Abstract
Introduction: To test the hypotheses that changes in the aortic pulse-wave produced by arterial
stiffening are (1) propagated into cerebral small vessels, (2) associated with reduced
compliance of small cerebral arterial vessels, and (3) associated with the presence
of dilated perivascular spaces (PVS). Methods: Fifteen volunteers and 19 patients with late-onset depression (LOD) were prospectively
recruited, of which 6 fulfilled the criteria for treatment-resistant depression (TRD).
Aortic pulse-wave velocity (PWV) was determined using Carotid-Femoral Doppler. Pulse-wave
analysis (PWA) was performed using a SphygmoCor system. White-matter lesion load and
PVS were scored on established MRI scales. Cerebral arterial and aqueductal cerebrospinal
fluid (CSF) flow patterns were studied using quantitative phase-contrast angiography.
Results: Depressed patients had more PVS (P < .05) and prolongation of the width of the arterial systolic pulse-wave in the carotid
arteries (P < .01). There was no significant group difference for any PWV or PWA measurement.
TRD patients showed more PVS than other LOD patients (P < .05). The fractional width of the arterial systolic peak correlated significantly
with augmentation index (AIx) and heart rate-corrected augmentation index (AIx75;
R2 = 0.302, P < .01and R2 = 0.363, P < .01 respectively). Arterial–aqueductal delay showed a negative correlation with
estimated aortic systolic pressure (PWVsys; R2 = 0.293; P < .01), AIx (R2 = −0.491; P < .01) and AIx75 (R2 = −0.310; P < .01). PVS scores correlated with AIx (R2 = 0.485; P < .01) and AIx75 (R2 = −0.292; P < .01). Conclusion: Our findings support the hypothesis that increased arterial pulsatility resulting
from central arterial stiffness propagates directly into cerebral vessels and is associated
with the development of microvascular angiopathy, characterized by dilated PVS and
decreased compliance of small arterial vessels.
Key Words
Abbreviations:
AAD (arterial-aqueductal delay), AIx (augmentation index), AIx75 (heart rate-corrected augmentation index), LOD (late-onset depression), PWA (pulse-wave analysis), PCA (phase-contrast angiography), PVS (perivascular spaces / Virchow-Robin spaces), PWV (aortic pulse-wave velocity), SVD (small vessel disease), TRD (treatment-resistant depression)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 13, 2019
Accepted:
January 18,
2019
Received in revised form:
December 11,
2018
Received:
March 29,
2018
Footnotes
Funding: No supporting grant.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.01.020
Copyright
© 2019 Elsevier Inc. All rights reserved.
