Janssen Joost, Hulshoff Pol Hilleke E, Schnack Hugo G, Kok Rob M, Lampe Indrag K, de Leeuw Frank-Erik, Kahn Rene S, Heeren Thea J
Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, The Netherlands.
Int J Geriatr Psychiatry. 2007 May;22(5):468-74. doi: 10.1002/gps.1790.
Late life depression is associated with volumetric reductions of gray matter and increased prevalence of subcortical white matter lesions. Previous studies have shown a poorer treatment outcome in those with more severe structural brain abnormalities. In this study, quantitative and semi-quantitative magnetic resonance imaging (MRI) measures were studied in relation to response to a 12-week controlled antidepressant monotherapy trial.
MRI (1.5 T) brain scans of 42 elderly inpatients with major depression, of which 23 were non-responder to a controlled 12-week antidepressant monotherapy trial, were acquired. In addition, clinical outcome was assessed after a one year period. Measures were volumes of global cerebral and subcortical structures.
After controlling for confounding, no differences were found between non-responders and responders after 12 weeks and after one year in volumes of cerebral gray and white matter, orbitofrontal cortex, hippocampus and white matter lesions.
Structural brain measures associated with late life depression may not be related to short-term treatment response.
晚年抑郁症与灰质体积减少及皮质下白质病变患病率增加有关。先前的研究表明,脑结构异常越严重的患者治疗效果越差。在本研究中,对定量和半定量磁共振成像(MRI)测量结果与一项为期12周的对照抗抑郁药单一疗法试验的反应进行了研究。
对42名患有重度抑郁症的老年住院患者进行了MRI(1.5T)脑部扫描,其中23名在为期12周的对照抗抑郁药单一疗法试验中无反应。此外,在一年后评估临床结果。测量指标为全脑和皮质下结构的体积。
在控制混杂因素后,12周和一年后,无反应者和有反应者在脑灰质和白质、眶额皮质、海马体及白质病变的体积方面未发现差异。
与晚年抑郁症相关的脑结构测量指标可能与短期治疗反应无关。