Ashtari M, Greenwald B S, Kramer-Ginsberg E, Hu J, Wu H, Patel M, Aupperle P, Pollack S
Division of Geriatric Psychiatry and the Brain Morphometry and Image Analysis Center, Hillside Hospital, Glen Oaks, New York 11004, USA.
Psychol Med. 1999 May;29(3):629-38. doi: 10.1017/s0033291799008405.
The hippocampus, amygdala and related functional circuits have been implicated in the regulation of emotional expression and memory processes, which are affected in major depression. Several recent investigations have reported abnormalities in these structures in adult and elderly depressives.
Elderly DSM-III-R unipolar depressives (N = 40) and normal controls (N = 46) participated in a magnetic resonance imaging study (1.0T). Brain images were obtained in the coronal plane. Using established anatomical guidelines for structure delineation, volumetric measurements of left and right hippocampus and anterior hippocampus/amygdala complex were completed under blinded conditions using a semi-automated computer mensuration system, with patients and controls in random order.
Medial temporal volumes did not significantly distinguish either elderly depressed and age-similar normal control subjects, or late onset and early onset depressed patients (ANCOVA). Major overlap of measured volumes existed between patient and control groups. In depressives, hippocampal volumes significantly correlated with age, and cognitive and depression ratings, but not with number of prior depressive episodes or age-at-onset of first depression.
Hippocampal volumes do not discriminate a typical clinical population of elderly depressed patients from age-similar normal control subjects. If hippocampal dysfunction contributes to a diagnosis of syndromal depression in the elderly, such dysfunction does not appear to be regularly reflected in structural abnormalities captured by volumetric measurement as conducted. On the other hand, relationships between hippocampal volumes and clinical phenomena in depressives, but not controls, suggest potentially meaningful interactions between hippocampal structure and the expression of major depression in the elderly.
海马体、杏仁核及相关功能回路与情绪表达和记忆过程的调节有关，而这些在重度抑郁症中会受到影响。最近的几项研究报告了成年和老年抑郁症患者这些结构的异常情况。
符合DSM-III-R标准的老年单相抑郁症患者（N = 40）和正常对照组（N = 46）参与了一项磁共振成像研究（1.0T）。在冠状面获取脑图像。使用既定的解剖学指南进行结构描绘，在盲态条件下，使用半自动计算机测量系统对左右海马体和前海马体/杏仁核复合体进行体积测量，患者和对照组按随机顺序进行。
内侧颞叶体积在老年抑郁症患者与年龄相仿的正常对照组之间，或晚发性和早发性抑郁症患者之间均无显著差异（协方差分析）。患者组和对照组的测量体积存在较大重叠。在抑郁症患者中，海马体体积与年龄、认知和抑郁评分显著相关，但与既往抑郁发作次数或首次抑郁发作的发病年龄无关。
海马体体积无法区分典型的老年抑郁症临床患者群体与年龄相仿的正常对照组。如果海马体功能障碍导致老年人综合征性抑郁症的诊断，这种功能障碍似乎并未如本研究那样通过体积测量所捕捉到的结构异常而得到规律性反映。另一方面，抑郁症患者而非对照组中海马体体积与临床现象之间的关系，提示了海马体结构与老年人重度抑郁症表达之间可能存在有意义的相互作用。
