Departments of Health Sciences Research (Krell-Roesch, Syrjanen, Rakusa, Kremers, Mielke, Vassilaki), Radiology (Vemuri, Lowe, Jack), Psychiatry and Psychology (Machulda), and Neurology (Mielke, Knopman, Petersen), Mayo Clinic, Rochester, Minn.; Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany (Krell-Roesch); Department of Neurology, University Medical Center, Maribor, Slovenia (Rakusa); International Clinical Research Center, St. Anne Hospital, Brno, Czech Republic (Stokin); and Department of Neurology, Barrow Neurological Institute, Phoenix (Geda).
J Neuropsychiatry Clin Neurosci. 2021 Winter;33(1):64-71. doi: 10.1176/appi.neuropsych.20050103. Epub 2020 Oct 22.
The purpose of this study was to test the hypothesis that subcortical β-amyloid (Aβ) deposition was associated with elevated scores on standardized measures of depressive and anxiety symptoms when compared with cortical (Aβ) deposition in persons without dementia.
The authors performed a cross-sectional study, derived from the population-based Mayo Clinic Study of Aging, comprising participants aged ≥70 years (N=1,022; 55% males; 28% apolipoprotein E [APOE] ε4 carriers; without cognitive impairment, N=842; mild cognitive impairment; N=180). To assess Aβ deposition in cortical and subcortical (the amygdala, striatum, and thalamus) regions, participants underwent Pittsburgh Compound B positron emission tomography (PiB-PET) and completed the Beck Depression Inventory-II (BDI-II) and the Beck Anxiety Inventory (BAI). The investigators ran linear regression models to examine the association between PiB-PET standardized uptake value ratios (SUVRs) in the neocortex and subcortical regions and depressive and anxiety symptoms (BDI-II and BAI total scores). Models were adjusted for age, sex, education level, and APOE ε4 carrier status and stratified by cognitive status (without cognitive impairment, mild cognitive impairment).
Cortical PiB-PET SUVRs were associated with depressive symptoms (β=0.57 [SE=0.13], p<0.001) and anxiety symptoms (β=0.34 [SE=0.13], p=0.011). PiB-PET SUVRs in the amygdala were associated only with depressive symptoms (β=0.80 [SE=0.26], p=0.002). PiB-PET SUVRs in the striatum and thalamus were associated with depressive symptoms (striatum: β=0.69 [SE=0.18], p<0.001; thalamus: β=0.61 [SE=0.24], p=0.011) and anxiety symptoms (striatum: β=0.56 [SE=0.18], p=0.002; thalamus: β=0.65 [SE=0.24], p=0.008). In the mild cognitive impairment subsample, Aβ deposition, regardless of neuroanatomic location, was associated with depressive symptoms but not anxiety symptoms.
Elevated amyloid deposition in cortical and subcortical brain regions was associated with higher depressive and anxiety symptoms, although these findings did not significantly differ by cortical versus subcortical Aβ deposition. This cross-sectional observation needs to be confirmed by a longitudinal study.
本研究旨在检验以下假设，即与无痴呆症的个体相比，皮质（Aβ）沉积与抑郁和焦虑症状的标准测量评分升高相关，而皮质下β-淀粉样蛋白（Aβ）沉积与抑郁和焦虑症状升高相关。
作者进行了一项横断面研究，该研究源自基于人群的梅奥诊所老龄化研究，参与者年龄≥70 岁（N=1022；55%为男性；28%为载脂蛋白 E [APOE] ε4 携带者；无认知障碍，N=842；轻度认知障碍，N=180）。为了评估皮质和皮质下（杏仁核、纹状体和丘脑）区域的 Aβ 沉积，参与者接受了匹兹堡化合物 B 正电子发射断层扫描（PiB-PET），并完成了贝克抑郁量表第二版（BDI-II）和贝克焦虑量表（BAI）。研究人员运行线性回归模型，以检查新皮层和皮质下区域 PiB-PET 标准化摄取值比（SUVR）与抑郁和焦虑症状（BDI-II 和 BAI 总分）之间的关联。模型调整了年龄、性别、教育水平和 APOE ε4 携带者状态，并按认知状态（无认知障碍、轻度认知障碍）进行分层。
皮质 PiB-PET SUVR 与抑郁症状相关（β=0.57[SE=0.13]，p<0.001）和焦虑症状（β=0.34[SE=0.13]，p=0.011）。杏仁核的 PiB-PET SUVR 仅与抑郁症状相关（β=0.80[SE=0.26]，p=0.002）。纹状体和丘脑的 PiB-PET SUVR 与抑郁症状相关（纹状体：β=0.69[SE=0.18]，p<0.001；丘脑：β=0.61[SE=0.24]，p=0.011）和焦虑症状（纹状体：β=0.56[SE=0.18]，p=0.002；丘脑：β=0.65[SE=0.24]，p=0.008）。在轻度认知障碍亚组中，无论神经解剖位置如何，Aβ 沉积与抑郁症状相关，但与焦虑症状无关。
皮质和皮质下脑区的淀粉样蛋白沉积增加与更高的抑郁和焦虑症状相关，尽管这些发现并未因皮质与皮质下 Aβ 沉积的不同而显著不同。这一横断面观察需要通过纵向研究来证实。
