RT Journal Article
SR Electronic
T1 Impact of white matter hyperintensity location on depressive symptoms in memory-clinic patients: a lesion–symptom mapping study
JF Journal of Psychiatry and Neuroscience
JO J Psychiatry Neurosci
FD Canadian Medical Association
SP E1
OP E10
DO 10.1503/jpn.180136
VO 44
IS 4
A1 Anna E. Leeuwis
A1 Nick A. Weaver
A1 J. Matthijs Biesbroek
A1 Lieza G. Exalto
A1 Hugo J. Kuijf
A1 Astrid M. Hooghiemstra
A1 Niels D. Prins
A1 Philip Scheltens
A1 Frederik Barkhof
A1 Wiesje M. van der Flier
A1 Geert Jan Biessels
A1 ,
YR 2019
UL http://jpn.ca/content/44/4/E1.abstract
AB Background: We investigated the association between white matter hyperintensity location and depressive symptoms in a memory-clinic population using lesion–symptom mapping.Methods: We included 680 patients with vascular brain injury from the TRACE-VCI cohort (mean age ± standard deviation: 67 ± 8 years; 52% female): 168 patients with subjective cognitive decline, 164 with mild cognitive impairment and 348 with dementia. We assessed depressive symptoms using the Geriatric Depression Scale. We applied assumption-free voxel-based lesion–symptom mapping, adjusted for age, sex, total white matter hyperintensity volume and multiple testing. Next, we applied exploratory region-of-interest linear regression analyses of major white matter tracts, with additional adjustment for diagnosis.Results: Voxel-based lesion–symptom mapping identified voxel clusters related to the Geriatric Depression Scale in the left corticospinal tract. Region-of-interest analyses showed no relation between white matter hyperintensity volume and the Geriatric Depression Scale, but revealed an interaction with diagnosis in the forceps minor, where larger regional white matter hyperintensity volume was associated with more depressive symptoms in subjective cognitive decline (β = 0.26, p < 0.05), but not in mild cognitive impairment or dementia.Limitations: We observed a lack of convergence of findings between voxel-based lesion–symptom mapping and region-of-interest analyses, which may have been due to small effect sizes and limited lesion coverage despite the large sample size. This warrants replication of our findings and further investigation in other cohorts.Conclusion: This lesion–symptom mapping study in depressive symptoms indicates the corticospinal tract and forceps minor as strategic tracts in which white matter hyperintensity is associated with depressive symptoms in memory-clinic patients with vascular brain injury. The impact of white matter hyperintensity on depressive symptoms is modest, but it appears to depend on the location of white matter hyperintensity and disease severity.