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MRI-defined vascular depression: a review of the construct
Michelle E Culang-Reinlieb1, Lauren C Johnert, Adam M Brickman
1The Graduate Center, City University of New York, NY, USA.
International Journal of Geriatric Psychiatry
|December 31, 2010
Summary
This review examines MRI-defined vascular depression in late life. Key issues include linking brain imaging findings to depression outcomes and defining this subtype for better treatment.
Area of Science:
- Geriatric Psychiatry
- Neuroimaging
- Vascular Neurology
Background:
- Late-life depression is heterogeneous.
- Cerebrovascular disease is increasingly recognized as a contributing factor.
- Magnetic Resonance Imaging (MRI) can detect brain changes associated with vascular depression.
Purpose of the Study:
- To review the construct of MRI-defined vascular depression.
- To examine issues affecting its validity as a distinct subtype of late-life depression.
Main Methods:
- Comprehensive literature review.
Main Results:
- Three critical areas for validity were identified: (1) relationship between MRI hyperintensities, executive dysfunction, and treatment outcomes; (2) validity of qualitative vs. quantitative MRI hyperintensity measurement; (3) clinical presentation and course of vascular depression compared to other late-life disorders.
Conclusions:
- Considerable data support MRI-defined vascular depression's validity.
- Remaining issues include establishing causality with cerebrovascular disease, consistent diagnostic criteria, lesion importance, and disorder course.
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