Neuropathological analysis of lacunes and microvascular lesions in late-onset depression: Vascular pathology in late-onset depression
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AIMS: Previous neuropathological studies documented that small vascular and microvascular pathology is associated with cognitive decline. More recently, we showed that thalamic and basal ganglia lacunes are associated with post-stroke depression and may affect emotional regulation. The present study examines whether this is also the case for late-onset depression. METHODS: We performed a detailed analysis of small macrovascular and microvascular pathology in the post mortem brains of 38 patients with late-onset major depression (LOD) and 29 healthy elderly controls. A clinical diagnosis of LOD was established while the subjects were alive using the DSM-IV criteria. Additionally, we retrospectively reviewed all charts for the presence of clinical criteria of vascular depression. Neuropathological evaluation included bilateral semi-quantitative assessment of lacunes, deep white matter and periventricular demyelination, cortical microinfarcts and both focal and diffuse gliosis. The association between vascular burden and LOD was investigated using Fisher's exact test and univariate and multivariate logistic regression models. RESULTS: Neither the existence of lacunes nor the presence of microvascular ischaemic lesions was related to occurrence of LOD. Similarly, there was no relationship between vascular lesion scores and LOD. This was also the case within the subgroup of LOD patients fulfilling the clinical criteria for vascular depression. CONCLUSIONS: Our results challenge the vascular depression hypothesis by showing that neither deep white matter nor periventricular demyelination is associated with LOD. In conjunction with our previous observations in stroke patients, they also imply that the impact of lacunes on mood may be significant solely in the presence of acute brain compromise.
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Neither lacunes nor microvascular ischemic lesions were related to occurrence of late-onset depression.
“Neither lacunes nor microvascular ischemic lesions were related to occurrence of late-onset depression65,66.”
From Mechanisms and treatment of late-life depression (2019) · cites this paper as [65]
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Alexopoulos, G. S. (2021) · Focus · doi:10.1176/appi.focus.19304 · Cited by 22 · see citing works
- Authors
- Santos, M., Gold, G., Kövari, E., Herrmann, F. R., Hof, P. R., Bouras, C., & Giannakopoulos, P.
- Affiliations
- University Hospital of Geneva (CH)
- Icahn School of Medicine at Mount Sinai (US)
- University of Lausanne (CH)
- Corresponding author
- Santos, M.
- Venue
- Neuropathology and Applied Neurobiology
- Publisher
- Wiley
- Published
- 2010-06-29
- Volume
- 36
- Issue
- 7
- Pages
- 661-672
- ISSN
- 0305-1846 (ISSN-L)
- PMC
- PMC2962688
- OpenAlex
- W1735335130
- Cited by
- 32
- References
- 86
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 2 · 2022: 3 · 2021: 2 · 2019: 3 · 2017: 1 · 2016: 5 · 2015: 1 · 2014: 2 · 2013: 2 · 2012: 3
- FWCI
- 1.94
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Neuropathology and Applied Neurobiology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Archive ouverte UNIGE (University of Geneva) (acceptedVersion, other-oa)
- IRIS (submittedVersion)
- SERVAL (Université de Lausanne) (submittedVersion, other-oa)
- Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by)
- Funders
- National Institutes of Health (AG02219)
- National Institute on Aging (AG-02219, P01AG002219)
- Topics
- Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- lacunes, microvascular lesions, vascular depression hypothesis, cortical microinfarcts, gliosis, vascular burden, post-stroke depression
- MeSH terms
- Aged, Aged, 80 and over, Autopsy, Basal Ganglia, Brain, Capillaries, Cerebral Hemorrhage, Cerebral Infarction, Cerebrovascular Circulation, Demyelinating Diseases, Depressive Disorder, Female, Humans, Male, Thalamus, Intracranial Thrombosis, Diagnostic and Statistical Manual of Mental Disorders
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