Microvascular pathology in late-life depression

Santos, Micaela; Xekardaki, Aikaterini; Kovari, Eniko Veronika; Gold, Gabriel; Bouras, Constantin; Giannakopoulos, Pantéleimon

doi:10.1016/j.jns.2012.05.048

Cited by 17 publications

(12 citation statements)

References 70 publications

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“…Several mechanistic theories have evolved to explain both the heterogeneous presentation of CMVD-linked depression and the range of factors that contribute to disease progression. A discussion of all proposed mechanisms is beyond the scope of this work, and although many mechanistic theories have been thoroughly reviewed (Butters et al, 2008;Smith et al, 2009;Santos et al, 2012;Taylor et al, 2013), few focus on inflammation as playing a key role. Therefore, we focus here on the potential role of neuroinflammation in the manifestation of CMVD-linked depression.…”

Section: Ischemia Behavior and Neuroinflammationmentioning

confidence: 99%

Heartsick: psychiatric and inflammatory implications of cerebromicrovascular disease

Nemeth

Haroon

Neigh

2013

Int J Geriat Psychiatry

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Although the concept of cerebrovascular-induced behavioral change has existed for over 100 years, the difficulty of diagnosis, the slow progression of CMVD, and the lack of causative data have led to an underestimation of the patient population and poor treatment strategies. Preclinical studies have focused on the use of microsphere embolic models and vascular inflammation models to assess the mechanisms of, and treatment options for, CMVD. Though preclinical models provide support for correlative data collected in the clinic, translational reciprocity has not been established. The lack of clinical appreciation for the role of cerebrovascular health in brain function may result in missed diagnoses and inadequate treatment of underlying cardiovascular disease. Enhanced recognition of symptoms and disease presentation will allow for earlier prevention, detection, and identification of novel targets for drug development and other intervention strategies.

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Section: Ischemia Behavior and Neuroinflammationmentioning

confidence: 99%

Heartsick: psychiatric and inflammatory implications of cerebromicrovascular disease

Nemeth

Haroon

Neigh

2013

Int J Geriat Psychiatry

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“…Third, physical activity and sedentary behavior were not statistically significantly associated with retinal microvascular function. These findings suggest that increasing habitual daily physical activity should be investigated as a means to improving microvascular function in T2D, with the ultimate goal of reducing risk of heart failure, (lacunar) stroke, depression, cognitive decline, retinopathy, chronic kidney disease, and neuropathy …”

Section: Discussionmentioning

confidence: 99%

“…Microvascular dysfunction is an important underlying mechanism in common diseases, such as heart failure, (lacunar) stroke, depression, cognitive decline, chronic kidney disease, and neuropathy, which occur in the general population and more frequently in individuals with T2D . It is therefore important to identify, in particular modifiable, factors that contribute to the development of microvascular dysfunction, as these can be targeted in preventive strategies.…”

Section: Introductionmentioning

confidence: 99%

Higher levels of daily physical activity are associated with better skin microvascular function in type 2 diabetes—The Maastricht Study

et al. 2020

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Objective Physical activity may provide a means for the prevention of cardiovascular disease via improving microvascular function. Therefore, this study investigated whether physical activity is associated with skin and retinal microvascular function. Methods In The Maastricht Study, a population‐based cohort study enriched with type 2 diabetes (n = 1298, 47.3% women, aged 60.2 ± 8.1 years, 29.5% type 2 diabetes), we studied whether accelerometer‐assessed physical activity and sedentary time associate with skin and retinal microvascular function. Associations were studied by linear regression and adjusted for major cardiovascular risk factors. In addition, we investigated whether associations were stronger in type 2 diabetes. Results In individuals with type 2 diabetes, total physical activity and higher‐intensity physical activity were independently associated with greater heat‐induced skin hyperemia (regression coefficients per hour), respectively, 10 (95% CI: 1; 18) and 36 perfusion units (14; 58). In individuals without type 2 diabetes, total physical activity and higher‐intensity physical activity were not associated with heat‐induced skin hyperemia. No associations with retinal arteriolar %‐dilation were identified. Conclusion Higher levels of total and higher‐intensity physical activity were associated with greater skin microvascular vasodilation in individuals with, but not in those without, type 2 diabetes.

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“…There exist three main etiopathogenetic pathways which have been implicated in both cardiovascular pathologies and latelife depression: hyperhomocysteinemia, endothelial dysfunction and inflammation. The authors also state that a vascular stress-induced decrease in the neurogenesis of the hippocampal dentate gyrus may bring on depressive episodes (9,29). Disturbed adult neurogenesis, possibly leading to a malfunctioning hippocampus, may add to the cognitive deficits and reduced hippocampal volumes seen in depressed patients.…”

Section: Discussionmentioning

confidence: 99%

Microvascular Abnormalities in Depression

Sadykov

Hosák

Studnička

et al. 2016

Iran J Psychiatry Behav Sci

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Context: Depression is a risk factor for vascular disease and vice versa. Identification of biological mechanisms common for depression and vascular pathology at microvascular level, and understanding their clinical significance may contribute to better treatment and prognosis of this combined physical/psychiatric disorder.Evidence Acquisition: We searched the PubMed computer database for the following key words "Microvascular AND Depression" on the 28th of October, 2015 to obtain relevant articles, which were consequently summarized to facilitate further research in the field of psychiatry. Results:The majority of studies support the suggestion that microvascular abnormality is associated with depression even if several documents do not necessarily support this idea. It seems probable that microvascular abnormality is only relevant in particular subtypes of depression, for example depression due to a general medical condition, late-life depression, or pharmacoresistant depression. The biological mechanisms by which microvascular abnormality is interconnected with depression may cover genetics, epigenetics, endothelial dysfunction, inflammation or hyperhomocysteinemia. Conclusions:Further research should be aimed at identifying biological mechanisms common in depression and microvascular pathology, including genetics and epigenetics, longitudinal studies of this subcategory of patients with depression, and possible pharmacotherapy overcoming the usual non-responsiveness. An active detection and aggressive treatment of physical diseases associated with microvascular pathology and depression, like hypertension, diabetes or inflammation, is warranted. This way, the patients experience less distress, their quality of life will increase, and societal cost of this vascular/psychiatric disorder will be reduced.

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Microvascular pathology in late-life depression

Cited by 17 publications

References 70 publications

Heartsick: psychiatric and inflammatory implications of cerebromicrovascular disease

Heartsick: psychiatric and inflammatory implications of cerebromicrovascular disease

Higher levels of daily physical activity are associated with better skin microvascular function in type 2 diabetes—The Maastricht Study

Microvascular Abnormalities in Depression

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