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1.
Acta Psychiatr Scand ; 128(5): 387-96, 2013 Nov.
Article in English | MEDLINE | ID: mdl-23350796

ABSTRACT

OBJECTIVE: To explore the relationship between brain-derived neurotrophic factor (BDNF) and vascular endothelial growth factor (VEGF), cerebral deep white matter lesions (DWMLs), and measures of white matter integrity in patients with late-onset depression, with respect to vascular risk factors. METHOD: We examined 22 patients with late-onset depression and 22 matched controls. Quantification of plasma BDNF and VEGF levels were performed with enzyme-linked immunosorbent assay (ELISA) kits. Measures of white matter integrity comprised apparent diffusion coefficient (ADC) and fractional anisotropy (FA), obtained by diffusion tensor imaging (DTI). Effects of DWMLs, FA, ADC, and vascular risk factors on BDNF and VEGF were assessed using multiple linear regression. RESULTS: The BDNF and VEGF levels did not differ significantly between groups. With pooled data for patients and controls, the BDNF level was positively associated with both number (t = 2.14, P = 0.039) and volume (t = 2.04, P = 0.048) of prefrontal DWMLs and negatively associated with FA in prefrontal normal-appearing white matter (t = -2.40, P = 0.02), adjusted for age and gender. Smoking and hypercholesterolemia was positively associated with the BDNF (t = 2.36, P = 0.023) and VEGF levels (t = 2.28, P = 0.028), respectively. CONCLUSION: Our results suggest a role for BDNF in the complex pathophysiologic mechanisms underlying DWMLs in both normal aging and late-onset depression.


Subject(s)
Aging , Brain-Derived Neurotrophic Factor/blood , Depressive Disorder, Major , Frontal Lobe/pathology , Leukoencephalopathies , Vascular Endothelial Growth Factor A/blood , Age of Onset , Aged , Aging/blood , Aging/pathology , Anisotropy , Depressive Disorder, Major/blood , Depressive Disorder, Major/pathology , Diffusion Tensor Imaging , Female , Humans , Leukoencephalopathies/blood , Leukoencephalopathies/pathology , Male , Middle Aged , Risk Factors
2.
Psychol Med ; 40(8): 1389-99, 2010 Aug.
Article in English | MEDLINE | ID: mdl-19895719

ABSTRACT

BACKGROUND: Several studies suggest that patients with late-onset major depression (MD) have an increased load of cerebral white-matter lesions (WMLs) compared with age-matched controls. Vascular risk factors such as hypertension and smoking may confound such findings. Our aim was to investigate the association between the localization and load of WMLs in late-onset MD with respect to vascular risk factors. METHOD: We examined 22 consecutive patients with late-onset first-episode MD and 22 age- and gender-matched controls using whole-brain magnetic resonance imaging (MRI). The localization, number and volume of WMLs were compared between patients and controls, while testing the effect of vascular risk factors. RESULTS: Among subjects with one or more WMLs, patients displayed a significantly higher WML density in two white-matter tracts: the left superior longitudinal fasciculus and the right frontal projections of the corpus callosum. These tracts are part of circuitries essential for cognitive and emotional functions. Analyses revealed no significant difference in the total number and volume of WMLs between groups. Patients and controls showed no difference in vascular risk factors, except for smoking. Lesion load was highly correlated with smoking. CONCLUSIONS: Our results indicate that lesion localization rather than lesion load differs between patients with late-onset MD and controls. Increased lesion density in regions associated with cognitive and emotional functions may be crucial in late-onset MD, and vascular risk factors such as smoking may play an important role in the pathophysiology of late-onset MD, consistent with the vascular depression hypothesis.


Subject(s)
Blood Pressure/physiology , Brain/pathology , Cerebral Infarction/diagnosis , Depressive Disorder, Major/diagnosis , Depressive Disorder, Major/pathology , Image Processing, Computer-Assisted , Imaging, Three-Dimensional , Magnetic Resonance Imaging , Nerve Fibers, Myelinated/pathology , Smoking/adverse effects , Aged , Antidepressive Agents/therapeutic use , Cerebral Infarction/pathology , Corpus Callosum/pathology , Depressive Disorder, Major/drug therapy , Dominance, Cerebral/physiology , Female , Frontal Lobe/pathology , Humans , Male , Middle Aged , Neural Pathways/pathology , Prefrontal Cortex/pathology , Reference Values , Risk Factors , Statistics as Topic
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