MRI-defined vascular depression: A review of the construct
Objective To review the construct of MRI-defined vascular depression and to examine the substantive and methodological issues that bear on its validity as a distinct subtype of depression in late life. Design Literature review. Results We identified three areas that are critical to establishing the validity of MRI-defined vascular depression: (1) understanding and delineating the relationship between MRI hyperintensities, executive dysfunction, and antidepressant treatment outcome; (2) understanding the relationship between, and establishing the validity of, qualitative and quantitative approaches to the measurement of MRI hyperintensities (the primary feature of the proposed subtype); (3) establishing the clinical presentation and course of the subtype in the context of other late-life disorders. Conclusions Despite considerable data supporting the validity of MRI-defined vascular depression, there are a number of critical issues that remain, including establishing a causal relationship between cerebrovascular disease and late-life depression, establishing consistent diagnostic criteria, determining the importance of lesion type and location, and understanding the course of the disorder. Copyright © 2010 John Wiley & Sons, Ltd.
Culang-Reinlieb, ME; Johnert, LC; Brickman, AM; Steffens, DC; Garcon, E; Sneed, JR
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