皮质萎缩与亚综合征抑郁的轻度认知障碍认知衰退加速有关。
Cortical Atrophy is Associated with Accelerated Cognitive Decline in Mild Cognitive Impairment with Subsyndromal Depression.
机构信息
Department of Mental Health, V.A. Northern California Health Care System, Martinez, CA.
Center for Imaging of Neurodegenerative Diseases, Veterans Administration Medical Center, San Francisco, CA.
出版信息
Am J Geriatr Psychiatry. 2017 Sep;25(9):980-991. doi: 10.1016/j.jagp.2017.04.011. Epub 2017 Apr 20.
OBJECTIVES
To investigate the association between cognitive decline and cortical atrophy in individuals with mild cognitive impairment (MCI) and chronic subsyndromal symptoms of depression (SSD) over a 4-year period.
DESIGN
Prospective cohort study.
SETTING
Multicenter, clinic-based.
PARTICIPANTS
Within the Alzheimer's Disease Neuroimaging Initiative repository, the Neuropsychiatric Inventory was used to identify individuals with MCI and stable endorsement (SSD group N = 32) or no endorsement (non-SSD group N = 69) of depressive symptoms across time points.
MEASUREMENTS
Repeated measures of cognitive outcomes, cortical atrophy, and their associations were evaluated with mixed effects models adjusting for age, education, sex, and APOE genotype.
RESULTS
The SSD group demonstrated accelerated decline on measures of global cognition (Alzheimer Disease Assessment Scale; df = 421, t = 2.242, p = 0.025), memory (Wechsler Memory Scale-Revised Logical Memory II; df = 244, t = -2.525, p = 0.011), information processing speed (Trail Making Test Parts A [df = 421, t = 2.376, p = 0.018] and B [df = 421, t = 2.533, p = 0.012]), and semantic fluency (Category Fluency; df = 424, t = -2.418, p = 0.016), as well as accelerated frontal lobe (df = 341, t = -2.648, p = 0.008) and anterior cingulate (df = 341, t = -3.786, p < 0.001) atrophy. No group differences were observed for rate of decline on measures of attention, learning, and confrontation naming or for rate of atrophy in any other regions. Accelerated frontal lobe and anterior cingulate atrophy was associated with cognitive decline on measures of global cognition, information processing speed, and semantic fluency (all p < 0.05), but not memory.
CONCLUSIONS
Individuals with chronic SSD may represent an MCI subgroup that is highly vulnerable to accelerated cognitive decline, an effect that may be governed by frontal lobe and anterior cingulate atrophy.
目的
在 4 年内，研究轻度认知障碍（MCI）和慢性亚综合征性抑郁症状（SSD）个体认知能力下降与皮质萎缩之间的关系。
设计
前瞻性队列研究。
地点
多中心、基于诊所。
参与者
在阿尔茨海默病神经影像学倡议资料库中，使用神经精神病学问卷识别出在各时间点持续存在（SSD 组 N=32）或不存在（非 SSD 组 N=69）抑郁症状的 MCI 个体。
测量
使用混合效应模型，对认知结果、皮质萎缩及其相关性进行重复测量，调整年龄、教育、性别和 APOE 基因型。
结果
SSD 组在全球认知能力（阿尔茨海默病评估量表；df=421，t=2.242，p=0.025）、记忆（韦氏记忆量表修订版逻辑记忆 II；df=244，t=-2.525，p=0.011）、信息处理速度（连线测试 A 部分[df=421，t=2.376，p=0.018]和 B 部分[df=421，t=2.533，p=0.012]）和语义流畅性（类别流畅性；df=424，t=-2.418，p=0.016）方面表现出认知能力下降加速，以及额叶（df=341，t=-2.648，p=0.008）和前扣带（df=341，t=-3.786，p<0.001）萎缩加速。在注意力、学习和命名测试方面的认知能力下降率或其他任何区域的萎缩率方面，两组之间没有差异。额叶和前扣带萎缩与全球认知、信息处理速度和语义流畅性方面的认知能力下降相关（均 p<0.05），但与记忆无关。
结论
患有慢性 SSD 的个体可能代表 MCI 亚组，其认知能力下降速度极快，这种效应可能受额叶和前扣带萎缩的影响。
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