Study Of Transcranial Doppler Ultrasonography In Auxiliary Diagnosis Of Cerebral Small Vessel Disease Complicated With Affective Disorder

Objective To study the changes of cerebral hemodynamics in elderly patients with clinically defined vascular depression by transcranial doppler ultrasound,and to explore a non-invasive and convenient evaluation model of vascular depression.Methods The cranial MRI of 67 patients(mean age 71.67 ± 6.86 years old,female accounted for 65.7%)met the diagnostic criteria of white matter hyperintensity(WMH),and the white matter injury was graded according to the Fazekas scale.The depressive symptoms were quantitatively evaluated with 17 items of Hamilton Depression scale(HAMD).According to the imaging criteria of vascular depression,the patients were divided into vascular depression group and non-depression group.1.Vascular depression group(WMH with depression disorder): In accordance with WMH diagnostic criteria,there were 2 or more points in deep white matter high signal or lateral paraventricular high signal grade and HAMD score ? 8;2.Non-depression group(WMH without depression disorder): In accordance with WMH diagnostic criteria and HAMD score < 8.The mean blood flow velocity(Vm)and pulsatility index(PI)of bilateral anterior cerebral artery(ACA),middle cerebral artery(MCA)and terminal internal carotid artery(TICA)were recorded and compared between the two groups.Result 1.There were no significant differences in age(P=0.355),sex(P=0.494),smoking(P=0.562),drinking(P=1.000),hypertension(P=0.614),diabetes(P=0.373),ischemic stroke(P=0.206),hemorrhagic stroke(P=0.614),coronary heart disease(P=0.783),abnormal lipid metabolism(P=0.922),hypersensitive C-reactive protein(P=0.564),glycosylated hemoglobin(P=0.482),homocysteine(P=0.118),white matter score(P=0.358)and white matter grade(P=0.357)between the non-depression groupand vascular depression group(P>0.05).2.The Vm on both sides of ACA and MCA in vascular depression group was significantly lower than that in non-depression group(P<0.05),but there was no significant difference in Vm on both sides of TICA between vascular depression group and non-depression group(P>0.05).3.The PI on both sides of ACA and MCA in vascular depression group was significantly higher than that in non-depression group(P<0.05).There was no significant difference in PI on both sides of TICA between vascular depression group and non-depression group(P > 0.05).4.There was no significant difference in Vm and PI of ACA and MCA between the left and the right in vascular depression group(P>0.05).Conclusions 1.Hemodynamic disorders may play a pathogenic role in depression of the old,which supports the hypothesis of vascular depression.2.The hemodynamic disorders of vascular depression are characterized by increased vascular resistance and slower blood flow velocity of small vessels.3.Transcranial doppler is a valuable tool for dynamic evaluation of patients with vascular depression.