The Study On Vascular Risk Factor, Cognitive Impairment And White Matter Niicrostructural Abnormalities In Patients With Subcortical Ischemic Depression

Objective The goal of our study was to explore vascular risk factors and theneuropsychological profiles of patients with magnetic resonance imaging(MRI)-defined subcortical ischemic depression (SID), and to provide evidence forclinical individualized therapy.Methods Thirty-five patients with SID,37patients with subcortical ischemic vasculardisease no depression (SIVD) and40normal controls (NC) were recruited in thiscase-control study. The SID group and SIVD group were recruited from thedepartment of Neurology, First Affiliated Hospital of Anhui Medical Universitybetween October2010and September2011. The NC group was recruited from healthmedical center of First Affiliated Hospital of Anhui Medical University over the sameperiod. All participants’ vascular risk factors were assessed using the Framinghamscale. Depression symptoms were assessed using the geriatric depression scale (GDS)and Hamilton depression scale (HAMD). Cognitive functions were assessed using themini-mental state examination (MMSE), the Montreal Cognitive Assessment (MoCA),the Cambridge cognitive examination-Chinese version (CAMCOG-C), and the clockdrawing task (CDT).Results Both SID (12.3±4.7) and SIVD (13.5±3.4) Groups showed significantlyhigher Framingham scores than NC group (8.6±1.8)(F=20.850，P=0.000). Comparedwith NC group (28.3±1.8；23.1±3.4；8.0±1.8), the MMSE, MoCA, CDT scores weresignificantly lower in SID (26.7±2.5；20.0±4.0；5.2±2.7) and SIVD (26.8±1.9；20.7±3.0；6.1±2.1) groups (P <0.05). There were significantly lower CAMCOG-Cscores in SID (82.7±9.0) and SIVD (86.2±6.9) groups compared with NC group (92.3±6.2)(P <0.05), and in SID group compared with SIVD group (P <0.05).Among subtests of CAMCOG-C, the orientation，language, memory scores in bothSID (9.0±1.4；24.7±4.0；19.5±3.4) and SIVD (9.4±0.9；25.5±2.1；20.3±2.3) groupswere significantly lower than those in NC group (9.9±0.4；27.4±1.9；22.1±2.4)(P <0.05); the praxis scores in SID group (9.4±1.9) were significantly lower than those inNC group (10.4±1.5)(P <0.05); and the thinking and perception scores in SID group(5.4±1.7；6.3±1.4) were significantly lower than those in SIVD (6.2±1.3；7.0±1.4) andNC (6.6±1.3；7.2±1.4) groups. In SID group, no significant correlation was foundbetween the Framingham scores and neuropsychological assessments. There were anegative correlation between the GDS, HAMD scores and the MMSE, MoCA,CAMCOG-C, CDT scores (P <0.05).Conclusions The SID patients showed broad neuropsychological deficits, especiallyin thinking, perception and praxis. No significant correlation between vascular riskfactors and depression symptoms was found in patients with SID. Objective The goal of our study was to examine whether white matter microstructuralabnormalities are associated with late-life depression using diffusion tensor imagning(DTI) technology.Methods Eighteen patients with late-onset depression (LOD) and18normal controls(NC) were recruited in this case-control study. The LOD group was recruited from thedepartment of Neurology, First Affiliated Hospital of Anhui Medical Universitybetween October2010and September2011. The NC group was recruited from healthmedical center of First Affiliated Hospital of Anhui Medical University over the sameperiod. All participants’ vascular risk factors were assessed using the Framinghamscale. Depression symptoms were assessed using the Hamilton depression scale(HAMD). Cognitive functions were assessed using the mini-mental state examination(MMSE). There were no significant difference (P＞0.05) between the two groups ingender, age, educational level. Routine MRI were taken on each cases by GE signa3.0T superconducting MRI in order to eliminate disease of the brain, followed by DTIscan. The fractional anisotropy (FA) and mean diffusion (MD) were measured inregions of interest (ROI) placed in the superior frontal gyrus (SFG), middle frontalgyrus (MFG), anterior limb internal capsule (ALIC), superior longitudinal fasciculus(SLF), insula, corpus callosum (CC). We used statistical software to compare thedifference of the DTI measurement between LOD group and NC group. Results The FA value of the LOD group (0.223±0.037,0.262±0.036,0.334±0.067) inthe left MFG, SLF, ALIC were significant lower than in the NC group （0.252±0.042,0.290±0.043,0.394±0.097）(P＞0.05). However, there were no significant differencesof the MD value between the two groups (P＞0.05).Conclusions1) White matter microstructure abnormalities in the MFG, SLF, ALICwere associate with late-onset depression compared with the NC group matched withage, gender, educational level and vascular risk factors scores.2) Thecortical-subcortical circuits are important for mood regulation. Alterations in thewhite matter connections of these circuits may affect their role in mood regulation andincrease the risk of depression.