Depression after heart attack tied to brain changes

But more research is needed to determine whether depression causes these changes or vice versa, said the German study authors.

Depression is common after a heart attack and its presence increases the risk of recurrent heart problems and death.

The study included 22 patients who underwent brain scans three months after a heart attack. The researchers looked for cerebral deep white matter changes and structural abnormalities in the parts of the brain called the anterior cingulate cortex and dorsolateral prefrontal cortex.

In addition, the patients were assessed for other heart problems, depression and cardiovascular risk factors.

According to researchers led by Dr. Michael A. Rapp of the department of psychiatry at St. Hedwig's Hospital in Berlin, even after taking into account other existing heart problems, depression severity was associated with changes in the anterior cingulate cortex.

But when the researchers took into account other cardiovascular risk factors, the association disappeared.

Compared with the 14 patients who were not depressed three months after hospitalization, the eight patients with depressive symptoms had more advanced deep white matter changes overall, but not when the investigators took into account cardiovascular comorbidities.

“This study provides the first evidence that persistent depressive symptoms after (a heart attack) are associated with vascular brain changes. Longitudinal studies are needed to determine whether depressive symptoms precede these changes or vice versa,” the researchers concluded.

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