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Pathologies and pathological mechanisms for white matter hyperintensities in depression
Alan J Thomas1, Robert Perry, Robert Barber
1Department of Psychiatry and Institute for Ageing and Health, University of Newcastle upon Tyne, Newcastle upon Tyne NE4 6BE, United Kingdom. a.j.thomas@ncl.ac.uk
Annals of the New York Academy of Sciences
|December 14, 2002
Summary
White matter hyperintensities (WMH) in elderly depression are linked to cerebrovascular disease. Findings suggest hypotensive disease may underlie WMH in late-life depression, differing from large or small vessel disease.
Area of Science:
- Neuroimaging
- Neuropathology
- Geriatric Psychiatry
Background:
- White matter hyperintensities (WMH) and deep gray matter lesions are observed in dementia and depression.
- Previous research has not specifically investigated WMH in major depressive disorder.
Purpose of the Study:
- To investigate the pathological causes of WMH in elderly individuals with major depression.
- To compare WMH pathology with cerebral microvascular and atheromatous disease.
Main Methods:
- In vitro MRI of brain tissue from elderly depressed and control subjects.
- Histopathological analysis of WMH using various stains.
- Assessment of cerebral microvessels and atheromatous disease.
Main Results:
- WMH in elderly depression are primarily caused by dilated perivascular spaces, oligemic demyelination, or ischemic demyelination.
- Cerebral microvascular disease contributed minimally to WMH.
- Atheromatous disease showed no association with WMH.
Conclusions:
- WMH in elderly depression are a manifestation of cerebrovascular disease.
- Hypotensive disease may be a significant, unrecognized mechanism underlying WMH in late-life depression, distinct from large or small vessel disease.