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老年期抑郁症中尾状核的三维表面映射

Three-dimensional surface mapping of the caudate nucleus in late-life depression.

作者信息

Butters Meryl A, Aizenstein Howard J, Hayashi Kiralee M, Meltzer Carolyn C, Seaman Jamie, Reynolds Charles F, Toga Arthur W, Thompson Paul M, Becker James T

机构信息

Department of Psychiatry, University of Pittsburgh, and Western Psychiatric Institute and Clinic, 3811 O'Hara St., Pittsburgh, PA 15213, USA.

出版信息

Am J Geriatr Psychiatry. 2009 Jan;17(1):4-12. doi: 10.1097/JGP.0b013e31816ff72b.

Abstract

OBJECTIVE

To compare the volumes of the caudate nucleus, using traditional volumetry and a three-dimensional brain mapping technique, in a group of individuals with late-life depression and a group of age- and education-equated nondepressed comparison subjects.

DESIGN

Cross-sectional.

SETTING

University Medical Center.

PARTICIPANTS

Twenty-three nondemented subjects with late-life depression and 15 age- and education-equated elderly comparison subjects (depressed mean years of age: 70.5 +/- 5.7 SD, comparison subjects = 69.9 years +/- 6.4) with no history of psychiatric or neurologic disease.

MEASUREMENTS

Structural magnetic resonance imaging. Three-dimensional (3-D) surface models were created from manually traced outlines of the caudate nucleus from spoiled gradient echo images. Models were geometrically averaged across subjects and statistical maps created to localize any regional volume differences between groups.

RESULTS

Relative to comparison subjects, depressed subjects had significantly lower mean volumes for both the left (p = 0.029) and right (p = 0.052) caudate nucleus as well as total caudate volume (p = 0.032). Total volumes were 13.1% less in the depressed group (13.5% on the left and 12.6% on the right). 3-D maps further localized these reductions to the caudate head. Volume reductions were correlated with depression severity, as measured by the 17-item Hamilton Depression Rating Scale.

CONCLUSION

Late-life depression is associated with left and right caudate nucleus reduction especially in anterior portions. Among depressed subjects, greater caudate reduction was associated with more severe depression. These results are consistent with growing evidence that the anterior caudate nucleus, especially the head, may be structurally and functionally abnormal in affective disorders.

摘要

目的

采用传统体积测量法和三维脑图谱技术,比较一组老年抑郁症患者与一组年龄和教育程度匹配的非抑郁症对照受试者的尾状核体积。

设计

横断面研究。

地点

大学医学中心。

参与者

23名无痴呆的老年抑郁症患者和15名年龄和教育程度匹配的老年对照受试者(抑郁症患者平均年龄:70.5±5.7标准差,对照受试者=69.9岁±6.4),无精神或神经疾病史。

测量

结构磁共振成像。从 spoiled梯度回波图像中手动勾勒出尾状核轮廓,创建三维(3-D)表面模型。对受试者的模型进行几何平均,并创建统计图谱以定位两组之间的任何区域体积差异。

结果

与对照受试者相比,抑郁症患者的左侧(p = 0.029)和右侧(p = 0.052)尾状核平均体积以及尾状核总体积(p = 0.032)均显著降低。抑郁症组的总体积减少了13.1%(左侧减少13.5%,右侧减少12.6%)。三维图谱进一步将这些减少定位到尾状核头部。体积减少与抑郁严重程度相关,抑郁严重程度通过17项汉密尔顿抑郁量表测量。

结论

老年抑郁症与左右尾状核缩小有关,尤其是前部。在抑郁症患者中,更大程度的尾状核缩小与更严重的抑郁症相关。这些结果与越来越多的证据一致,即尾状核前部,尤其是头部,在情感障碍中可能存在结构和功能异常。

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