Transcranial Doppler in the assessment of hypoperfusion in Vascular Depression

Background: there is agreement that late-life depression is a condition at risk for future dementia (1). Increasing evidences showed also a link between cerebral hypoperfusion and neurodegeneration (2), although data on Trascranical Doppler (TCD)-derived measures in patients with Vascular Depression (VD) are lacking. The aim of this study was to assess TCD parameters and compare them with cognitive functions and severity of subcortical vascular disease in a sample of VD patients. Methods: mean blood flow velocity (MBFV) and pulsatility index (PI) of the middle cerebral artery were evaluated. Quantification of depressive symptoms, neuropsychological tests evaluating frontal lobe abilities, and white matter lesions (WMLs) load were assessed. Results: an increased PI and a reduced MBFV were found. They both significantly correlated with WMLs severity, poor performance in executive functions, and depressive symptoms. Conclusion: PI and MBFV indexes of cerebral hypoperfusion are associated with WMLs load and cognitive dysfunction in VD. TCD is a promising tool for the early detection, assessment and therapy of VD in patients at risk for dementia.