Rabins P V, Pearlson G D, Aylward E, Kumar A J, Dowell K
Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD.
Am J Psychiatry. 1991 May;148(5):617-20. doi: 10.1176/ajp.148.5.617.
The purpose of the study was to determine if magnetic resonance imaging (MRI) scans of elderly depressed patients differ from MRI scans of age-matched control subjects and age-matched patients with Alzheimer's disease.
The authors studied 21 patients 60 years or older with major depression, 16 patients with Alzheimer's disease, and 14 age-matched control subjects.
Compared to control subjects, depressed patients had greater cerebral sulcal and temporal sulcal atrophy; larger sylvian fissures, lateral ventricles, third ventricles, and temporal horns; and greater severity of subcortical white matter lesions. Depressed patients also had more basal ganglia lesions but similar levels of periventricular hyperintensity. There were no differences between depressed patients with and without delusions on any MRI measure. Depressed patients who received ECT had more temporal horn atrophy and greater subcortical abnormality summary scores than normal subjects. Cortical sulcal atrophy correlated with age at onset of depression.
The findings suggest that elderly hospitalized depressed patients have greater cortical as well as subcortical atrophy and more basal ganglia lesions than age-matched normal control subjects. The correlation of these abnormalities with outcome remains unknown.
本研究旨在确定老年抑郁症患者的磁共振成像（MRI）扫描结果与年龄匹配的对照受试者以及年龄匹配的阿尔茨海默病患者的MRI扫描结果是否存在差异。
作者研究了21名60岁及以上的重度抑郁症患者、16名阿尔茨海默病患者以及14名年龄匹配的对照受试者。
与对照受试者相比，抑郁症患者有更严重的脑沟和颞沟萎缩；大脑外侧裂、侧脑室、第三脑室和颞角更大；皮质下白质病变更严重。抑郁症患者的基底节病变也更多，但脑室周围高信号水平相似。有妄想和无妄想的抑郁症患者在任何MRI测量指标上均无差异。接受ECT治疗的抑郁症患者比正常受试者有更多的颞角萎缩和更高的皮质下异常综合评分。皮质沟萎缩与抑郁症发病年龄相关。
研究结果表明，与年龄匹配的正常对照受试者相比，老年住院抑郁症患者有更严重的皮质和皮质下萎缩以及更多的基底节病变。这些异常与预后的相关性尚不清楚。
