Depression caused by vascular brain diseases: the role of neuroimaging methods in prevention, early detection ant treatment

Introduction: Depression, as frequent disorder in patients with cerebrovascular disease (CVD), is considered to be a factor that favors poor outcome. Several reports suggested high frequency of hypoechogenicity of mesencephalic raphe (RM) in patients with endogenous depression, while frequency of this ultrasound finding in patients with vascular depression is unknown. Aims: 1. To analyze possible relationship between hypoechogenicity of RM with depression and cognitive status. 2. To analyze possible relationship between RM hypoechogenicity with results of brain MRI. 3. To determine correlation between MTHFR mutations and ApoE polymorphism with clinical, RM and MRI finding. Methods: prospective study of minimum 200 patients with CVD and control group of 100 subjects.At the study beginning, all subjects will be examined in the course of cognitive and affective status, MRI and RM. Antidepressants will be add to all depressive patients and control examination will be performed after 6 and 12 months.Expected results:1. Positive correlation between hypoechogenicity of RM and depression, 2. Positive correlation between MTHFR TT and ApoE4 genotype with cognitive and affective status; 3. Correlation between severity of vascular lesions, cognitive impairment with depression. Conclusion: The results of this study should offer markers whose presence suggests greater possibility of developing vascular depression and recognition of patients resistant to antidepressive therapy.