University Department of Psychiatry, Warneford Hospital, Oxford, UK.
Br J Psychiatry. 2012 Jul;201(1):46-51. doi: 10.1192/bjp.bp.111.105361.
Late-life depression is a common and heterogeneous illness, associated with structural abnormalities in both grey and white matter.
To examine the relationship between age at onset and magnetic resonance imaging (MRI) measures of grey and white matter to establish whether they support particular hypotheses regarding the anatomy and aetiology of network disruption in late-life depression.
We studied 36 participants with late-life depression. Grey matter was examined using T(1)-weighted MRI and analysed using voxel-based morphometry. The hippocampus was automatically segmented and volume and shape analysis performed. White matter was examined using diffusion tensor imaging and analysed using tract-based spatial statistics.
Later age at onset was significantly associated with reduced fractional anisotropy of widespread tracts, in particular the anterior thalamic radiation and superior longitudinal fasciculus. Earlier age at onset was associated with reduced hippocampal volume normalised to whole brain size bilaterally. However, no significant correlations were detected using hippocampal shape analysis or voxel-based morphometry.
Overall, the results were compatible with the vascular hypothesis, and provided some support for the glucocorticoid cascade hypothesis.
老年期抑郁症是一种常见且异质性的疾病，与灰质和白质的结构异常有关。
研究发病年龄与磁共振成像（MRI）测量的灰质和白质之间的关系，以确定它们是否支持关于老年期抑郁症网络破坏的解剖学和发病机制的特定假设。
我们研究了 36 名老年期抑郁症患者。使用 T1 加权 MRI 检查灰质，并使用基于体素的形态计量学进行分析。自动分割海马体并进行体积和形状分析。使用弥散张量成像检查白质，并使用基于束的空间统计学进行分析。
发病年龄较晚与广泛束的各向异性分数降低显著相关，尤其是前丘脑辐射和上纵束。发病年龄较早与双侧海马体体积相对于全脑大小的降低有关。然而，使用海马体形状分析或基于体素的形态计量学未检测到显著相关性。
总体而言，结果与血管假说一致，并为糖皮质激素级联假说提供了一些支持。
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