Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA, USA.
Curr Psychiatry Rep. 2018 Mar 1;20(1):7. doi: 10.1007/s11920-018-0870-6.
Mood and anxiety disorders are very commonly experienced by older adults and are becoming a growing concern due to the rapidly aging global population. Recent advances in neuroimaging may help in improving outcomes in late-life mood and anxiety disorders. The elucidation of mechanisms contributing to late-life mental health disorders may ultimately lead to the identification of novel therapeutic interventions. Alternatively, clinically validated imaging biomarkers may allow for the prediction of treatment response and identification of better therapeutic approaches in late-life mood and anxiety disorders.
In community samples, late-life depression and late-life generalized anxiety disorder occur up to 38 and 15%, respectively, while late-life bipolar disorder is less common and occur in approximately 0.5% of the population. There are significant challenges in treating and improving outcome in late-life mood and anxiety disorders. Time to treatment response and treatment resistance are increased in older adults. Novel neuroimaging techniques have the potential to improve diagnostic and therapeutic outcome in late-life mood and anxiety disorders either through "personalized pharmacotherapy" or through identifying dysfunction regions/networks to be subsequently used for direct interventions such as transcranial magnetic stimulation. This review will provide an overview of recent literature that substantiates the potential role of neuroimaging in clinical practice, as well as the barriers that must be overcome prior to clinical translation.
情绪和焦虑障碍在老年人中非常常见，由于全球人口迅速老龄化，这些问题越来越受到关注。神经影像学的最新进展可能有助于改善老年情绪和焦虑障碍的治疗效果。阐明导致老年心理健康障碍的机制最终可能会发现新的治疗干预措施。或者，经过临床验证的影像学生物标志物可以预测治疗反应，并确定老年情绪和焦虑障碍的更好治疗方法。
在社区样本中，老年抑郁症和老年广泛性焦虑症的发生率分别高达 38%和 15%，而老年双相情感障碍则较为少见，约占人口的 0.5%。老年情绪和焦虑障碍的治疗和改善预后存在重大挑战。老年患者的治疗反应时间和治疗抵抗增加。新的神经影像学技术有可能通过“个性化药物治疗”或通过识别功能障碍区域/网络来改善老年情绪和焦虑障碍的诊断和治疗效果，随后可以直接进行干预，如经颅磁刺激。这篇综述将概述最近的文献，证实神经影像学在临床实践中的潜在作用，以及在临床转化之前必须克服的障碍。
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