Affective status in cerebral small vessel disease

Abstract

Introduction. Cerebral small vessel disease is a neurological con- dition characterized by motor, cognitive and affective disorders,

often found on brain magnetic resonance imaging scans in patients with vascular risk factors. Affective disorders may have a major impact on patients’ quality of life, although they are often ignored as an entity in cerebrovascular pathology. Material and Methods. This prospective study included 80 patients with the diagnosis of cerebral small vessel disease admitted at the Clinic of Neurology, Clinical Center of Serbia in the period from January 1, 2017 to January 1, 2019. Baseline demographic data and brain magnetic

resonance findings were obtained along with the results of cogni- tive function and affective status tests. Data were analyzed using

standard statistical tests. Results. Standard screening tests revealed that 51.25% and 33.75% of our patients with cerebral small vessel

disease suffer from apathy and depression, respectively. A sig- nificant correlation was found between the severity of white mat- ter changes on magnetic resonance scans and apathy (p = 0.0092).

Additionally, white matter changes were also significantly associ- ated with depression (p = 0.021). Conclusion. Affective disorders

are not uncommon in cerebral small vessel disease and apathy was

the leading phenomenon among our patients. Since a strong cor- relation was detected between affective disorders and severity of

vascular changes on magnetic resonance scans, we may conclude that both apathy and depression are key features of an underlying brain injury, rather than just comorbidity.

Uvod. Bolest malih krvnih sudova mozga je neurološko stanje za koje su karakteristični motorni, kognitivni i afektivni poremećaji i

koje se često dijagnostikuje na snimcima mozga magnetnom rezo- nancijom kod pacijenata sa vaskularnim faktorima rizika. Promene

u afektivnom statusu imaju veliki uticaj na kvalitet života pacijena- ta iako su neretko bile zanemaren fenomen u cerebrovaskularnoj

patologiji. Materijal i metode. U prospektivnoj studiji obuhvaćeno je 80 pacijenata sa dijagnozom bolest malih krvnih sudova mozga

lečenih i ispitivanih na Klinici za neurologiju Kliničkog centra Sr- bije, u periodu od 1. januara 2017. godine do 1. januara 2019. godine.

Analizirani su osnovni demografski podaci, nalaz na magnetnoj

rezonanciji mozga i rezultati testova kognitivnih funkcija i afektiv- nog statusa, upotrebom standardnih statističkih metoda. Rezultati.

Rezultati testova za apatiju i depresiju ukazali su da je 51,25% bo- lesnika sa ovom bolešću pokazivalo prisustvo apatije, a 33,75%

prisustvo depresivnog poremećaja. Dokazana je statistički značajna

povezanost između težine lezija bele mase mozga na magnetnore- zonantnim snimcima mozga i apatije (p = 0,0092), odnosno težine

lezija bele mase i depresije (p = 0,021). Zaključak. Izmene afektiv- nog statusa nisu retka manifestacija cerebralne bolesti malih krvnih

sudova mozga, a najčešći fenomen u našoj grupi bolesnika bila je

apatija. Budući da je detektovana značajna povezanost između afek- tivnih poremaćaja i težine vaskularnih lezija na magnetno-rezonan- tnim snimcima mozga, smatramo da su apatija i depresivnost najpre

deo kliničke slike ove bolesti a ne jedan od komorbiditeta.