College of Medicine, Kangwon National University, Chuncheon, Republic of Korea.
Department of Neurology, Kangwon National University Hospital, Chuncheon, Republic of Korea.
J Alzheimers Dis. 2017;58(4):1255-1264. doi: 10.3233/JAD-170225.
Depressive symptoms are prevalent in patients with mild cognitive impairment (MCI) and are considered to be a risk factor for progression to dementia.
The purpose of this study was to evaluate whether depressive symptoms in MCI promote disease progression in a manner related to amyloid status, and to determine the relationship between depressive symptoms and longitudinal cerebral structural changes.
Baseline data for 336 patients with MCI (75 with depression and 261 without) from the Alzheimer's Disease Neuroimaging Initiative study were analyzed. All participants underwent comprehensive cognitive testing, volumetric magnetic resonance imaging (MRI), and [18F]AV45 positron emission tomography amyloid imaging. Depressive symptoms were measured using the Neuropsychiatric Inventory Questionnaire. A voxel-based morphometric analysis using volumetric brain MRI data was used to compare longitudinal structural changes related to depressive symptoms.
The conversion rate to dementia was different between patients with and without depression in amyloid-positive MCI (40.8% versus 19.7%, respectively; p = 0.006). Patients who were amyloid-positive at baseline also exhibited a greater degree of 2-year cognitive decline. Depression in amyloid-positive MCI was associated with longitudinal cortical atrophy in the left cingulate gyrus.
Our study indicates that the presence of depressive symptoms in patients with amyloid-positive MCI is associated with higher progression to dementia and longitudinal cortical atrophy.
抑郁症状在轻度认知障碍（MCI）患者中很常见，被认为是向痴呆发展的一个风险因素。
本研究旨在评估 MCI 中的抑郁症状是否以与淀粉样蛋白状态相关的方式促进疾病进展，并确定抑郁症状与纵向脑结构变化之间的关系。
对来自阿尔茨海默病神经影像学倡议研究的 336 名 MCI 患者（75 名有抑郁症状，261 名无抑郁症状）的基线数据进行分析。所有参与者均接受了全面的认知测试、容积磁共振成像（MRI）和 [18F]AV45 正电子发射断层扫描淀粉样蛋白成像。使用神经精神病学问卷评估抑郁症状。使用基于体素的形态计量学分析方法，对与抑郁症状相关的纵向结构变化进行比较。
在淀粉样蛋白阳性 MCI 患者中，有抑郁症状和无抑郁症状患者的痴呆转化率不同（分别为 40.8%和 19.7%；p=0.006）。基线时淀粉样蛋白阳性的患者也表现出更大程度的 2 年认知下降。在淀粉样蛋白阳性的 MCI 中，抑郁与左扣带回皮质的纵向皮质萎缩有关。
我们的研究表明，淀粉样蛋白阳性的 MCI 患者存在抑郁症状与向痴呆发展和纵向皮质萎缩有关。
