Pišljar Marko, Repovš Grega, Trošt Maja, Tomše Petra, Pirtošek Zvezdan
Psychiatric Hospital Idrija, Pot sv. Antona 49, 5280 Idrija, Slovenia,
Psychiatr Danub. 2022 Winter;34(4):668-676. doi: 10.24869/psyd.2022.668.
Late onset depression is characterised by pronounced cognitive impairment, more somatic complaints and psychomotor retardation. Psychomotor slowing may be due to impairment in either motor or cognitive domain. Electrophysiology may be particularly convenient as a tool in studies of psychomotor retardation, as it can separate central cognitive processing from the motor processing.
In this study we compared event related potentials (ERP) in the two groups of patients with late onset depression and psychomotor slowing as measured by reaction time (RT): a group of patients with lower RT was compared to a group with a higher RT. Twenty patients with late onset depression were included in the study after they had reached remission. Four weeks after reaching remission patients were reevaluated clinically using Hamilton Depression Rating Scale, Mini Mental State Examination, and with a computer version of the Stroop task. ERP, accuracy and RTs were simultaneously recorded. Both groups of patients aditionaly underwent a perfusion SPECT imaging.
There were no differences between the short and long RT groups of patients in amplitudes of the late positive Stroop related potentials. The group of patients with longer RTs showed significant hyperperfusion in precentral gyrus, parietal regions, cuneus and hypoperfusion within insular, frontal, temporal and limbic (parahyppocampal gyrus and anterior cingulate) cortices, as well as cerebellum.
We found no ERP differences between the two groups suggesting that although patients may differ on psychomotor retardation measured as RT, their cognitive abilities may be quite similar. Perfusion SPECT imaging however revealed a significant difference between them. This may be due to a process of compensation and applying different strategies to cope with cognitive impairment in the two groups.
迟发性抑郁症的特征是明显的认知障碍、更多的躯体主诉和精神运动迟缓。精神运动迟缓可能是由于运动或认知领域的损害。电生理学作为研究精神运动迟缓的工具可能特别方便，因为它可以将中枢认知处理与运动处理分开。
在本研究中，我们比较了两组迟发性抑郁症且有通过反应时间（RT）测量的精神运动迟缓患者的事件相关电位（ERP）：一组RT较低的患者与一组RT较高的患者进行比较。20例迟发性抑郁症患者在病情缓解后纳入研究。病情缓解四周后，使用汉密尔顿抑郁量表、简易精神状态检查表以及计算机版的斯特鲁普任务对患者进行临床重新评估。同时记录ERP、准确性和RT。两组患者还额外接受了灌注单光子发射计算机断层扫描（SPECT）成像。
在与斯特鲁普相关的晚期正性电位的波幅方面，RT短和RT长的两组患者之间没有差异。RT较长的患者组在中央前回、顶叶区域、楔叶显示出明显的血流灌注过多，而在岛叶、额叶、颞叶和边缘（海马旁回和前扣带回）皮质以及小脑显示出血流灌注不足。
我们发现两组之间ERP没有差异，这表明尽管患者在以RT测量的精神运动迟缓方面可能存在差异，但他们的认知能力可能非常相似。然而，灌注SPECT成像显示出两组之间存在显著差异。这可能是由于两组在应对认知障碍时的补偿过程和应用不同策略所致。
