A Relevant Research Between Depression And Lesion Region And Severity In Patients With Cerebral Small Vessel Disease

Objective This paper conducts a clinical cross-sectional study that if the lesion region and severity of cerebral small vessel disease(CSVD)patients are the related factors for depression in patients with CSVD,so as to investigate the relationship between depression and the lesion region and severity in patients with cerebral small vessel disease.Method Patients with CSVD were diagnosed in the Sino-French Department of Neurological Rehabilitation of Gansu Provincial Hospital from July 2016 to February2017 were enrolled.The patients were examined and typed through head MRI(including SWI).The distribution and the numbers of LI(lacunar infarction)were evaluated by head MRI.The distribution and severity of LA(leukoaraiosis)were evaluated by head MRI,Fazekas scores and the age-related white matter change(ARWMC)scale.The distribution and the numbers of cerebral microbleed(CMB)were evaluated by head SWI.Moreover,the patients were made a diagnosis of depression according to the American Diagnostic and Statistical Manual of mental disorders-4th edition(DSM-IV).The depression group and non-depression group are confirmed according to the depression diagnosis and demographic data matching.The relationship between depression and the lesion region and severity in patients with cerebral small vessel disease is analyzed through chi-square test,t test,Wilcoxon runk-sum test,Pearson correlation analysis and multivariate logistic regression analysis.Results A total of 150 patients with CSVD were enrolled.They were divided into three subtypes,which were respectively LI,LA and CMB.Thereinto,49 patients(32.7%)had depression were served as the depression group while 49 patients without depression matched in both age and sex selected from 101 non-depression patients were served as non-depression patients.In comparison with the non-depression group,there were no statistical differences on detection ratio of LI,LA and CMB between the depression group and the non-depression group(P>0.05).There were statistical differences on hypertension between the depression group and the non-depression group.Patients in the depression group were likely to have higher DWMHs(Deep white matter hyperintensities)scores,and there were statistical differences in the patients with DWMHs between the depression group and the non-depression group(p<0.05).There were statistical differences on detection ratio in the patients with basal ganglia lacunar infarction,lobar CMB between the depression group and the non-depression group(p<0.05).However,in comparison with the non-depression group,there were no statistical differences in the patients with periventricular white matter hyperintensities(PWMHs),the grade of LI numbers and the grade of CMB numbers between the depression group and the non-depression group(P>0.05).there was positive relativity between the severity of depression and DWMHs scores in patients with CSVD.Multivariate logistic regression analysis showed that DWMHs,lobar CMB and hypertension were independently associated with depression in patients with CSVD.Conclusion: 1.Basal ganglia LI is the related factors for depression in patients with CSVD.2.The DWMHs may increase the vulnerability of depression in patients with CSVD.3.DWMHs,lobar CMB and hypertension are the independent risk factors for depression with CSVD.