Sédille-Mostafaie Nazanin, Zehetmayer S, Krampla W, Krugluger W, Fischer P
Ludwig Boltzmann Society, L. Boltzmann Institute of Aging Research, Danube Hospital, Langobardenstr. 122, 1220, Vienna, Austria,
J Neural Transm (Vienna). 2015 Sep;122(9):1323-8. doi: 10.1007/s00702-015-1389-1. Epub 2015 Mar 11.
The pathogenesis of executive dysfunction in geriatric depression remains uncertain although causal bidirectional relationships with depression have been discussed. Previous studies have described a potential link with 'vascular depression'. In this study, we investigate the influence of vascular risk factors and magnetic resonance imaging markers of structural brain ageing, such as increasing deep white matter hyperintensities (DWMH), on executive function in an age-homogeneous population-based study cohort. A total of 606 participants of identical age (75.8 years; standard deviation 0.45 years) took part in the baseline investigation of the Vienna Transdanube Ageing (VITA) study. Each participant underwent a full psychometric examination with standardised neuroimaging and clinical chemistry investigations. Participants were re-examined with the same protocol after exactly 30 and 60 months. Data refer to the individuals who completed the examination at baseline. In the ordinal logistic regression, fewer years of education (P < 0.0001), Trail Making Test-A (P < 0.0001), high homocysteine (P = 0.001), and depression (P < 0.0001) were significantly associated with Trail Making Test-B (TMT-B) values. A significant influence of other vascular risk factors, such as lipids, diabetes, and smoking, on executive dysfunction was not observed. A comparison of both lacunes and DWMH with respect to the TMT-B results showed no significant correlation. Our data do not support the notion that vascular pathogenesis might underlie executive dysfunction.
尽管已经讨论了老年抑郁症执行功能障碍与抑郁症之间的因果双向关系,但其发病机制仍不明确。先前的研究描述了与“血管性抑郁”的潜在联系。在本基于人群的年龄同质化研究队列中,我们调查了血管危险因素和大脑结构老化的磁共振成像标志物(如深部白质高信号(DWMH)增加)对执行功能的影响。共有606名年龄相同(75.8岁;标准差0.45岁)的参与者参加了维也纳多瑙河老化(VITA)研究的基线调查。每位参与者都接受了全面的心理测量检查以及标准化的神经影像学和临床化学检查。在30个月和60个月后,按照相同方案对参与者进行重新检查。数据涉及在基线时完成检查的个体。在有序逻辑回归中,受教育年限较少(P < 0.0001)、连线测验A(P < 0.0001)、高同型半胱氨酸(P = 0.001)和抑郁症(P < 0.0001)与连线测验B(TMT - B)值显著相关。未观察到其他血管危险因素(如血脂、糖尿病和吸烟)对执行功能障碍有显著影响。关于TMT - B结果,腔隙和DWMH的比较未显示出显著相关性。我们的数据不支持血管发病机制可能是执行功能障碍基础的观点。