Wenzler Sofia, Knochel Christian, Balaban Ceylan, Kraft Dominik, Kopf Juliane, Alves Gilberto S, Prvulovic David, Carvalho Andre F, Oertel-Knochel Viola
Laboratory of Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe- University, Frankfurt/Main, Germany.
Translational Psychiatry Research Group and Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil.
Curr Alzheimer Res. 2017;14(4):441-452. doi: 10.2174/1567205013666160603011256.
Depression is a common neuropsychiatric manifestation among Alzheimer's disease (AD) patients. It may compromise everyday activities and lead to a faster cognitive decline as well as worse quality of life. The identification of promising biomarkers may therefore help to timely initiate and improve the treatment of preclinical and clinical states of AD, and to improve the long-term functional outcome. In this narrative review, we report studies that investigated biomarkers for AD-related depression. Genetic findings state AD-related depression as a rather complex, multifactorial trait with relevant environmental and inherited contributors. However, one specific set of genes, the brain derived neurotrophic factor (BDNF), specifically the Val66Met polymorphism, may play a crucial role in AD-related depression. Regarding neuroimaging markers, the most promising findings reveal structural impairments in the cortico-subcortical networks that are related to affect regulation and reward / aversion control. Functional imaging studies reveal abnormalities in predominantly frontal and temporal regions. Furthermore, CSF based biomarkers are seen as potentially promising for the diagnostic process showing abnormalities in metabolic pathways that contribute to AD-related depression. However, there is a need for standardization of methodological issues and for replication of current evidence with larger cohorts and prospective studies.
抑郁症是阿尔茨海默病（AD）患者常见的神经精神表现。它可能会影响日常活动，导致认知能力更快下降以及生活质量更差。因此，确定有前景的生物标志物可能有助于及时启动和改善AD临床前和临床状态的治疗，并改善长期功能结局。在这篇叙述性综述中，我们报告了研究AD相关抑郁症生物标志物的研究。遗传学研究结果表明，AD相关抑郁症是一种相当复杂的多因素特征，有相关的环境和遗传因素。然而，一组特定的基因，即脑源性神经营养因子（BDNF），特别是Val66Met多态性，可能在AD相关抑郁症中起关键作用。关于神经影像学标志物，最有前景的研究结果显示，与情感调节和奖赏/厌恶控制相关的皮质-皮质下网络存在结构损伤。功能影像学研究显示主要在额叶和颞叶区域存在异常。此外，基于脑脊液的生物标志物在诊断过程中被视为具有潜在前景，显示出参与AD相关抑郁症的代谢途径存在异常。然而，需要对方法学问题进行标准化，并通过更大规模的队列和前瞻性研究来重复现有证据。
