a Division of Geriatric Psychiatry , McLean Hospital , Belmont , MA , USA.
b Department of Psychiatry , Harvard Medical School , Boston , MA , USA.
Int Rev Psychiatry. 2017 Dec;29(6):597-617. doi: 10.1080/09540261.2017.1397608. Epub 2017 Dec 4.
The prevalence of mood disorders in the rapidly-growing older adult population merits attention due to the likelihood of increased medical comorbidities, risk of hospitalization or institutionalization, and strains placed on caregivers and healthcare providers. Magnetic resonance spectroscopy (MRS) quantifies biochemical compounds in vivo, and has been used specifically for analyses of neural metabolism and bioenergetics in older adults with mood disorders, usually via proton or phosphorous spectroscopy. While yet to be clinically implemented, data gathered from research subjects may help indicate potential biomarkers of disease state or trait or putative drug targets. Three prevailing hypotheses for these mood disorders are used as a framework for the present review, and the current biochemical findings within each are discussed with respect to particular metabolites and brain regions. This review covers studies of MRS in geriatric mood disorders and reveals persisting gaps in research knowledge, especially with regard to older age bipolar disorder. Further MRS work, using higher field strengths and larger sample sizes, is warranted in order to better understand the neurobiology of these prevalent late-life disorders.
心境障碍在快速增长的老年人群中较为普遍,值得关注,因为这可能会导致更多的合并症、住院或住院治疗的风险,以及对护理人员和医疗保健提供者的压力。磁共振波谱(MRS)定量分析体内的生化化合物,已专门用于分析患有心境障碍的老年人的神经代谢和生物能量,通常通过质子或磷波谱分析。尽管尚未在临床上实施,但从研究对象收集的数据可能有助于指示疾病状态或特征的潜在生物标志物或假定的药物靶点。目前的研究使用三种流行的心境障碍假说作为本综述的框架,并根据特定的代谢物和脑区讨论了每种假说的当前生化发现。本综述涵盖了老年心境障碍的 MRS 研究,揭示了研究知识中持续存在的差距,特别是在老年双相情感障碍方面。需要进行更多的 MRS 研究,使用更高的场强和更大的样本量,以便更好地了解这些普遍的晚年疾病的神经生物学。