Correlation Between White Matter Lesions And Depressive Disorder

Background and ObjectiveWhite matter lesions(WML) is also known as leukoaraiosis (LA), is caused bya variety of different causes an ischemic cerebral small vessel disease clinicalsyndrome. With the development and application of MRI and other imagingtechniques, WML in the detection rate of the elderly population is increasing.Clinically，it can be expressed in the formation of three kinds of edge loops andperiventricular fiber connection of memory, emotion, behavior, cognitive disorder,also can appear difficult to walk. Some scholars from the perspective of spiritualpsychology research that WML can appear mental disorders. Depressive disorderis caused by a variety of reasons, such as depression, lack of interest, loss of pleasureof mood disorders clinical syndrome.. Accompanied by intensification of the ageingsociety, depressive disorder in the elderly population the incidence increased year byyear, a lot of nervous system diseases can lead to depressive disorder, such aspost-stroke, Parkinson’s disease, epilepsy，etc. Since the performance of the primarydisease is more prominent or hidden, often obscure or ignore the symptoms ofdepression,and elderly people suffering from depression is difficult to recover.Therefore, early detection of neurological disease complicated by depressive disorder, enhance their recognition rate of disease prognosis and prognosticsignificance. This topic through the analysis of the relationship between the differentdegree of white matter lesions(WML) and depressive disorder, to explore thecorrelation between them, to provide clinical evidence for the prevention andtreatment of depressive disorder.Materials and MethodsSelected neurology patient hospitalization and outpatient departments of theSecond Affiliated Hospital of Zhengzhou University from September2012toSeptember2013, met the inclusion criteria, were carried out physical examination,and then cranial MRI.According to the imaging findings, randomly selected120patients with whitematter lesions as the observation group, aged from60to80years old, average age(68.4±6.0),66cases of male and54cases female, male to female ratio was about1.2:1. Another Chose30cases of without white matter lesions in the same agegroups as the control group.No statistical difference was found between two groupsof basic data.120cases in the observation group, according to WML patient occupation:Workers28cases,25cases of farmers,24cases of teachers,27cases of civilservants, the other16cases. Based on the current monthly minimum wagestandards in Zhengzhou city, monthly income was divided into three levels:<1200yuan,38cases;1200-3000yuan,46cases;>3000yuan,36cases. According topatients’ education background were divided into: junior high school,28cases; Highschool/technical school,39cases; College or above, major in53cases.Based on cranial MRI imaging and white matter lesions, according toAbaron-peretz standard,120WML patients were divided into three groups： Ⅰdegree, Ⅱ degree, Ⅲdegree.Referring to Chinese Classification and diagnostic criteria of mental disordersthird edition(CCMD-3)and the American Diagnostic and Statistical Manual ofMental Disorders Fourth Edition(DSM-Ⅳ) version of the diagnostic criteria, theobservation group and the control group under went24Hamilton Depression Rating Scale score, which was divided into as follows:8-20score, mild depressivedisorder;21-35score, moderate depressive disorder;＞35score, severe depressivedisorder.Using SPSS17.0software for statistical processing. Quantitative informationand data using±s, were compared using t-test analysis between group differences.The qualitative data by chi-square test. Correlation analysis was carried on.Inspection standards were α=0.05,as the difference was statistically significant.Results1Analysis of patients with depressive disorder were age, genderfactors in two groupsTwo groups of patients with depression compare differences in age, there wassignificant (P <0.05). While the control group and observation group in patientswith depressive disorder in terms of gender showed no statistical difference (P>0.05).Analysis of correlation between age and HAMD score of patients withdepressive disorder in the two group, there was a correlation between the two, withthe age increasing, the HAMD score increased significantly (P <0.05, r=0.664).2Analysis of social factors in patients with major depressivedisorder occupation, income, educational background and other inthe observation groupIn the observation group, in terms of income, education background was astatistically significant (P <0.05). Cerebral white matter lesions in patients with lowincome, the education level was low, the relatively high incidence of depressivedisorder. And occupational factors was no statistically significant difference (P>0.05).3Control group compared with the observation group of Hamiltondepression scale score In HAMD total scores, average score in the control group (5.10±1.73),observer group total average score (6.98±5.57), both groups were statisticallysignificant difference (P<0.05).In the observation group, Ⅰ degreeaverage score was (5.59±3.03), Ⅱdegreeaverage score was (7.53±5.67), Ⅲdegree average score was (11.92±10.42).Two comparison of the differences were statistically significant (P <0.05).In comparison to HAMD24single item rating, sleep was not deep, work andinterest, anxiety, systemic symptom, body as suspected disease, reduced capacity, thecontrol group and observation group each group was more significant difference,with statistical significance (P <0.05). No statistically significant differences incompared to other projects (P>0.05).4Control group and observation group the incidence of depressivedisorderDepressive disorder occurred in the control group was6.7%(2/30).Observation group overall incidence of depressive disorder was17.5%(21/120).In the observation group, the incidence of depressive disorder degreeⅠWML group was9.3%(6/64), the occurrence of depressive disorder degree ⅡWML group was25.5%(11/43), the degree ⅢWML group the incidence ofdepressive disorder was30.7%(4/13).In the control group, Ⅰ degree and Ⅱ degree,Ⅲ degree group difference wasstatistically significant (P <0.05).5Correlation between white matter lesions and depressive disorderThe results showed that the observation group of cerebral white matter lesionswere associated with depressive disorder (P <0.05, r=0.226), the more severe whitematter lesions, the higher the incidence of depressive disorder.Conclusions1There is a certain correlation between white matter lesions and depressivedisorder, the degree of white matter lesions are positively correlated with the severity and incidence of depressive disorder.2The higher the age of patients with white matter lesions is, the more severe itscomorbid depressive disorder.3White matter lesions in patients with depressive disorder has no genderdifference.4Low degree of economic income and education are white matter lesions withdepressive disorder susceptible factors...