Section - Quick Takes

03. Neuropsychiatric Symptoms Associated With Cerebral Small Vessel Disease: A Systematic Review and Meta-Analysis

Published on June 1, 2021 Expired on April 1, 2024

James Phelps, M.D.

Research Editor - Psychopharmacology Institute

Key Points

White matter hyperintensities on cerebral MRI are markers of small vessel disease. Their grade and volume are correlated with apathy, fatigue, and dementia but not with anxiety or depression, although the latter finding is at odds with an earlier relatively large body of literature.

To unlock this audio you need to become a Silver, Gold, Silver extended or Gold extended Member.

Check Our CME Program

Downloads for Offline Access

Download Audio File (MP3)

Text version

Does small vessel disease cause psychiatric symptoms? How much of what you routinely see —depression, anxiety, psychosis—might be explained, at least in older patients, by vascular compromise?

Hi! Jim Phelps here for the Psychopharmacology Institute. This Quick Take examines psychiatric symptoms in people with white matter hyperintensities on MRI as a marker of cerebral small vessel disease. Wait a minute. White matter hyperintensities are an indicator of vascular compromise? I remember when we call these UBOs, unidentified bright objects. I became interested in them because people with bipolar disorder have UBOs, and they even run in families of patients with bipolar disorder. In this new review, white matter hyperintensities are used as an indicator of small vessel disease in the brain. The authors did look at other MRI findings such as lacunes, subcortical infarcts, microbleeds, and increased perivascular space. But white matter hyperintensities, it turns out, are clearly associated with

Unlock this Quick Take and earn 0.50 CMEs
Become a Silver, Gold, Silver extended or Gold extended Member.

Get Instant Access

Already have an account? Sign in

Next Section

04. New Approaches to Symptomatic Treatments for Alzheimer’s Disease

Learning Objectives:

After completing this activity, the learner will be able to:

Review clinical presentations of neuroleptic malignant syndrome and serotonin syndrome as considerations in a patient presenting with malignant hyperthermia.
Consider the implications of post-marketing adverse events reported for users of esketamine.
Observe the correlations between white matter hyperintensities and select psychiatric symptoms, particularly apathy and fatigue versus depression and anxiety.
Examine data on new treatment options for symptomatic Alzheimer's disease by learning about medications in Phase 2 and Phase 3 trials.
Examine the assumptions behind studies of suicide rates in terms of ethical principles, including beneficence and autonomy.

Original Release Date: 06/01/2021

Review Date: 03/01/2024

Expiration Date: 04/01/2024

Relevant Financial Disclosures:

The following planners, faculty, and reviewers have the following relevant financial relationships with commercial interests to disclose:

Dr. Phelps has disclosed the following relationships:

McGraw-Hill: book on bipolar disorder
W.W. Norton & Co.: books on bipolar disorder

All of the relevant financial relationships listed for these individuals have been mitigated.

Contact Information: For questions regarding the content or access to this activity, contact us at support@psychopharmacologyinstitute.com

Instructions for Participation and Credit:

Participants must complete the activity online during the valid credit period that is noted above.

Follow these steps to earn CME credit:

View the required educational content provided on this course page.
Complete the Post Activity Evaluation for providing the necessary feedback for continuing accreditation purposes and for the development of future activities. NOTE: Completing the Post Activity Evaluation after the quiz is required to receive the earned credit.
Download your certificate.