MRI-defined vascular depression: a review of the construct

作者：Culang Reinlieb Michelle E; Johnert Lauren C; Brickman Adam M; Steffens David C; Garcon Ernst; Sneed Joel R^*

来源：International Journal of Geriatric Psychiatry, 2011, 26(11): 1101-1108.

DOI：10.1002/gps.2668

• vascular depression
• late-life depression
• cerebrovascular disease
• deep white matter lesions
• executive dysfunction
• antidepressant response

Objective: To review the construct of MRI-defined vascular depression and to examine the substantive and methodological issues that bear on its validity as a distinct subtype of depression in late life.
Design: Literature review.
Results: We identified three areas that are critical to establishing the validity of MRI-defined vascular depression: (1) understanding and delineating the relationship between MRI hyperintensities, executive dysfunction, and antidepressant treatment outcome; (2) understanding the relationship between, and establishing the validity of, qualitative and quantitative approaches to the measurement of MRI hyperintensities (the primary feature of the proposed subtype); (3) establishing the clinical presentation and course of the subtype in the context of other late-life disorders.
Conclusions: Despite considerable data supporting the validity of MRI-defined vascular depression, there are a number of critical issues that remain, including establishing a causal relationship between cerebrovascular disease and late-life depression, establishing consistent diagnostic criteria, determining the importance of lesion type and location, and understanding the course of the disorder.

• 出版日期2011-11