School of Medicine, Southeast University, Nanjing 210009, China; Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Nanjing 210009, China.
School of Medicine, Southeast University, Nanjing 210009, China; Department of Psychosomatics and Psychiatry, Affiliated ZhongDa Hospital of Southeast University, Nanjing 210009, China.
Prog Neuropsychopharmacol Biol Psychiatry. 2021 Jun 8;108:110192. doi: 10.1016/j.pnpbp.2020.110192. Epub 2020 Dec 4.
Neuropsychological impairment is a key feature of late-onset depression (LOD), with deficits observed across multiple cognitive domains. And this neuropsychological impairment can persist even after the remission of depressive symptoms. However, none of previous studies have explored the pattern of cognitive deficit in remitted LOD (rLOD), and investigated the specific neural circuit underlying the key cognitive deficit of LOD. 40 rLOD patients and 36 controls underwent comprehensive neuropsychological assessments and magnetic resonance imaging (MRI) scans. The influence of executive function or information processing speed deficit on other cognitive domains was first investigated. We then applied a multivariate machine learning technique known as relevance vector regression to evaluate the potential of multiple-modal MRI (i.e., integrating whole-brain grey-matter [GM] volume and white-matter [WM] tract features) for making accurate predictions about the key cognitive deficit for individual rLOD patient. We revealed that the information processing speed appears to represent a key cognitive deficit in rLOD. Further the machine learning model identified a wide range of GM regions and WM tracts that significantly contributed to the prediction of individual performance on information processing speed (r = 0.50, P < 0.001). The GM regions mainly located in the frontal-subcortical and limbic systems; and the WM tracts mainly located in the frontal-limbic pathway, including the anterior corona radiata, fornix, posterior cingulate bundle, and uncinate fasciculus. This present study provide strongly evidence supporting the concept of rLOD that the core aspect of the cognitive deficits (i.e., information processing speed) is associated with disruption of the frontal-subcortical-limbic pathway.
神经心理学损伤是迟发性抑郁症（LOD）的一个主要特征，在多个认知领域都存在缺陷。而且这种神经心理学损伤甚至在抑郁症状缓解后仍会持续存在。然而，之前的研究都没有探讨缓解后的 LOD（rLOD）的认知缺陷模式，也没有研究导致 LOD 关键认知缺陷的特定神经回路。40 名 rLOD 患者和 36 名对照者接受了全面的神经心理学评估和磁共振成像（MRI）扫描。首先研究了执行功能或信息处理速度缺陷对其他认知领域的影响。然后，我们应用了一种称为相关向量回归的多变量机器学习技术，来评估多模态 MRI（即整合全脑灰质[GM]体积和白质[WM]束特征）对个体 rLOD 患者关键认知缺陷做出准确预测的潜力。我们发现，信息处理速度似乎代表了 rLOD 的一个关键认知缺陷。此外，机器学习模型确定了一系列 GM 区域和 WM 束，这些区域和 WM 束对信息处理速度的个体表现预测有显著贡献（r=0.50，P<0.001）。GM 区域主要位于额皮质下和边缘系统；WM 束主要位于额-边缘通路，包括前放射冠、穹窿、后扣带束和钩束。本研究为 rLOD 的概念提供了有力证据，即认知缺陷的核心方面（即信息处理速度）与额皮质下-边缘通路的破坏有关。
