Dolan R J, Bench C J, Brown R G, Scott L C, Friston K J, Frackowiak R S
Department of Psychiatry, Royal Free Hospital, School of Medicine, London.
J Neurol Neurosurg Psychiatry. 1992 Sep;55(9):768-73. doi: 10.1136/jnnp.55.9.768.
Depression with cognitive impairment, so called depressive pseudodementia, is commonly mistaken for a neurodegenerative dementia. Using positron emission tomography (PET) derived measures of regional cerebral blood flow (rCBF) a cohort of 33 patients with major depression was studied. Ten patients displayed significant and reversible cognitive impairment. The patterns of rCBF of these patients were compared with a cohort of equally depressed non-cognitively impaired depressed patients. In the depressed cognitively impaired patients a profile of rCBF abnormalities was identified consisting of decreases in the left anterior medial prefrontal cortex and increases in the cerebellar vermis. These changes were additional to those seen in depression alone and are distinct from those described in neurodegenerative dementia. The cognitive impairment seen in a proportion of depressed patients would seem to be associated with dysfunction of neural systems distinct from those implicated in depression alone or the neurodegenerative dementias.
伴有认知障碍的抑郁症，即所谓的抑郁性假性痴呆，通常被误诊为神经退行性痴呆。利用正电子发射断层扫描（PET）得出的局部脑血流量（rCBF）测量值，对一组33名重度抑郁症患者进行了研究。10名患者表现出显著且可逆的认知障碍。将这些患者的rCBF模式与一组同样患有抑郁症但无认知障碍的抑郁症患者进行了比较。在伴有认知障碍的抑郁症患者中，发现了rCBF异常的特征，包括左前内侧前额叶皮质血流量减少和小脑蚓部血流量增加。这些变化是除了单纯抑郁症所见的变化之外的，并且与神经退行性痴呆中所描述的变化不同。在一部分抑郁症患者中出现的认知障碍似乎与不同于单纯抑郁症或神经退行性痴呆所涉及的神经系统功能障碍有关。
