Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
J Affect Disord. 2011 Jul;132(1-2):275-84. doi: 10.1016/j.jad.2011.01.020. Epub 2011 Feb 24.
Late-life depressive symptoms (DS) increase the risk of incident mild cognitive impairment and probable dementia in the elderly. Our objectives were to examine the relationship between elevated DS and regional brain volumes including frontal lobe subregions, hippocampus and amygdala, and to determine whether elevated DS were associated with increased subclinical cerebrovascular disease in postmenopausal women.
DS were assessed an average of 8years prior to structural brain MRI in 1372 women. The 8-item Burnam regression algorithm was used to define DS with a cut-point of 0.009. Adjusting for potential confounders, mean differences in total brain, frontal lobe subregions, hippocampus and amygdala volumes and total ischemic lesion volumes in the basal ganglia and the cerebral white and gray matter outside the basal ganglia were compared between women with and without DS.
Depressed women had lower baseline global cognition and were more likely to have prior hormone therapy history. After full adjustment, DS at baseline were associated with smaller superior and middle frontal gyral volumes. Hippocampal and amygdala volumes, and ischemic lesion volumes were similar in depressed and non-depressed women.
Depression was not assessed based on semi-structured interview, and MRI scans were obtained cross-sectionally rather than longitudinally. Longitudinal MRI assessments will be necessary to define the temporal relationships between DS and frontal lobe volumes.
Elevated DS were associated with lower volumes in certain frontal lobe subregions but not in the medial temporal lobe structures. Our findings support the role of frontal lobe structures in late-life DS among women.
晚年抑郁症状（DS）会增加老年人轻度认知障碍和可能痴呆的发病风险。我们的目的是研究DS 与包括额叶亚区、海马体和杏仁核在内的区域性脑容量之间的关系，并确定DS 是否与绝经后妇女亚临床脑血管疾病的增加有关。
在 1372 名女性接受结构脑 MRI 平均 8 年前评估了 DS。采用 0.009 切点的 Burnam 回归算法来定义 DS。在调整潜在混杂因素后，比较有和无 DS 的女性之间总脑、额叶亚区、海马体和杏仁核体积以及基底节和基底节外脑白质和灰质的总缺血性病变体积的平均差异。
抑郁女性的基线整体认知较低，且更有可能有既往激素治疗史。在充分调整后，基线时的 DS 与额上和中回体积较小有关。抑郁和非抑郁女性的海马体和杏仁核体积以及缺血性病变体积相似。
抑郁不是基于半结构化访谈进行评估，MRI 扫描是横断面而不是纵向获得的。需要进行纵向 MRI 评估才能确定 DS 和额叶体积之间的时间关系。
DS 升高与某些额叶亚区的体积减少有关，但与内侧颞叶结构无关。我们的研究结果支持额叶结构在女性晚年 DS 中的作用。
