Lacunar stroke, deep white matter disease and depression: a meta-analysis

Abstract

The pooled group of patients with lacunar stroke and deep white matter disease appear to have a similar prevalence of depression compared to those with other types of cerebrovascular diseases. However, the small number of studies, heterogeneous comparison groups, and high statistical heterogeneity between studies posed an obstacle to the meta-analysis. To determine appropriate screening and treatment approaches, future research will need to separate lacunar stroke and deep white matter disease patients, and include larger sample sizes and healthy control groups to determine their distinct contributions to depression.

Baseline characteristic of patients presenting with lacunar stroke and cerebral small vessel disease may predict future development of depression

“…Depression development does not have to be strictly linked to disease onset, and Whyte et al (2004) showed that patients were six times more likely to develop depression ≥2 years following stroke (Whyte et al, 2004). Increased frequency of depression in our cohort compared with other studies could be secondary to different severity of stroke, difference in burden of underlying SVD and different diagnostic tools (White et al, 2011;Egeto et al, 2014). In this cross-sectional study, diagnosis of depression was made rather cross-sectionally than longitudinally, so it is possible that depression developed earlier than detected.…”

“…Interestingly enough, in a recent meta‐analysis, Egeto et al . () did not find influence of deep WMH, multiple LI or volume of lacunes on the occurrence of depression, underlying the problem of a small number of studies with great heterogeneity in design and statistical analysis.…”

“…However, there was a relation between LI in deep WMH and an increased severity and more fluctuating course of depressive symptoms during follow-up (Grool et al, 2013). Interestingly enough, in a recent meta-analysis, Egeto et al (2014) did not find influence of deep WMH, multiple LI or volume of lacunes on the occurrence of depression, underlying the problem of a small number of studies with great heterogeneity in design and statistical analysis.…”

“…Increased frequency of depression in our cohort compared with other studies could be secondary to different severity of stroke, difference in burden of underlying SVD and different diagnostic tools (White et al ., ; Egeto et al ., ). In this cross‐sectional study, diagnosis of depression was made rather cross‐sectionally than longitudinally, so it is possible that depression developed earlier than detected.…”

Total magnetic resonance imaging burden of cerebral small‐vessel disease is associated with post‐stroke depression in patients with acute lacunar stroke

“…O'Brien et al [24] found a weak correlation between asymptomatic LIs and depression in basal ganglia. Nonetheless, Egeto et al [25] demonstrated that no substantial association was detected between deep WMLs, multiple asymptomatic LIs and the volume of lacunes and the occurrence of depression after lacunar stroke. In contrast, our present study showed that silent LIs and WMLs were separately associated with the presence of PSD in patients with lacunar stroke.…”