Center for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology, University of Bari 'Aldo Moro', "Pia Fondazione Cardinale G. Panico", Lecce, Italy.
Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari 'Aldo Moro', Bari, Italy.
Ann Clin Transl Neurol. 2023 Oct;10(10):1704-1713. doi: 10.1002/acn3.51860. Epub 2023 Jul 31.
Depressive symptoms are frequently reported in patients affected by frontotemporal dementia (FTD). At structural MRI, cortical features of depressed FTD patients have been poorly described. Our objective was to investigate correlations between cortical measures and depression severity in FTD patients.
Data were obtained from the Frontotemporal Lobar Degeneration Neuroimaging Initiative (FTLDNI) database. We included 98 controls and 92 FTD patients, n = 38 behavioral variant FTD (bvFTD), n = 26 non-fluent variant Primary Progressive Aphasia (nfvPPA), and n = 28 semantic variant Primary Progressive Aphasia (svPPA). Patients underwent clinical and cognitive evaluations, as well as a 3D T1-weighted MRI on a 3 Tesla scanner (Siemens, Trio Tim system). Depression was evaluated by means of Geriatric Depression Scale (GDS). Surface-based analysis was performed on T1-weighted images to evaluate cortical thickness, a measure of gray matter integrity, and local gyrification index (lGI), a quantitative metric of cortical folding.
Patients affected by svPPA were more depressed than controls at NPI and depression severity at GDS was higher in svPPA and bvFTD. Severity of depression correlated with a decrease in lGI in left precentral and superior frontal gyrus, supramarginal and postcentral gyrus and right precentral, supramarginal, superior parietal and superior frontal gyri. Furthermore, depression severity correlated positively with cortical thickness in the left medial orbitofrontal cortex.
We found that lGI was associated with depressive symptoms over brain regions involved in the pathophysiology of major depressive disorder. This finding provides novel insights into the mechanisms underlying psychiatric symptoms in FTD.
抑郁症状在额颞叶痴呆（FTD）患者中经常被报告。在结构 MRI 中，抑郁 FTD 患者的皮质特征描述较差。我们的目的是研究 FTD 患者皮质测量值与抑郁严重程度之间的相关性。
数据来自额颞叶变性神经影像学倡议（FTLDNI）数据库。我们纳入了 98 名对照和 92 名 FTD 患者，n=38 例行为变异型额颞叶痴呆（bvFTD），n=26 例非流利型原发性进行性失语（nfvPPA），n=28 例语义变异型原发性进行性失语（svPPA）。患者接受了临床和认知评估，以及 3 特斯拉扫描仪（西门子，Trio Tim 系统）上的 3D T1 加权 MRI。使用老年抑郁量表（GDS）评估抑郁。在 T1 加权图像上进行基于表面的分析，以评估皮质厚度，这是衡量灰质完整性的指标，以及局部脑回指数（lGI），这是衡量皮质折叠的定量指标。
svPPA 患者在 NPI 中比对照组更抑郁，在 GDS 中抑郁严重程度在 svPPA 和 bvFTD 中更高。抑郁严重程度与左侧中央前回和额上回、缘上回和中央后回以及右侧中央前回、缘上回、顶上回和额上回的 lGI 减少相关。此外，抑郁严重程度与左侧内侧眶额皮质的皮质厚度呈正相关。
我们发现 lGI 与涉及重性抑郁障碍病理生理学的大脑区域的抑郁症状相关。这一发现为 FTD 中精神症状的潜在机制提供了新的见解。
