Centre for Psychiatric Research, Aarhus University Hospital, Skovagervej 2, 8240 Risskov, Denmark.
J Affect Disord. 2010 Sep;125(1-3):177-83. doi: 10.1016/j.jad.2010.01.002. Epub 2010 Mar 9.
Several lines of evidence suggest hippocampal dysfunction in major depression, but the prevalence and nature of specific dysfunctions during the long-term course of major depression is yet to be assessed. A 3D virtual environment navigation task and measurements of hippocampal volume were assessed in remitted former inpatients with moderate to severe depression after an 8 year follow-up period to evaluate whether functional and structural differences existed in the hippocampus beyond depression.
Performance on a right hippocampus-dependent 3D virtual reality navigation task, memory tests and right and left hippocampal volumes were assessed in 31 remitted depressed (unipolar) patients and 37 healthy subjects.
Remitted depressed patients did not differ significantly from healthy subjects in terms of either neuropsychological performance or hippocampal volume.
The sample consisted of remitted inpatients that had been treated with psychotropic drugs during the 8-year follow-up period. Moreover, 11 of the 42 patients included in the original study were excluded from the follow-up study due to persisting depressive illness and suicide.
The study of visuospatial navigation ability and hippocampal volume in remitted depressed patients offers a specific way of assessing dysfunction in the hippocampus in major depression. Our findings do not support the notion that hippocampal impairment of visuospatial function exists beyond the depressive state, thus indicating that hippocampus-related cognitive dysfunction and previously reported reduced hippocampal volume might represent a state and not a permanent trait of the illness. Moreover, our study suggests that intensive drug treatment of the depressive episodes might prevent the deterioration of the hippocampus.
有几条证据表明，在重度抑郁症中存在海马功能障碍，但在重度抑郁症的长期病程中，特定功能障碍的患病率和性质尚未得到评估。在 8 年的随访期后，对中度至重度抑郁症的前住院缓解患者进行了 3D 虚拟环境导航任务和海马体积测量，以评估海马是否存在除抑郁以外的功能和结构差异。
在 31 名缓解的抑郁（单相）患者和 37 名健康受试者中，评估了右侧海马依赖的 3D 虚拟现实导航任务、记忆测试以及右侧和左侧海马体积的表现。
缓解的抑郁患者在神经心理学表现或海马体积方面与健康受试者无显著差异。
该样本由在 8 年随访期间接受精神药物治疗的缓解住院患者组成。此外，由于持续的抑郁疾病和自杀，在最初研究中纳入的 42 名患者中有 11 名被排除在随访研究之外。
对缓解的抑郁患者的视空间导航能力和海马体积的研究提供了一种评估重度抑郁症中海马功能障碍的特定方法。我们的发现不支持海马对视空间功能的损害存在于抑郁状态之外的观点，因此表明海马相关的认知功能障碍和先前报道的海马体积减少可能代表疾病的状态而不是永久性特征。此外，我们的研究表明，抑郁发作的强化药物治疗可能防止海马的恶化。
