Zahodne Laura B, Gongvatana Assawin, Cohen Ronald A, Ott Brian R, Tremont Geoffrey
Cognitive Neuroscience Division, Department of Neurology and Taub Institute for Research on Alzheimer's Disease and The Aging Brain, Columbia University College of Physicians and Surgeons, Providence, RI.
Am J Geriatr Psychiatry. 2013 Nov;21(11):1098-106. doi: 10.1016/j.jagp.2013.01.043. Epub 2013 Apr 28.
To examine whether depression and apathy are independently associated with longitudinal trajectories of cortical atrophy in the entorhinal cortex compared with frontal subregions previously implicated in late-life mood disturbance.
Data from 334 participants classified as having mild cognitive impairment in the Alzheimer's Disease Neuroimaging Initiative (ADNI) were analyzed by using multilevel models for change adjusted for age, global cognitive status, and total intracranial volume at enrollment. Participants in ADNI were recruited from >50 clinical research sites in the United States and Canada. Depression and apathy were identified by informants using the Neuropsychiatric Inventory Questionnaire. Serial magnetic resonance imaging was performed on 1.5-Tesla scanners according to the standardized ADNI-1 protocol on an average of 5 occasions over an average of 30.5 months. Regional cortical thickness values were derived from longitudinal data processing in FreeSurfer version 4.4.
Depression was associated with reduced cortical thickness in the entorhinal cortex at baseline and accelerated atrophy in the anterior cingulate cortex. Similar relationships between depression and the orbitofrontal cortex and between apathy and the anterior cingulate cortex were not significant.
In mild cognitive impairment, depression signs are a better marker of longitudinal cortical atrophy than apathy. Results are consistent with hypotheses that depression is an early sign of a more aggressive neurodegenerative process or that depression lowers brain reserve capacity, allowing for more rapid progression of Alzheimer disease neuropathology.
与先前认为与晚年情绪障碍有关的额叶亚区域相比，研究抑郁和淡漠是否与内嗅皮质皮质萎缩的纵向轨迹独立相关。
使用多水平变化模型对来自阿尔茨海默病神经影像学倡议（ADNI）中334名被归类为轻度认知障碍的参与者的数据进行分析，并对入组时的年龄、整体认知状态和总颅内体积进行校正。ADNI的参与者是从美国和加拿大的50多个临床研究地点招募的。抑郁和淡漠由知情者使用神经精神科问卷进行评定。根据标准化的ADNI-1方案，在1.5特斯拉扫描仪上平均进行5次连续磁共振成像，平均时间为30.5个月。区域皮质厚度值来自FreeSurfer 4.4版本的纵向数据处理。
抑郁与基线时内嗅皮质皮质厚度降低以及前扣带回皮质萎缩加速有关。抑郁与眶额皮质之间以及淡漠与前扣带回皮质之间的类似关系不显著。
在轻度认知障碍中，抑郁症状比淡漠更能作为纵向皮质萎缩的指标。结果与以下假设一致，即抑郁是更具侵袭性的神经退行性过程的早期迹象，或者抑郁会降低脑储备能力，使阿尔茨海默病神经病理学进展更快。
