data.SettingRadboud University Nijmegen Medical Centre, The Netherlands.Participants438 individuals aged between 50-85 years, with SVD without dementia.MeasurementsDiffusion tensor imaging parameters and depressive symptoms, assessed with the Center for Epidemiologic Studies Depression Scale.ResultsCompared with non-depressed participants (N = 287), those with depressive symptoms (N = 151) had lower fractional anisotropy in the genu and body of the corpus callosum, bilateral inferior fronto-occipital fasciculus, uncinate fasciculus, and corona radiata. These differences disappeared after adjustment for white matter hyperintensities (WMH) and lacunar infarcts. Mean-, axial- and radial diffusivity were higher in these areas in participants with depressive symptoms. After additional adjustment for WMH and lacunar infarcts, the changes observed in radial diffusivity also disappeared. Adding global cognition as confounding variable altered the diffusion parameters only slightly.ConclusionThis study indicates that elderly with depressive symptoms show a lower WM integrity, independent of global cognitive function, and that the presence of SVD is mostly responsible, affecting the fronto-subcortical regions and hereby disrupting the neural circuitry involved in mood regulation.Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

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