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帕金森病伴发重度抑郁症的神经影像学研究:皮质厚度、皮质及皮质下体积和光谱学研究结果

Neuroimaging of major depression in Parkinson's disease: Cortical thickness, cortical and subcortical volume, and spectroscopy findings.

作者信息

Chagas Marcos Hortes N, Tumas Vitor, Pena-Pereira Márcio A, Machado-de-Sousa João Paulo, Carlos Dos Santos Antonio, Sanches Rafael Faria, Hallak Jaime E C, Crippa José Alexandre S

机构信息

Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Av. Bandeirantes, 3900 CEP 14048-900, Ribeirão Preto, Brazil; INCT Translacional em Medicina (CNPq), São Paulo, Brazil; Departamento de Gerontologia, Centro de Ciências Biológicas e da Saúde, Universidade Federal de São Carlos, Brazil.

Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Av. Bandeirantes, 3900 CEP 14048-900, Ribeirão Preto, Brazil.

出版信息

J Psychiatr Res. 2017 Jul;90:40-45. doi: 10.1016/j.jpsychires.2017.02.010. Epub 2017 Feb 13.

Abstract

Depression is the most common psychiatric disorder in Parkinson's disease (PD). The aim of this study was to compare PD patients with current Major Depressive Disorder (MDD), lifetime MDD, and no MDD using three neuroimaging techniques. A total of 43 PD patients were selected and divided into three groups: (i) current MDD (n = 15), (ii) previous MDD without current MDD (n = 10); and (iii) control group (no current or lifetime MDD; n = 18). All participants underwent magnetic resonance imaging to evaluate cortical thickness, cortical and subcortical volume, and spectroscopy in the bilateral putamen and cingulate cortex. Volumetric analysis showed volume decreases in frontal and temporal areas, bilateral amygdala, and left cerebellar white matter in the lifetime MDD group compared to the control group. Furthermore, the volumes of the anterior cingulate cortex, right amygdala, and left cerebellar white matter were smaller in the group with current MDD compared to the control group. Regarding cortical thickness, the left rostral anterior cingulate gyrus of the group with previous MDD was thinner compared to the control group. There was a weak negative correlation between the NAA/Cre ratio in the right putamen and depressive symptoms. The results suggested current and lifetime MDD have a negative impact on the neurodegenerative process of PD, with decreased volume and/or reduction of cortical thickness in temporal and frontal areas, anterior cingulate cortex, amygdala, and cerebellar white matter.

摘要

抑郁症是帕金森病(PD)中最常见的精神障碍。本研究的目的是使用三种神经影像学技术比较患有当前重度抑郁症(MDD)、终生MDD和无MDD的PD患者。总共选择了43名PD患者并将其分为三组:(i)当前MDD组(n = 15),(ii)既往有MDD但当前无MDD组(n = 10);以及(iii)对照组(当前和终生均无MDD;n = 18)。所有参与者均接受了磁共振成像检查,以评估皮质厚度、皮质和皮质下体积,以及双侧壳核和扣带回皮质的波谱。体积分析显示,与对照组相比,终生MDD组的额叶和颞叶区域、双侧杏仁核以及左侧小脑白质体积减小。此外,与对照组相比,当前MDD组的前扣带回皮质、右侧杏仁核和左侧小脑白质体积更小。关于皮质厚度,既往有MDD组的左侧喙状前扣带回回比对照组更薄。右侧壳核中的NAA/Cre比值与抑郁症状之间存在微弱的负相关。结果表明,当前和终生MDD对PD的神经退行性过程有负面影响,颞叶和额叶区域、前扣带回皮质、杏仁核和小脑白质的体积减小和/或皮质厚度降低。

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