Department of Neurology, School of Medicine, University of Belgrade, Belgrade, Serbia.
J Neurol Sci. 2011 Nov 15;310(1-2):61-3. doi: 10.1016/j.jns.2011.05.036.
Depression and apathy are among the most common neuropsychiatric disturbances in Parkinson's disease (PD), and among the most important factors associated with a poor quality of life. However, their neural bases remain unclear. The results of the magnetic resonance imaging (MRI) studies on depression in PD differ dramatically. Some of them proposed a role of morphologic changes in the mediodorsal thalamus. In contrast to previous voxel-based morphometry (VBM) data, our study did not confirm a decrease in gray matter (GM) density in any brain region of depressed PD patients. Instead, a more severe white matter (WM) loss in the right frontal lobe was found, including the anterior cingulate bundle and the inferior orbitofrontal (OF) region. We suggested that the negative correlation between the severity of depression and WM density in the right OF region reinforces the hypothesis of depression in PD as a "disconnection syndrome". Only one MRI study using VBM found that high apathy scores correlated with low GM density values in the right (posterior) cingulate gyrus and the bilateral inferior frontal gyrus, in line with the findings in Alzheimer's disease and elderly adults with major depression.
抑郁和淡漠是帕金森病（PD）中最常见的神经精神障碍之一，也是与生活质量较差相关的最重要因素之一。然而，它们的神经基础仍不清楚。磁共振成像（MRI）研究 PD 患者抑郁的结果差异很大。其中一些研究提出了中脑背侧丘脑形态变化的作用。与之前的基于体素的形态测量学（VBM）数据不同，我们的研究并未证实抑郁 PD 患者任何脑区的灰质（GM）密度降低。相反，在右侧额叶发现了更严重的白质（WM）丢失，包括前扣带束和下眶额（OF）区域。我们认为，抑郁严重程度与右侧 OF 区域 WM 密度之间的负相关，加强了 PD 抑郁作为“连接中断综合征”的假说。只有一项使用 VBM 的 MRI 研究发现，高淡漠评分与右侧（后）扣带回和双侧额下回 GM 密度值降低相关，这与阿尔茨海默病和老年抑郁症患者的发现一致。
