Department of Organismal Biology, Uppsala University, Uppsala, Sweden.
Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.
Psychol Med. 2023 Jul;53(10):4355-4363. doi: 10.1017/S003329172200112X. Epub 2022 May 10.
Cerebrovascular disease is regarded as a potential cause of late-life depression. Yet, evidence for associations of neuroimaging markers of vascular brain disease with depressive symptoms is inconclusive. We examined the associations of neuroimaging markers and depressive symptoms in a large population-based study of middle-aged and elderly persons over time.
A total of 4943 participants (mean age = 64.6 ± 11.1 years, 55.7% women) from the Rotterdam Study were included. At baseline, total brain volume, gray matter volume, white matter volume, white matter hyperintensities volume, cortical infarcts, lacunar infarcts, microbleeds, white matter fractional anisotropy, and mean diffusivity (MD) were measured with a brain MRI (1.5T). Depressive symptoms were assessed twice with the Center for Epidemiologic Studies Depression scale (median follow-up time: 5.5 years, IQR = 0.9). To assess temporal associations of neuroimaging markers and depressive symptoms, linear mixed models were used.
A smaller total brain volume ( = -0.107, 95% CI -0.192 to -0.022), larger white matter hyperintensities volume ( = 0.047, 95% CI 0.010-0.084), presence of cortical infarcts ( = 0.194, 95% CI 0.047-0.341), and higher MD levels ( = 0.060, 95% CI 0.022-0.098) were cross-sectionally associated with more depressive symptoms. Longitudinal analyses showed that small total brain volume ( = -0.091, 95% CI -0.167 to -0.015) and presence of cortical infarcts ( = 0.168, 95% CI 0.022-0.314) were associated with increasing depressive symptoms over time. After stratification on age, effect sizes were more pronounced at older ages.
Neuroimaging markers of white matter microstructural damage were associated with depressive symptoms longitudinally in this study of middle-aged and elderly persons. These associations were more pronounced at older ages, providing evidence for the role of white matter structure in late-life depressive symptomatology.
脑血管疾病被认为是导致晚年抑郁症的潜在原因。然而，血管性脑疾病的神经影像学标志物与抑郁症状之间的关联证据并不明确。我们在一项针对中年和老年人的大型人群研究中，随着时间的推移，研究了神经影像学标志物与抑郁症状之间的关联。
该研究共纳入 4943 名参与者（平均年龄 64.6±11.1 岁，55.7%为女性），来自鹿特丹研究。在基线时，使用脑部 MRI（1.5T）测量了总脑容量、灰质容量、白质容量、白质高信号体积、皮质梗死、腔隙性梗死、微出血、白质各向异性分数和平均弥散度（MD）。使用流行病学研究中心抑郁量表两次评估抑郁症状（中位随访时间：5.5 年，IQR=0.9）。为了评估神经影像学标志物和抑郁症状之间的时间关联，使用线性混合模型进行分析。
较小的总脑容量（=-0.107，95%CI-0.192 至-0.022）、较大的白质高信号体积（=0.047，95%CI0.010 至 0.084）、皮质梗死的存在（=0.194，95%CI0.047 至 0.341）和较高的 MD 水平（=0.060，95%CI0.022 至 0.098）与更多的抑郁症状存在横断面关联。纵向分析表明，较小的总脑容量（=-0.091，95%CI-0.167 至-0.015）和皮质梗死的存在（=0.168，95%CI0.022 至 0.314）与抑郁症状随时间的增加有关。在按年龄分层后，这些关联在年龄较大的人群中更为明显。
在这项针对中年和老年人的研究中，白质微观结构损伤的神经影像学标志物与抑郁症状存在纵向关联。这些关联在年龄较大的人群中更为明显，为白质结构在晚年抑郁症状学中的作用提供了证据。
