Objective: To investigate the diagnostic value of transcranial Doppler ultrasound (TCD) in elderly patients with cerebrovascular disease and emotional disorder. Methods: Sixty-seven patients with cerebrovascular disease aged 60 years or above and with white matter hyperintensity (WMH) on magnetic resonance imaging (MRI) were enrolled in the study. The patients were divided into two groups according to Hamilton Depression Scale (HAMD) score: vascular depression group (WMH with depression) and non-depressive group (WMH without depression). TCD was performed in both groups, and the results of vascular pulsatility index (PI) and average blood flow velocity (Vm) were compared. Results: A total of 67 elderly patients were enrolled, with 33 cases in the vascular depression group and 34 in the non-depression group according to HAMD scores.(1) No statistically significant differences were observed between the two groups in age, gender, smoking history, alcohol consumption history, hypertension history, diabetes history, ischemic stroke history, hemorrhagic stroke history, coronary heart disease history, white matter score, and white matter grading (P > 0.05). (2) The Vm on both sides of the anterior cerebral artery (ACA) and middle cerebral artery (MCA) in the vascular depression group was significantly lower than that in the non-depressive group (P < 0.05). However, no statistically significant difference was found in Vm on both sides of the terminal internal carotid artery (TICA) between the two groups (P > 0.05). (3) The PI on both sides of the ACA and MCA in the vascular depressive group was significantly higher than that in the non-depression group (P < 0.05), while no statistically significant difference was observed in TICA PI values (P > 0.05). (4) No statistically significant differences were found in Vm and PI values of the left ACA and MCA compared to the right side in the vascular depression group (P> 0.05). Conclusion: The hemodynamic disturbance of vascular depression can be manifested as increased resistance and slowed flow velocity of intracranial small arteries. Transcranial Doppler ultrasound is a valuable method for dynamic evaluation and auxiliary diagnosis of vascular depression.

Lipoprotein(a) [Lp(a)] is a unique plasma lipoprotein particle with a distinct structure that has garnered significant research attention due to its strong association with various cerebrovascular diseases. Recent studies underscore elevated Lp(a) levels as a critical risk factor, with multiple Lp(a)-targeted therapies advancing through clinical trials. This review explores the structural, functional, and genetic features of Lp(a), its connection to cerebrovascular diseases, and the latest therapeutic strategies aimed at reducing its impact. By consolidating these advancements, we aim to provide new insights for Lp(a)-centered research and propose innovative approaches for cerebrovascular disease prevention and management.