Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, CA.
Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California at Los Angeles, Los Angeles, CA.
Am J Geriatr Psychiatry. 2018 Aug;26(8):874-883. doi: 10.1016/j.jagp.2018.04.004. Epub 2018 Apr 23.
Greater psychological resilience may protect against developing depression in a growing geriatric population. Identifying the neural correlates of resilience in geriatric depression could provide neurobiologic targets to inform clinical interventions. However, most prior neuroimaging studies have only considered the presence or absence of resilience and have not addressed the multifactorial nature of resilience. The current study aimed to establish the neural correlates of four factors of resilience in the depressed elderly.
White matter integrity was assessed using diffusion-weighted magnetic resonance imaging data collected from 70 older adults with major depressive disorder. We used four resilience factors previously derived in an exploratory factor analysis of the Connor-Davidson Resilience Scale in a large sample of depressed older adults: 1, grit; 2, active coping self-efficacy; 3, accommodative coping self-efficacy; and 4, spirituality.
The resilience factor "grit" was positively associated with fractional anisotropy in the callosal region connecting prefrontal cortex and fractional anisotropy in cingulum fibers; however, the latter did not survive correction for multiple comparisons.
Structural integrity of major white matter pathways implicated in cognitive control and emotion regulation (i.e., connecting prefrontal cortex) was positively associated with the resilience factor "grit" in our sample of older adults with depression. Prospective studies are needed to determine the utility of the structural integrity of these pathways as a biomarker in predicting risk for depression and treatment response.
更强的心理适应力可能有助于保护老年人群免受抑郁的影响。确定老年抑郁症患者适应力的神经相关性，可以为提供神经生物学靶点，为临床干预提供信息。然而，大多数先前的神经影像学研究仅考虑了适应力的存在与否，而没有解决适应力的多因素性质。本研究旨在确定抑郁老年人适应力的四个因素的神经相关性。
使用从 70 名患有重度抑郁症的老年人中收集的弥散加权磁共振成像数据来评估白质完整性。我们使用了先前在对大量抑郁老年患者的 Connor-Davidson 适应力量表进行探索性因子分析中得出的四个适应力因素：1、坚韧；2、积极应对自我效能；3、适应应对自我效能；4、精神性。
适应力因素“坚韧”与胼胝体区域连接前额叶皮质和扣带纤维的各向异性分数呈正相关；然而，后者在进行多次比较校正后并不显著。
在我们的抑郁老年患者样本中，与认知控制和情绪调节相关的主要白质通路（即连接前额叶皮质的通路）的结构完整性与适应力因素“坚韧”呈正相关。需要前瞻性研究来确定这些通路的结构完整性作为预测抑郁风险和治疗反应的生物标志物的效用。
