Teodorczuk A, O'Brien J T, Firbank M J, Pantoni L, Poggesi A, Erkinjuntti T, Wallin A, Wahlund L-O, Gouw A, Waldemar G, Schmidt R, Ferro J M, Chabriat H, Bäzner H, Inzitari D
Institute for Ageing and Health, Newcastle General Hospital, Westgate Road, Newcastle upon Tyne NE4 6BE, UK.
Br J Psychiatry. 2007 Sep;191:212-7. doi: 10.1192/bjp.bp.107.036756.
Evidence from cross-sectional studies suggests a link between cerebral age-related white matter changes and depressive symptoms in older people, although the temporal association remains unclear.
To investigate age-related white matter changes on magnetic resonance imaging (MRI) as an independent predictor of depressive symptoms at 1 year after controlling for known confounders.
In a pan-European multicentre study of 639 older adults without significant disability, MRI white matter changes and demographic and clinical variables, including cognitive scores, quality of life, disability and depressive symptoms, were assessed at baseline. Clinical assessments were repeated at 1 year.
Using logistic regression analysis, severity of white matter changes was shown to independently and significantly predict depressive symptoms at 1 year after controlling for baseline depressive symptoms, quality of life and worsening disability (P<0.01).
White matter changes pre-date and are associated with the development of depressive symptoms. This has implications for treatment and prevention of depression in later life.
横断面研究的证据表明,老年人脑白质与年龄相关的变化和抑郁症状之间存在联系,尽管时间关联仍不明确。
在控制已知混杂因素后,研究磁共振成像(MRI)上与年龄相关的白质变化作为1年后抑郁症状的独立预测因素。
在一项针对639名无明显残疾的老年人的泛欧洲多中心研究中,在基线时评估了MRI白质变化以及人口统计学和临床变量,包括认知得分、生活质量、残疾情况和抑郁症状。1年后重复进行临床评估。
使用逻辑回归分析,在控制基线抑郁症状、生活质量和残疾恶化情况后,白质变化的严重程度被证明可独立且显著地预测1年后的抑郁症状(P<0.01)。
白质变化先于抑郁症状出现并与之相关。这对晚年抑郁症的治疗和预防具有启示意义。