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通过功能近红外光谱评估缓解期晚发性抑郁症的额叶功能减退和微血管调节异常。

Hypofrontality and microvascular dysregulation in remitted late-onset depression assessed by functional near-infrared spectroscopy.

作者信息

Matsuo Koji, Onodera Yoichi, Hamamoto Taku, Muraki Kenro, Kato Nobumasa, Kato Tadafumi

机构信息

Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Japan.

出版信息

Neuroimage. 2005 May 15;26(1):234-42. doi: 10.1016/j.neuroimage.2005.01.024.

Abstract

Accumulated evidence suggests the involvement of vascular factors in late-onset depression. Late-onset depression has characteristics of poor outcome, cognitive decline, and high prevalence rather than early-onset depression. The aim of the present study was to determine whether or not the functional hypofrontality--that is, hypoperfusion and hypometabolism in the frontal lobes-seen in late-onset depression is a trait-dependent abnormality of microvascular regulation. This study was conducted on 10 patients with remitted late-onset major depressive disorder (MDD) and 10 healthy volunteers matched for vascular factors and subcortical, or white matter, hyperintensities (WMH). Using near-infrared spectroscopy combined with magnetic resonance imaging, we investigated the microvascular reactivity in the prefrontal cortex during a cognitive task and during carbon dioxide (CO(2)) inhalation. Activation of the prefrontal cortex during the cognitive task was significantly less in patients as compared with controls, although task performance was not significantly different between the two groups. In the patients, a tendency of negative correlation between the reduced prefrontal activation during a cognitive task and the severity of hyperintensity in periventricular region was observed. Vasomotor reactivity to CO(2) inhalation was significantly lower in the patients than in the controls. Although there was no significant association between the activation during the cognitive and that during the CO(2) inhalation task, the present results suggest that prefrontal microvascular dysregulation as shown by NIRS is involved in the pathophysiological basis of functional hypofrontality in late-onset depression. This finding will provide a new framework for the development of diagnostic methods, treatments, and preventive strategies against late-onset depression.

摘要

越来越多的证据表明血管因素与晚发性抑郁症有关。晚发性抑郁症具有预后差、认知功能衰退和高患病率的特点,与早发性抑郁症不同。本研究的目的是确定晚发性抑郁症中出现的额叶功能减退——即额叶灌注不足和代谢减退——是否是微血管调节的特质依赖性异常。本研究对10例缓解期晚发性重度抑郁症(MDD)患者和10名在血管因素、皮质下或白质高信号(WMH)方面相匹配的健康志愿者进行。我们使用近红外光谱结合磁共振成像,研究了认知任务期间和吸入二氧化碳(CO₂)期间前额叶皮质的微血管反应性。与对照组相比,患者在认知任务期间前额叶皮质的激活明显较少,尽管两组之间的任务表现没有显著差异。在患者中,观察到认知任务期间前额叶激活减少与脑室周围区域高信号严重程度之间存在负相关趋势。患者对吸入CO₂的血管运动反应性明显低于对照组。虽然认知任务期间的激活与吸入CO₂任务期间的激活之间没有显著关联,但目前的结果表明,近红外光谱显示的前额叶微血管调节异常参与了晚发性抑郁症功能性额叶功能减退的病理生理基础。这一发现将为晚发性抑郁症的诊断方法、治疗和预防策略的发展提供一个新的框架。

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