Department of Psychiatry, Duke University Medical Center, Durham, NC 27710, USA.
J Psychiatr Res. 2013 Jun;47(6):829-34. doi: 10.1016/j.jpsychires.2013.02.008. Epub 2013 Mar 8.
Major depressive disorder is associated with smaller hippocampal volumes but the mechanisms underlying this relationship are unclear. To examine the effect of environmental influences, we examined the relationship between self-reported stressors and two-year change in hippocampal volume. Seventy elderly nondepressed subjects and eighty-nine elderly depressed subjects were followed for two years. The number of negative stressful life events (nSLE), perceived stress levels, and cranial MRI were obtained at baseline and at the two-year assessment. For secondary analyses, subjects provided blood for 5-HTTLPR polymorphism genotyping. After controlling for covariates including presence or absence of depression, greater numbers of baseline nSLEs were significantly associated with greater baseline hippocampal volumes bilaterally. Greater numbers of baseline nSLEs were also associated with reduction in hippocampal volume over two years in the right but not the left hemisphere. Neither perceived stress levels nor changes in stress measures were significantly associated with hippocampal volume measures. However, in secondary analyses, we found that increases in perceived stress over time was associated with volume reduction of the left hippocampus, but only in 5-HTTLPR L/L homozygotes. Our findings suggest different short- and long-term effects of negative life stressors on hippocampal volumes in older adults. These effects appear independent on the presence or absence of depression. Furthermore, these effects may be moderated by genetic polymorphisms in key neurotransmitter systems. These novel findings have important implications for understanding environmental influences on brain aging.
重度抑郁症与海马体体积较小有关,但这种关系的机制尚不清楚。为了研究环境影响的作用,我们研究了报告的应激源与海马体体积两年变化之间的关系。70 名老年非抑郁受试者和 89 名老年抑郁受试者接受了两年的随访。在基线和两年评估时获得了负性生活事件的数量(nSLE)、感知压力水平和颅磁共振成像。作为二次分析,受试者提供了 5-HTTLPR 多态性基因分型的血液。在包括是否存在抑郁的协变量控制后,基线 nSLE 的数量与双侧更大的基线海马体体积显著相关。基线 nSLE 的数量也与右半球而不是左半球的两年内海马体体积减少有关。感知压力水平或压力测量的变化与海马体体积测量均无显著相关性。然而,在二次分析中,我们发现随着时间的推移感知压力的增加与左海马体的体积减少有关,但仅在 5-HTTLPR L/L 纯合子中有关。我们的研究结果表明,负性生活应激源对老年人大脑海马体体积的短期和长期影响不同。这些影响似乎与抑郁的存在与否无关。此外,这些影响可能受到关键神经递质系统中遗传多态性的调节。这些新发现对于理解环境对大脑衰老的影响具有重要意义。