Vascular risk factors and cognitive impairment of patients with magnetic resonance imaging-defined subcortical ischemic depression

Abstract

To explore the vascular risk factors and neuropsychological profiles of patients with magnetic resonance imaging (MRI)-defined subcortical ischemic depression (SID). Thirty-five SID patients, 37 patients with subcortical ischemic vascular disease without depression (SIVD) and 40 normal controls (NC) participated in this case-control study. The SID and SIVD groups were recruited from the Department of Neurology, First Affiliated Hospital, Anhui Medical University between October 2010 and September 2011. And the NC group came from Medical Center, First Affiliated Hospital of Anhui Medical University over the same period. The vascular risk factors of all participants were assessed by the Framingham scale. Depression symptoms were assessed by the geriatric depression scale (GDS) and Hamilton depression scale (HAMD) while cognitive functions by the mini-mental state examination (MMSE) and Montreal cognitive clock drawing task (CDT). Both the SID (12.3 ± 4.7) and SIVD (13.5 ± 3.4) groups showed significantly higher Framingham scores than the NC group (8.6 ± 1.8) (F = 20.850, P = 0.000). Compared with the NC group (28.3 ± 1.8; 23.1 ± 3.4; 8.0 ± 1.8), the MMSE, MoCA and CDT scores were significantly lower in the SID (26.7 ± 2.5; 20.0 ± 4.0; 2.0 ± 2.7) and SIVD (26.8 ± 1.9; 20.7 ± 3.0; 6.1 ± 2.1) groups (P < 0.05). There were significantly lower CAMCOG-C scores in the SID (82.7 ± 9.0) and SIVD (86.2 ± 6.9) groups versus the NC group (92.3 ± 6.2) (P < 0.05) and similarly in the SID group versus the SIVD group (P < 0.05). Among the subtests of CAMCOG-C, the orientation, language and memory scores in both SID (9.0 ± 1.4; 24.7 ± 4.0; 19.5 ± 3.4) and SIVD (9.4 ± 0.9; 25.5 ± 2.1; 20.3 ± 2.3) groups were significantly lower than those in the NC group (9.9 ± 0.4; 27.4 ± 1.9; 22.1 ± 2.4) (P < 0.05); the praxis scores in the SID group (9.4 ± 1.9) were significantly lower than those in the NC group (10.4 ± 1.5) (P < 0.05). And the thinking and perception scores in the SID group (5.4 ± 1.7; 6.3 ± 1.4) were significantly lower than those in the SIVD (6.2 ± 1.3; 7.0 ± 1.4) and NC (6.6 ± 1.3; 7.2 ± 1.4) groups. In the SID group, no significant correlation was found between the Framingham scores and neuropsychological assessments. There were a negative correlation between the GDS, HAMD scores and MMSE, MoCA, CAMCOG-C and CDT scores (P < 0.05). The SID patients demonstrate multiple neuropsychological deficits, especially in thinking, perception and praxis. No significant correlation between vascular risk factors and depression symptoms is found in SID patients.