Long Yin, Yang Ting-ting, Sun Zhong-wu
Department of Neurology, First Affiliated Hospital, Anhui Medical University, Hefei 230022, China.
Zhonghua Yi Xue Za Zhi. 2012 Feb 7;92(5):307-11.
To explore the vascular risk factors and neuropsychological profiles of patients with magnetic resonance imaging (MRI)-defined subcortical ischemic depression (SID).
Thirty-five SID patients, 37 patients with subcortical ischemic vascular disease without depression (SIVD) and 40 normal controls (NC) participated in this case-control study. The SID and SIVD groups were recruited from the Department of Neurology, First Affiliated Hospital, Anhui Medical University between October 2010 and September 2011. And the NC group came from Medical Center, First Affiliated Hospital of Anhui Medical University over the same period. The vascular risk factors of all participants were assessed by the Framingham scale. Depression symptoms were assessed by the geriatric depression scale (GDS) and Hamilton depression scale (HAMD) while cognitive functions by the mini-mental state examination (MMSE) and Montreal cognitive clock drawing task (CDT).
Both the SID (12.3 ± 4.7) and SIVD (13.5 ± 3.4) groups showed significantly higher Framingham scores than the NC group (8.6 ± 1.8) (F = 20.850, P = 0.000). Compared with the NC group (28.3 ± 1.8; 23.1 ± 3.4; 8.0 ± 1.8), the MMSE, MoCA and CDT scores were significantly lower in the SID (26.7 ± 2.5; 20.0 ± 4.0; 2.0 ± 2.7) and SIVD (26.8 ± 1.9; 20.7 ± 3.0; 6.1 ± 2.1) groups (P < 0.05). There were significantly lower CAMCOG-C scores in the SID (82.7 ± 9.0) and SIVD (86.2 ± 6.9) groups versus the NC group (92.3 ± 6.2) (P < 0.05) and similarly in the SID group versus the SIVD group (P < 0.05). Among the subtests of CAMCOG-C, the orientation, language and memory scores in both SID (9.0 ± 1.4; 24.7 ± 4.0; 19.5 ± 3.4) and SIVD (9.4 ± 0.9; 25.5 ± 2.1; 20.3 ± 2.3) groups were significantly lower than those in the NC group (9.9 ± 0.4; 27.4 ± 1.9; 22.1 ± 2.4) (P < 0.05); the praxis scores in the SID group (9.4 ± 1.9) were significantly lower than those in the NC group (10.4 ± 1.5) (P < 0.05). And the thinking and perception scores in the SID group (5.4 ± 1.7; 6.3 ± 1.4) were significantly lower than those in the SIVD (6.2 ± 1.3; 7.0 ± 1.4) and NC (6.6 ± 1.3; 7.2 ± 1.4) groups. In the SID group, no significant correlation was found between the Framingham scores and neuropsychological assessments. There were a negative correlation between the GDS, HAMD scores and MMSE, MoCA, CAMCOG-C and CDT scores (P < 0.05).
The SID patients demonstrate multiple neuropsychological deficits, especially in thinking, perception and praxis. No significant correlation between vascular risk factors and depression symptoms is found in SID patients.
探讨磁共振成像（MRI）定义的皮质下缺血性抑郁（SID）患者的血管危险因素及神经心理学特征。
35例SID患者、37例无抑郁的皮质下缺血性血管病（SIVD）患者和40名正常对照者（NC）参与了这项病例对照研究。SID组和SIVD组于2010年10月至2011年9月从安徽医科大学第一附属医院神经内科招募。NC组同期来自安徽医科大学第一附属医院医学中心。采用弗雷明汉量表评估所有参与者的血管危险因素。采用老年抑郁量表（GDS）和汉密尔顿抑郁量表（HAMD）评估抑郁症状，采用简易精神状态检查表（MMSE）和蒙特利尔认知钟表绘画任务（CDT）评估认知功能。
SID组（12.3±4.7）和SIVD组（13.5±3.4）的弗雷明汉评分均显著高于NC组（8.6±1.8）（F=20.850，P=0.000）。与NC组（28.3±1.8；23.1±3.4；8.0±1.8）相比，SID组（26.7±2.5；20.0±4.0；2.0±2.7）和SIVD组（26.8±1.9；20.7±3.0；6.1±2.1）的MMSE、MoCA和CDT评分显著降低（P<0.05）。SID组（82.7±9.0）和SIVD组（86.2±6.9）的CAMCOG-C评分显著低于NC组（92.3±6.2）（P<0.05），SID组与SIVD组相比同样如此（P<0.05）。在CAMCOG-C的子测试中，SID组（9.0±1.4；24.7±4.0；19.5±3.4）和SIVD组（9.4±0.9；25.5±2.1；20.3±2.3）的定向、语言和记忆评分均显著低于NC组（9.9±0.4；27.4±1.9；22.1±2.4）（P<0.05）；SID组的实践评分（9.4±1.9）显著低于NC组（10.4±1.5）（P<0.05）。SID组的思维和感知评分（5.4±1.7；6.3±1.4）显著低于SIVD组（6.2±1.3；7.0±1.4）和NC组（6.6±1.3；7.2±1.4）。在SID组中，未发现弗雷明汉评分与神经心理学评估之间存在显著相关性。GDS、HAMD评分与MMSE、MoCA、CAMCOG-C和CDT评分之间存在负相关（P<0.05）。
SID患者存在多种神经心理学缺陷，尤其是在思维、感知和实践方面。未发现SID患者的血管危险因素与抑郁症状之间存在显著相关性。
