Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands.
Biol Psychiatry. 2011 Jul 15;70(2):191-7. doi: 10.1016/j.biopsych.2011.04.014. Epub 2011 Jun 8.
Hippocampal volume loss on magnetic resonance imaging (MRI) has been reported in patients with depression. It is uncertain whether a small hippocampus renders a person vulnerable to develop depression or whether it is a consequence of depression. In this study, we addressed whether smaller baseline MRI hippocampal volumes increase the risk of incident depression. We also examined whether depressive symptoms at baseline were associated with decline in hippocampal volume during follow-up.
Data were obtained in a prospective population-based study over a 10-year period. A sample of 514 nondemented persons aged 60 to 90 years underwent baseline measurements in 1995-1996 including three-dimensional MRI scans for assessment of hippocampal volumes and depressive symptoms (measured with Center for Epidemiologic Studies Depression Scale). Follow-up MRIs were made in 1999-2000 and in 2006. Incident depression was identified through standardized psychiatric examinations and continuous monitoring of medical and pharmaceutical records.
During a mean follow-up of 6.8 years per person (range .07-10.01 years), 135 of the 514 persons developed a clinically relevant episode of incident depressive symptoms. There was no association between baseline hippocampal volumes and incident depression (hazard ratio per SD decrease of average hippocampal volume .98 [.81-1.19], p = .84). A baseline Center for Epidemiologic Studies Depression Scale score of 16 or higher predicted a faster rate of decline in hippocampal volume. Also, incident depression was accompanied by a faster decline in left hippocampal volume.
This study provides no evidence that a small hippocampal volume precedes the development of late-life depression. Depression, however, may lead to a faster rate of hippocampal volume decline.
磁共振成像（MRI）显示的海马体积损失已在抑郁症患者中报告。目前尚不清楚较小的海马体是否使人易患抑郁症，还是抑郁症的结果。在这项研究中，我们研究了基线时较小的 MRI 海马体体积是否会增加发生抑郁症的风险。我们还检查了基线时的抑郁症状是否与随访期间海马体体积的下降有关。
这项研究的数据来自一项为期 10 年的前瞻性人群研究。1995-1996 年，年龄在 60 至 90 岁之间的 514 名非痴呆者进行了基线测量，包括用于评估海马体体积和抑郁症状的三维 MRI 扫描（使用流行病学研究中心抑郁量表测量）。1999-2000 年和 2006 年进行了随访 MRI。通过标准化的精神科检查和对医疗和药物记录的连续监测来确定抑郁症的发病情况。
在平均每人 6.8 年的随访期内（范围为 0.07-10.01 年），514 人中的 135 人发生了临床相关的抑郁症发作。基线海马体体积与发病后抑郁症之间没有关联（平均海马体体积每减少 1 个标准差，发病风险比为 0.98[0.81-1.19]，p=0.84）。基线时流行病学研究中心抑郁量表得分为 16 或更高预示着海马体体积下降更快。此外，发病后抑郁症还伴随着左侧海马体体积下降更快。
本研究没有证据表明较小的海马体体积先于晚年抑郁症的发生。然而，抑郁症可能导致海马体体积下降更快。
