Center for Depression Research and Clinical Care, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas; Department of Psychiatry, Peter O'Donnell Jr. Brain Institute, University of Texas Southwestern Medical Center, Dallas, Texas.
Center for Depression Research and Clinical Care, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas; Department of Psychiatry, Peter O'Donnell Jr. Brain Institute, University of Texas Southwestern Medical Center, Dallas, Texas.
Biol Psychiatry Cogn Neurosci Neuroimaging. 2023 Apr;8(4):462-470. doi: 10.1016/j.bpsc.2022.09.006. Epub 2022 Sep 27.
Major depressive disorder (MDD) may be associated with accelerated brain aging (higher brain age than chronological age). This report evaluated whether brain age is a clinically useful biomarker by checking its test-retest reliability using magnetic resonance imaging scans acquired 1 week apart and by evaluating the association of accelerated brain aging with symptom severity and antidepressant treatment outcomes.
Brain age was estimated in participants of the EMBARC (Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care) study using T1-weighted structural magnetic resonance imaging (MDD n = 290; female n = 192; healthy control participants n = 39; female n = 24). Intraclass correlation coefficient was used for baseline-to-week-1 test-retest reliability. Association of baseline Δ brain age (brain age minus chronological age) with Hamilton Depression Rating Scale-17 and Concise Health Risk Tracking Self-Report domains (impulsivity, suicide propensity [measures: pessimism, helplessness, perceived lack of social support, and despair], and suicidal thoughts) were assessed at baseline (linear regression) and during 8-week-long treatment with either sertraline or placebo (repeated-measures mixed models).
Mean ± SD baseline chronological age, brain age, and Δ brain age were 37.1 ± 13.3, 40.6 ± 13.1, and 3.1 ± 6.1 years in MDD and 37.1 ± 14.7, 38.4 ± 12.9, and 0.6 ± 5.5 years in healthy control groups, respectively. Test-retest reliability was high (intraclass correlation coefficient = 0.98-1.00). Higher baseline Δ brain age in the MDD group was associated with higher baseline impulsivity and suicide propensity and predicted smaller baseline-to-week-8 reductions in Hamilton Depression Rating Scale-17, impulsivity, and suicide propensity with sertraline but not with placebo.
Brain age is a reliable and potentially clinically useful biomarker that can prognosticate antidepressant treatment outcomes.
重度抑郁症（MDD）可能与大脑衰老加速（大脑年龄高于实际年龄）有关。本报告通过检查相隔 1 周获得的磁共振成像扫描的测试-重测信度，以及评估大脑老化加速与症状严重程度和抗抑郁治疗结果的相关性，评估了大脑年龄是否是一种有用的临床生物标志物。
使用 T1 加权结构磁共振成像（MDD n=290；女性 n=192；健康对照组 n=39；女性 n=24），在 EMBARC（临床护理中抗抑郁反应的建立调节剂和生物标志物）研究中估算参与者的大脑年龄。采用组内相关系数评估基线至第 1 周的测试-重测信度。在基线（线性回归）和接受舍曲林或安慰剂 8 周治疗期间（重复测量混合模型），评估基线 Δ 大脑年龄（大脑年龄减去实际年龄）与汉密尔顿抑郁量表-17 和简明健康风险跟踪自我报告量表域（冲动、自杀倾向[衡量指标：悲观、无助、缺乏社会支持和绝望]和自杀意念）的相关性。
MDD 组和健康对照组的平均±标准差基线实际年龄、大脑年龄和 Δ 大脑年龄分别为 37.1±13.3、40.6±13.1 和 3.1±6.1 岁，37.1±14.7、38.4±12.9 和 0.6±5.5 岁。测试-重测信度较高（组内相关系数=0.98-1.00）。MDD 组中较高的基线 Δ 大脑年龄与较高的基线冲动性和自杀倾向相关，并预测舍曲林治疗时基线至第 8 周汉密尔顿抑郁量表-17、冲动性和自杀倾向的降幅较小，但与安慰剂无关。
大脑年龄是一种可靠的、潜在的临床有用的生物标志物，可以预测抗抑郁治疗的结果。
