White Matter Changes in Depression and Alzheimer's Disease: A Review of Magnetic Resonance Imaging Studies

White matter lesions on magnetic resonance imaging in dementia with Lewy bodies, Alzheimer's disease, vascular dementia, and normal aging

“…Periventricular hyperintensities were found in all patients with dementia and 92% of controls. Previous reports have found PVHs to occur in 44% to 100% of patients with Alzheimer’s disease, 70% to 100% with vascular dementia, and 8% to 92% of elderly controls 1-3. In common with other studies,9 11 34-36 a positive correlation between the PVHs and age was also found.…”

“…The similar pattern of hyperintensities in dementia with Lewy bodies and Alzheimer’s disease suggests that they may share a convergence in white matter pathology. White matter lesions in Alzheimer’s disease have been linked to ischaemic changes46 but histological findings from other studies have identified various abnormalities, including dilated perivascular spaces, arteriosclerosis, partial loss of myelin and axons, gliosis, lacunar infarcts, and congenital diverticula 3. Clearly not all WMHs result from ischaemic damage and postmortem examination, ideally preceded by postmortem brain MRI, is necessary to determine the nature of white matter pathology in dementia with Lewy bodies.…”

“…There are contrasting reports on the association between changes in white matter and cognitive function 34 Discrepancies may be explained by methodological differences.…”

Hippocampal volume change in depression: Late- and early-onset illness compared

“…The lack of difference between any of the study groups with respect to hyperintense lesions is surprising, given the large body of evidence supporting increased lesion load in depression (O’Brien et al , 1996; Salloway et al , 1996). Higher levels of vascular risk factors in both participants with depression and controls in the current study than in previous similar work and in the Framingham study may have been a confounding factor.…”

Criteria are needed for research in vascular depression

“…The same applies to DWMH in the frontal lobe. MRI studies show DWMH are more common in the frontal lobes in depression (O'Brien et al, 1996), but these findings show such frontal lesions are also more likely to be due to cerebral ischemia in elderly depressed subjects. Thus depression may be more closely linked to vascular disease than clinical risk factors show.…”