Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan.
Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan.
Psychiatry Res. 2014 Jan 30;221(1):86-91. doi: 10.1016/j.pscychresns.2013.11.002. Epub 2013 Nov 15.
Depressive symptoms are common in patients with Alzheimer's disease (AD) and increase the caregiver burden, although the etiology and pathologic mechanism of depressive symptoms in AD patients remain unclear. In this study, we tried to clarify the cerebral blood flow (CBF) correlates of depressive symptoms in AD, excluding the effect of apathy and anxiety. Seventy-nine consecutive patients with AD were recruited from outpatient units of the Memory Clinic of Okayama University Hospital. The level of depressive symptoms was evaluated using the depression domain of the Neuropsychiatric Inventory (NPI). The patients underwent brain SPECT with 99mTc-ethylcysteinate dimer. After removing the effects of age, anxiety and apathy scores of NPI, and five subscales of Addenbrooke's Cognitive Examination-revised (ACE-R), correlation analysis of NPI depression scores showed a significant cluster of voxels in the left middle frontal gyrus (Brodmann area 9), similar to the areas in the simple correlation analysis. The dorsolateral prefrontal area is significantly involved in the pathogenesis of depressive symptoms in AD, and the area on the left side especially may be closely related to the depressive symptoms revealed by NPI.
抑郁症状在阿尔茨海默病（AD）患者中很常见，增加了照顾者的负担，尽管 AD 患者抑郁症状的病因和病理机制仍不清楚。在这项研究中，我们试图阐明 AD 患者抑郁症状的脑血流（CBF）相关性，排除了淡漠和焦虑的影响。我们从冈山县医院记忆诊所的门诊单位招募了 79 名连续的 AD 患者。使用神经精神疾病问卷（NPI）的抑郁域评估抑郁症状的程度。患者接受了 99mTc-乙基半胱氨酸二聚体的脑 SPECT。在去除年龄、NPI 的焦虑和淡漠评分以及 Addenbrooke 的认知评估修订版（ACE-R）的五个亚量表的影响后，NPI 抑郁评分的相关分析显示左侧额中回（Brodmann 区域 9）有一个显著的体素簇，与简单相关分析中的区域相似。背外侧前额叶区域在 AD 患者抑郁症状的发病机制中起重要作用，左侧区域尤其可能与 NPI 揭示的抑郁症状密切相关。
