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Depression in small-vessel disease relates to white matter ultrastructural damage, not disability.

Brookes RL, Herbert V, Lawrence AJ, Morris RG, Markus HS - Neurology (2014)

Bottom Line: We then compared the same model in a non-SVD stroke cohort (n = 50) and healthy older adults (n = 203).The DTI study showed that fractional anisotropy, a marker of white matter damage, was related to depressive symptoms in patients with SVD.These results suggest that in stroke patients without SVD, disability is an important causal factor for depression, whereas in SVD stroke, other factors specific to this stroke subtype have a causal role.

View Article: PubMed Central - PubMed

Affiliation: From the Stroke and Dementia Research Centre (R.L.B., V.H., A.J.L.), St George's, University of London; University of Cambridge (H.S.M.), Department of Neurology, Cambridge Biomedical Campus; and Department of Psychology (R.G.M.), Institute of Psychiatry, King's College London, UK. rbrookes@sgul.ac.uk.

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SVD models(A) SVD exploratory model of the relationships among physical disability, depression, and reduction in QoL, in SVD. (B) SVD replication analysis of model 1 in a second independent SVD patient group. Standardized β weights are shown for each path. **Significant at the 0.001 level. For depression, higher = worse depression; QoL reduction, higher = poorer QoL; disability, higher = worse disability. ADL = Activities of Daily Living; mRS = modified Rankin Scale; QoL = quality of life; SVD = small-vessel disease.
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Figure 1: SVD models(A) SVD exploratory model of the relationships among physical disability, depression, and reduction in QoL, in SVD. (B) SVD replication analysis of model 1 in a second independent SVD patient group. Standardized β weights are shown for each path. **Significant at the 0.001 level. For depression, higher = worse depression; QoL reduction, higher = poorer QoL; disability, higher = worse disability. ADL = Activities of Daily Living; mRS = modified Rankin Scale; QoL = quality of life; SVD = small-vessel disease.

Mentions: The initial model was applied to the replication SVD cohort. Path analyses revealed a very similar pattern of results to that seen in the discovery cohort. The direct paths from depression to QoL (β = 0.51, p < 0.001; 95% CI = 0.36, 0.67) and disability to QoL (β = 0.58, p < 0.001; 95% CI = 0.37, 0.78) were highly significant with similar β values to the discovery group. The direct path between disability and depression was not significant (β = 0.21, p = 0.15; 95% CI = −0.07, 0.49) and the indirect path from disability to QoL via depression was also not significant (β = 0.11, p = 0.13; 95% CI = −0.03, 0.13). See figure 1.


Depression in small-vessel disease relates to white matter ultrastructural damage, not disability.

Brookes RL, Herbert V, Lawrence AJ, Morris RG, Markus HS - Neurology (2014)

SVD models(A) SVD exploratory model of the relationships among physical disability, depression, and reduction in QoL, in SVD. (B) SVD replication analysis of model 1 in a second independent SVD patient group. Standardized β weights are shown for each path. **Significant at the 0.001 level. For depression, higher = worse depression; QoL reduction, higher = poorer QoL; disability, higher = worse disability. ADL = Activities of Daily Living; mRS = modified Rankin Scale; QoL = quality of life; SVD = small-vessel disease.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4206159&req=5

Figure 1: SVD models(A) SVD exploratory model of the relationships among physical disability, depression, and reduction in QoL, in SVD. (B) SVD replication analysis of model 1 in a second independent SVD patient group. Standardized β weights are shown for each path. **Significant at the 0.001 level. For depression, higher = worse depression; QoL reduction, higher = poorer QoL; disability, higher = worse disability. ADL = Activities of Daily Living; mRS = modified Rankin Scale; QoL = quality of life; SVD = small-vessel disease.
Mentions: The initial model was applied to the replication SVD cohort. Path analyses revealed a very similar pattern of results to that seen in the discovery cohort. The direct paths from depression to QoL (β = 0.51, p < 0.001; 95% CI = 0.36, 0.67) and disability to QoL (β = 0.58, p < 0.001; 95% CI = 0.37, 0.78) were highly significant with similar β values to the discovery group. The direct path between disability and depression was not significant (β = 0.21, p = 0.15; 95% CI = −0.07, 0.49) and the indirect path from disability to QoL via depression was also not significant (β = 0.11, p = 0.13; 95% CI = −0.03, 0.13). See figure 1.

Bottom Line: We then compared the same model in a non-SVD stroke cohort (n = 50) and healthy older adults (n = 203).The DTI study showed that fractional anisotropy, a marker of white matter damage, was related to depressive symptoms in patients with SVD.These results suggest that in stroke patients without SVD, disability is an important causal factor for depression, whereas in SVD stroke, other factors specific to this stroke subtype have a causal role.

View Article: PubMed Central - PubMed

Affiliation: From the Stroke and Dementia Research Centre (R.L.B., V.H., A.J.L.), St George's, University of London; University of Cambridge (H.S.M.), Department of Neurology, Cambridge Biomedical Campus; and Department of Psychology (R.G.M.), Institute of Psychiatry, King's College London, UK. rbrookes@sgul.ac.uk.

Show MeSH
Related in: MedlinePlus