Cargando…

Confining the Concept of Vascular Depression to Late-Onset Depression: A Meta-Analysis of MRI-Defined Hyperintensity Burden in Major Depressive Disorder and Bipolar Disorder

Background: The vascular depression hypothesis emphasizes the significance of vascular lesions in late-life depression. At present, no meta-analytic model has investigated whether a difference in hyperintensity burden compared to controls between late-life and late-onset depression is evident. By in...

Descripción completa

Detalles Bibliográficos
Autores principales: Salo, Katharina I., Scharfen, Jana, Wilden, Isabelle D., Schubotz, Ricarda I., Holling, Heinz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6555192/
https://www.ncbi.nlm.nih.gov/pubmed/31214072
http://dx.doi.org/10.3389/fpsyg.2019.01241
_version_ 1783425108242595840
author Salo, Katharina I.
Scharfen, Jana
Wilden, Isabelle D.
Schubotz, Ricarda I.
Holling, Heinz
author_facet Salo, Katharina I.
Scharfen, Jana
Wilden, Isabelle D.
Schubotz, Ricarda I.
Holling, Heinz
author_sort Salo, Katharina I.
collection PubMed
description Background: The vascular depression hypothesis emphasizes the significance of vascular lesions in late-life depression. At present, no meta-analytic model has investigated whether a difference in hyperintensity burden compared to controls between late-life and late-onset depression is evident. By including a substantial number of studies, focusing on a meaningful outcome measure, and considering several moderating and control variables, the present meta-analysis investigates the severity of hyperintensity burden in major depressive disorder (MDD) and bipolar disorder (BD). A major focus of the present meta-analysis refers to the role of age at illness onset. It is analyzed whether late-onset rather than late-life depression characterizes vascular depression. Method: In total, 68 studies were included in the meta-analysis and a multilevel random effects model was calculated using Hedges' g as the effect size measure. Results: The severity of hyperintensity burden was significantly greater in the patient group compared to the control group. This effect was evident regarding the whole patient group (g = 0.229) as well as both depression subgroups, with a significantly greater effect in BD (g = 0.374) compared to MDD (g = 0.189). Hyperintensity burden was more pronounced in late-onset depression than in early-onset depression or late-life depression. A considerable heterogeneity between the included studies was observed, which is reflected by the large variability in effects sizes. Conclusion: In conclusion, the present meta-analysis underscores the association of hyperintensities with MDD and BD. Especially late-onset depression is associated with an increased hyperintensity burden, which is in line with the vascular depression hypothesis. The results suggest that it might be more feasible to confine the concept of vascular depression specifically to late-onset depression as opposed to late-life depression. Further research is needed to understand the causal mechanisms that might underlie the relation between hyperintensity burden and depression.
format Online
Article
Text
id pubmed-6555192
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-65551922019-06-18 Confining the Concept of Vascular Depression to Late-Onset Depression: A Meta-Analysis of MRI-Defined Hyperintensity Burden in Major Depressive Disorder and Bipolar Disorder Salo, Katharina I. Scharfen, Jana Wilden, Isabelle D. Schubotz, Ricarda I. Holling, Heinz Front Psychol Psychology Background: The vascular depression hypothesis emphasizes the significance of vascular lesions in late-life depression. At present, no meta-analytic model has investigated whether a difference in hyperintensity burden compared to controls between late-life and late-onset depression is evident. By including a substantial number of studies, focusing on a meaningful outcome measure, and considering several moderating and control variables, the present meta-analysis investigates the severity of hyperintensity burden in major depressive disorder (MDD) and bipolar disorder (BD). A major focus of the present meta-analysis refers to the role of age at illness onset. It is analyzed whether late-onset rather than late-life depression characterizes vascular depression. Method: In total, 68 studies were included in the meta-analysis and a multilevel random effects model was calculated using Hedges' g as the effect size measure. Results: The severity of hyperintensity burden was significantly greater in the patient group compared to the control group. This effect was evident regarding the whole patient group (g = 0.229) as well as both depression subgroups, with a significantly greater effect in BD (g = 0.374) compared to MDD (g = 0.189). Hyperintensity burden was more pronounced in late-onset depression than in early-onset depression or late-life depression. A considerable heterogeneity between the included studies was observed, which is reflected by the large variability in effects sizes. Conclusion: In conclusion, the present meta-analysis underscores the association of hyperintensities with MDD and BD. Especially late-onset depression is associated with an increased hyperintensity burden, which is in line with the vascular depression hypothesis. The results suggest that it might be more feasible to confine the concept of vascular depression specifically to late-onset depression as opposed to late-life depression. Further research is needed to understand the causal mechanisms that might underlie the relation between hyperintensity burden and depression. Frontiers Media S.A. 2019-05-31 /pmc/articles/PMC6555192/ /pubmed/31214072 http://dx.doi.org/10.3389/fpsyg.2019.01241 Text en Copyright © 2019 Salo, Scharfen, Wilden, Schubotz and Holling. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychology
Salo, Katharina I.
Scharfen, Jana
Wilden, Isabelle D.
Schubotz, Ricarda I.
Holling, Heinz
Confining the Concept of Vascular Depression to Late-Onset Depression: A Meta-Analysis of MRI-Defined Hyperintensity Burden in Major Depressive Disorder and Bipolar Disorder
title Confining the Concept of Vascular Depression to Late-Onset Depression: A Meta-Analysis of MRI-Defined Hyperintensity Burden in Major Depressive Disorder and Bipolar Disorder
title_full Confining the Concept of Vascular Depression to Late-Onset Depression: A Meta-Analysis of MRI-Defined Hyperintensity Burden in Major Depressive Disorder and Bipolar Disorder
title_fullStr Confining the Concept of Vascular Depression to Late-Onset Depression: A Meta-Analysis of MRI-Defined Hyperintensity Burden in Major Depressive Disorder and Bipolar Disorder
title_full_unstemmed Confining the Concept of Vascular Depression to Late-Onset Depression: A Meta-Analysis of MRI-Defined Hyperintensity Burden in Major Depressive Disorder and Bipolar Disorder
title_short Confining the Concept of Vascular Depression to Late-Onset Depression: A Meta-Analysis of MRI-Defined Hyperintensity Burden in Major Depressive Disorder and Bipolar Disorder
title_sort confining the concept of vascular depression to late-onset depression: a meta-analysis of mri-defined hyperintensity burden in major depressive disorder and bipolar disorder
topic Psychology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6555192/
https://www.ncbi.nlm.nih.gov/pubmed/31214072
http://dx.doi.org/10.3389/fpsyg.2019.01241
work_keys_str_mv AT salokatharinai confiningtheconceptofvasculardepressiontolateonsetdepressionametaanalysisofmridefinedhyperintensityburdeninmajordepressivedisorderandbipolardisorder
AT scharfenjana confiningtheconceptofvasculardepressiontolateonsetdepressionametaanalysisofmridefinedhyperintensityburdeninmajordepressivedisorderandbipolardisorder
AT wildenisabelled confiningtheconceptofvasculardepressiontolateonsetdepressionametaanalysisofmridefinedhyperintensityburdeninmajordepressivedisorderandbipolardisorder
AT schubotzricardai confiningtheconceptofvasculardepressiontolateonsetdepressionametaanalysisofmridefinedhyperintensityburdeninmajordepressivedisorderandbipolardisorder
AT hollingheinz confiningtheconceptofvasculardepressiontolateonsetdepressionametaanalysisofmridefinedhyperintensityburdeninmajordepressivedisorderandbipolardisorder