Markers of cerebral small vessel disease and severity of depression in the general population

Nese Direk, Heidi Saavedra Perez, Saloua Akoudad, Benjamin F J Verhaaren, Wiro J. Niessen, Albert Hofman, Meike W. Vernooij, M. Arfan Ikram, Henning Tiemeier*

*Corresponding author for this work

    Research output: Contribution to journalArticleScientificpeer-review

    20 Citations (Scopus)


    The vascular depression hypothesis postulates that cerebral small vessel disease can cause or exacerbate depression in elderly persons. Numerous studies explored the association of imaging markers of cerebral small vessel disease including white matter lesions (WMLs) and lacunar infarcts with depressive symptoms or disorders. However, cerebral microbleeds have not been tested in depression. In the current study, we aimed to explore the association of WMLs, lacunar infarcts and cerebral microbleeds with depression continuum in a large population-based sample, the Rotterdam Study. Study population consisted of 3799 participants (aged 45 or over) free of dementia. WML volumes, lacunar infarcts and cerebral microbleeds were measured with brain magnetic resonance imaging. Depressive symptoms, depressive disorders and co-morbid anxiety disorders were assessed with validated questionnaires and clinical interview. WML volumes and lacunar infarcts were associated with depressive symptoms and disorders. Cerebral microbleeds, especially in deep or infratentorial brain regions, were related to depressive disorders only. Our results indicate that WMLs and lacunar infarcts might be non-specific vascular lesions seen in depressive symptoms and disorders. Association of cerebral microbleeds with more severe forms of depression may indicate impaired brain iron homeostasis or minor episodes of cerebrovascular extraversion, which may play a role in depression etiology.

    Original languageEnglish
    Pages (from-to)1-6
    Number of pages6
    JournalPsychiatry Research - Neuroimaging
    Publication statusPublished - 30 Jul 2016


    • Anxiety
    • Cerebral microbleeds
    • Depressive iisorders
    • Depressive symptoms
    • Lacunar infracts
    • Vascular depression
    • White matter lesions


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