Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands.
Alzheimer Centrum Limburg, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands.
Psychol Med. 2023 Sep;53(12):5558-5568. doi: 10.1017/S0033291722002768. Epub 2022 Sep 7.
Altered white matter brain connectivity has been linked to depression. The aim of this study was to investigate the association of markers of white matter connectivity with prevalence, incidence and course of depressive symptoms.
Markers of white matter connectivity (node degree, clustering coefficient, local efficiency, characteristic path length, and global efficiency) were assessed at baseline by 3 T MRI in the population-based Maastricht Study ( = 4866; mean ± standard deviation age 59.6 ± 8.5 years, 49.0% women; 17 406 person-years of follow-up). Depressive symptoms (9-item Patient Health Questionnaire; PHQ-9) were assessed at baseline and annually over seven years of follow-up. Major depressive disorder (MDD) was assessed with the Mini-International Neuropsychiatric Interview at baseline only. We used negative binominal, logistic and Cox regression analyses, and adjusted for demographic, cardiovascular, and lifestyle risk factors.
A lower global average node degree at baseline was associated with the prevalence and persistence of clinically relevant depressive symptoms [PHQ-9 ⩾ 10; OR (95% confidence interval) per standard deviation = 1.21 (1.05-1.39) and OR = 1.21 (1.02-1.44), respectively], after full adjustment. On the contrary, no associations were found of global average node degree with the MDD at baseline [OR 1.12 (0.94-1.32) nor incidence or remission of clinically relevant depressive symptoms [HR = 1.05 (0.95-1.17) and OR 1.08 (0.83-1.41), respectively]. Other connectivity measures of white matter organization were not associated with depression.
Our findings suggest that fewer white matter connections may contribute to prevalent depressive symptoms and its persistence but not to incident depression. Future studies are needed to replicate our findings.
大脑白质连接的改变与抑郁症有关。本研究旨在探讨白质连接标记物与抑郁症状的患病率、发病率和病程的关系。
在基于人群的马斯特里赫特研究中，通过 3T MRI 在基线时评估白质连接标记物（节点度、聚类系数、局部效率、特征路径长度和全局效率）（n=4866；平均年龄 59.6±8.5 岁，49.0%为女性；17406 人年随访）。在基线和 7 年随访期间每年评估抑郁症状（9 项患者健康问卷；PHQ-9）。仅在基线时使用迷你国际神经精神访谈评估重性抑郁障碍（MDD）。我们使用负二项式、逻辑回归和 Cox 回归分析，并调整了人口统计学、心血管和生活方式危险因素。
基线时较低的全局平均节点度与临床相关抑郁症状的患病率和持续存在相关[PHQ-9 ⩾ 10；每标准差的优势比（95%置信区间）= 1.21（1.05-1.39）和 OR = 1.21（1.02-1.44）]，在完全调整后。相反，全局平均节点度与基线时的 MDD 无关联[OR 1.12（0.94-1.32）]，也与临床相关抑郁症状的发病或缓解无关[HR = 1.05（0.95-1.17）和 OR = 1.08（0.83-1.41）]。其他白质组织连通性测量指标与抑郁无关。
我们的研究结果表明，较少的白质连接可能导致普遍存在的抑郁症状及其持续存在，但与新发抑郁无关。需要进一步的研究来复制我们的发现。
