TY - JOUR
T1 - Retinal microvascular function and incidence and trajectories of clinically relevant depressive symptoms
T2 - the Maastricht Study
AU - van Gennip, April C E
AU - Gupta, Monideepa D
AU - Houben, Alfons J H M
AU - Berendschot, Tos T J M
AU - Webers, Carroll A B
AU - van Greevenbroek, Marleen M J
AU - van der Kallen, Carla J H
AU - Koster, Annemarie
AU - Wesselius, Anke
AU - Eussen, Simone J P M
AU - Schalkwijk, Casper G
AU - de Galan, Bastiaan E
AU - Köhler, Sebastian
AU - Schram, Miranda T
AU - Stehouwer, Coen D A
AU - van Sloten, Thomas T
PY - 2024/3/12
Y1 - 2024/3/12
N2 - BACKGROUND: Cerebral microvascular dysfunction may contribute to depression via disruption of brain structures involved in mood regulation, but evidence is limited. We investigated the association of retinal microvascular function, a proxy for microvascular function in the brain, with incidence and trajectories of clinically relevant depressive symptoms. METHODS: Longitudinal data are from The Maastricht Study of 5952 participants (59.9 ± 8.5 years/49.7% women) without clinically relevant depressive symptoms at baseline (2010-2017). Central retinal arteriolar equivalent and central retinal venular equivalent (CRAE and CRVE) and a composite score of flicker light-induced retinal arteriolar and venular dilation were assessed at baseline. We assessed incidence and trajectories of clinically relevant depressive symptoms (9-item Patient Health Questionnaire score ?10). Trajectories included continuously low prevalence (low, = 5225 [87.8%]); early increasing, then chronic high prevalence (early-chronic, = 157 [2.6%]); low, then increasing prevalence (late-increasing, = 247 [4.2%]); and remitting prevalence (remitting, = 323 [5.4%]). RESULTS: After a median follow-up of 7.0 years (range 1.0-11.0), 806 (13.5%) individuals had incident clinically relevant depressive symptoms. After full adjustment, a larger CRAE and CRVE were each associated with a lower risk of clinically relevant depressive symptoms (hazard ratios [HRs] per standard deviation [s.d.]: 0.89 [95% confidence interval (CI) 0.83-0.96] and 0.93 [0.86-0.99], respectively), while a lower flicker light-induced retinal dilation was associated with a higher risk of clinically relevant depressive symptoms (HR per s.d.: 1.10 [1.01-1.20]). Compared to the low trajectory, a larger CRAE was associated with lower odds of belonging to the early-chronic trajectory (OR: 0.83 [0.69-0.99]) and a lower flicker light-induced retinal dilation was associated with higher odds of belonging to the remitting trajectory (OR: 1.23 [1.07-1.43]). CONCLUSIONS: These findings support the hypothesis that cerebral microvascular dysfunction contributes to the development of depressive symptoms.
AB - BACKGROUND: Cerebral microvascular dysfunction may contribute to depression via disruption of brain structures involved in mood regulation, but evidence is limited. We investigated the association of retinal microvascular function, a proxy for microvascular function in the brain, with incidence and trajectories of clinically relevant depressive symptoms. METHODS: Longitudinal data are from The Maastricht Study of 5952 participants (59.9 ± 8.5 years/49.7% women) without clinically relevant depressive symptoms at baseline (2010-2017). Central retinal arteriolar equivalent and central retinal venular equivalent (CRAE and CRVE) and a composite score of flicker light-induced retinal arteriolar and venular dilation were assessed at baseline. We assessed incidence and trajectories of clinically relevant depressive symptoms (9-item Patient Health Questionnaire score ?10). Trajectories included continuously low prevalence (low, = 5225 [87.8%]); early increasing, then chronic high prevalence (early-chronic, = 157 [2.6%]); low, then increasing prevalence (late-increasing, = 247 [4.2%]); and remitting prevalence (remitting, = 323 [5.4%]). RESULTS: After a median follow-up of 7.0 years (range 1.0-11.0), 806 (13.5%) individuals had incident clinically relevant depressive symptoms. After full adjustment, a larger CRAE and CRVE were each associated with a lower risk of clinically relevant depressive symptoms (hazard ratios [HRs] per standard deviation [s.d.]: 0.89 [95% confidence interval (CI) 0.83-0.96] and 0.93 [0.86-0.99], respectively), while a lower flicker light-induced retinal dilation was associated with a higher risk of clinically relevant depressive symptoms (HR per s.d.: 1.10 [1.01-1.20]). Compared to the low trajectory, a larger CRAE was associated with lower odds of belonging to the early-chronic trajectory (OR: 0.83 [0.69-0.99]) and a lower flicker light-induced retinal dilation was associated with higher odds of belonging to the remitting trajectory (OR: 1.23 [1.07-1.43]). CONCLUSIONS: These findings support the hypothesis that cerebral microvascular dysfunction contributes to the development of depressive symptoms.
KW - depressive symptoms
KW - epidemiology
KW - longitudinal study
KW - retinal microvascular function
KW - trajectories
KW - vascular depression
U2 - 10.1017/S0033291724000618
DO - 10.1017/S0033291724000618
M3 - Article
SN - 0033-2917
SP - 1
EP - 10
JO - Psychological Medicine
JF - Psychological Medicine
ER -