|Home | About | Journals | Submit | Contact Us | Français|
is a common psychiatric disorder in late life and it may be associated
with vascular disease processes. Although there are clinical and
neuroimaging studies lending support to such a "vascular
depression" hypothesis there have been no neuropathological studies
to directly test this. Postmortem tissue was investigated to determine
whether late life depression was associated with atheromatous change in
large and medium vessels and microvascular disease in the brain.
METHODS—Postmortem tissue wae obtained from 20 patients with a history of at least one episode of DSM-IV major depression and 20 control subjects. Standard procedures were carried out to analyze and quantify Alzheimer type pathology (plaques, tangles, Braak staging) and cortical Lewy bodies. Coronary arteries, cerebral vessels, and aorta were rated for atheromatous disease on a 0-3 scale and the four neocortical areas were rated for microvascular disease.
RESULTS—The two groups showed no significant differences in age, sex, or postmortem delay. There was a significant increase in atheromatous disease in the depressed group (p=0.023). No differences were found for microvascular disease, either in the brain generally or locally in the frontal lobes. No subject had any significant Alzheimer type or Lewy body pathology.
CONCLUSIONS—Neuropathological evidence was found for an excess of atheromatous disease, related to the aortic and cerebral vessels, in late life depression. However, there was no evidence of an increase in microvascular disease. The findings broadly support the vascular depression hypothesis.