Cerebrovascular Dysfunction is Related to Depressive Symptom Severity in Young Adults

Cerebral vasodilatory responsiveness is blunted in older adults (~70 yrs) with depressive disorders and is thought to contribute to the link between depressive symptomology and increased risk for neurocognitive (e.g., dementia) and cerebral vascular (e.g., stroke) diseases. In young adults with major depressive disorder (MDD), peripheral vascular endothelial dysfunction is present and graded in relation to the severity of depressive symptoms; however, to date, limited investigations have examined cerebral vasodilatory function in young otherwise healthy adults with MDD. PURPOSE: We tested the hypothesis that cerebral vasodilatory responsiveness to a hypercapnic stimulus would be blunted in young otherwise healthy adults with MDD compared to healthy non-depressed adults (HA). Further, we hypothesized, that the magnitude of impairment in cerebrovascular function would be related to depressive symptom severity. METHODS: Ten HA (7 women; 22±2yrs) and 10 adults with MDD (8 women; 22±2yrs; n=5 tested during a major depressive episode) participated. Depressive symptom severity was evaluated with the Patient Health History Questionnaire-9 (PHQ-9) in both HA and adults with MDD. Beat-to-beat mean arterial pressure (MAP; finger photoplethysmography), middle cerebral artery blood velocity (MCAv; transcranial Doppler ultrasound), and end-tidal carbon dioxide concentration (PETCO2; capnograph) were continuously measured during baseline (i.e., normocapnia) and rebreathing-induced hypercapnia. Cerebral vascular conductance index (CVCi=MCAv•MAP-1) was calculated at baseline and at the highest common magnitude of hypercapnia achieved by all subjects during rebreathing (∆PETCO2 = 9 Torr). RESULTS: At baseline, there were no differences in MAP or CVCi between groups (both p\u3e0.05). During hypercapnia, there were no group differences in the increase in MAP (∆3±3 HA vs. ∆4±3 mmHg MDD; p=0.78). Further, neither the hypercapnia-induced increase in MCAv (∆29±7 HA vs. ∆26±8 cm•s-1 MDD; p=0.37) nor the increase in CVCi (∆39±12 HA vs. ∆30±12 %baseline MDD; p=0.13) were different between groups. However, greater severity of depressive symptoms was negatively related to cerebral vasodilatory responsiveness (R2=0.219, p=0.04). CONCLUSION: These preliminary data suggest that cerebral vasodilatory responsiveness to hypercapnia is not impaired in young adults with MDD, despite a negative relation between depressive symptom severity and the magnitude of hypercapnia-induced cerebral vasodilation