THE CEREBROVASCULAR BASIS OF DEPRESSION IN NON INSULIN DEPENDENT DIABETES MEL

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. SPECIFIC AIMS: To examine the cerebrovascular basis of depression in patients with Non-Insulin Dependent Diabetes Mellitus (NIDDM, type 2 diabetes). The precise role of microvascular disease in the pathophysiology of depression is unknown. Microvascular disease and depression coexist in patients with NIDDM, rendering it a unique clinical model in which to concurrently examine the role of structural abnormalities and microvascular disease in the pathophysiology of mood disturbances. Specific Aim 1: To examine the neuroanatomical correlates of depression in patients with NIDDM, we propose to use magnetic resonance imaging (MRI) to obtain volumetric estimates of brain volume and the volume of high intensity lesions in the parenchyma. Specific Aim 2: To estimate the volume of high intensity lesions in the brain parenchyma and microvascular disease in the retina, fundus photography will be utilized to estimate microvascular disease in the retina and retinal microangiopathy is conceptualized as a marker of microvascular disease in the brain. Specific Aim 3: To identify risk factors for depression and pathways that lead from clinical and neuroanatomical substrates to major depression, microvascular measures will be integrated with neuroanatomic indices in order to elucidate the pathways and mechanisms involved in the pathophysiology of depression in patients with NIDDM.