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CADASIL as a Useful Medical Model and Genetic Form of Vascular Depression
Year of publication 2017
Title of paper CADASIL as a Useful Medical Model and Genetic Form of Vascular Depression
Author Joon Hyuk Park, Bong-HeeJeon, Jung Seok Lee, Paul A. Newhouse, Warren D.Taylor, Brian D Boyd, Ki Woong Kim, Moon-Doo Kim
Publication in journal The American Journal of Geriatric Psychiatry
Status of publication accepted
Vol 25(7)
Link https://www.sciencedirect.com/science/article/abs/pii/S106474811730273… 285회 연결

Objective

The main magnetic resonance imaging (MRI) findings of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) are white matter hyperintensities (WMHs), lacunar infarctions, and cerebral microbleeds (CMBs). The purpose of this study was to investigate the effects of these three neuroimaging markers of CADASIL on depression to determine whether CADASIL is a useful medical model supporting the vascular depression hypothesis.

Methods

Eighty-four subjects with CADASIL, aged 34–86 years, participated in this study. They underwent comprehensive clinical evaluation, including 3T MRI and genotyping of NOTCH3. The effects of WMH, lacunar infarctions, and CMBs were analyzed by path analyses and multivariate logistic regression analyses.

Results

Patients with CADASIL exhibited frequencies of 17.9% for major depressive disorder (MDD) and 10.7% for minor depressive disorder. The frequency of MDD increased from 5.0% to 46.2% as WMH volume increased from first quartile to fourth quartile. WMH volume (OR: 1.03, 95% CI: 1.003–1.06) in patients with CADASIL was associated with the current depressive disorder. Path analyses demonstrated that only WMH volume was associated with the Korean version of the short form Geriatric Depression Scale score, Center for Epidemiologic Studies Depression Scale score, and 17-item Hamilton depression scale score. The effects of lacunar infarctions and CMBs on depression were not significant in path analyses and multivariate logistic regression analyses.

Conclusions

This study demonstrates that WMHs are closely associated with depression in patients with CADASIL. This supports that CADASIL might be a useful medical model and genetic form of vascular depression.