School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands; and Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, the Netherlands.
Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands.
Br J Psychiatry. 2024 Feb;224(2):66-73. doi: 10.1192/bjp.2023.143.
Late-life depression has been associated with volume changes of the hippocampus. However, little is known about its association with specific hippocampal subfields over time.
We investigated whether hippocampal subfield volumes were associated with prevalence, course and incidence of depressive symptoms.
We extracted 12 hippocampal subfield volumes per hemisphere with FreeSurfer v6.0 using -weighted and fluid-attenuated inversion recovery 3T magnetic resonance images. Depressive symptoms were assessed at baseline and annually over 7 years of follow-up (9-item Patient Health Questionnaire). We used negative binominal, logistic, and Cox regression analyses, corrected for multiple comparisons, and adjusted for demographic, cardiovascular and lifestyle factors.
A total of = 4174 participants were included (mean age 60.0 years, s.d. = 8.6, 51.8% female). Larger right hippocampal fissure volume was associated with prevalent depressive symptoms (odds ratio (OR) = 1.26, 95% CI 1.08-1.48). Larger bilateral hippocampal fissure (OR = 1.37-1.40, 95% CI 1.14-1.71), larger right molecular layer (OR = 1.51, 95% CI 1.14-2.00) and smaller right cornu ammonis (CA)3 volumes (OR = 0.61, 95% CI 0.48-0.79) were associated with prevalent depressive symptoms with a chronic course. No associations of hippocampal subfield volumes with incident depressive symptoms were found. Yet, lower left hippocampal amygdala transition area (HATA) volume was associated with incident depressive symptoms with chronic course (hazard ratio = 0.70, 95% CI 0.55-0.89).
Differences in hippocampal fissure, molecular layer and CA volumes might co-occur or follow the onset of depressive symptoms, in particular with a chronic course. Smaller HATA was associated with an increased risk of incident (chronic) depression. Our results could capture a biological foundation for the development of chronic depressive symptoms, and stresses the need to discriminate subtypes of depression to unravel its biological underpinnings.
老年期抑郁症与海马体体积变化有关。然而，关于其与特定海马亚区随时间的关联，我们知之甚少。
我们研究了海马亚区体积是否与抑郁症状的患病率、病程和发生率有关。
我们使用 FreeSurfer v6.0 从加权和液体衰减反转恢复 3T 磁共振图像中提取每个半球的 12 个海马亚区体积。使用 9 项患者健康问卷（PHQ-9）在基线和 7 年的随访中每年评估抑郁症状。我们使用负二项式、逻辑和 Cox 回归分析，校正多重比较，并调整人口统计学、心血管和生活方式因素。
共纳入 = 4174 名参与者（平均年龄 60.0 岁，标准差 8.6，51.8%为女性）。右侧海马裂体积越大，与现患抑郁症状相关（比值比（OR）=1.26，95%置信区间 1.08-1.48）。双侧海马裂（OR=1.37-1.40，95%置信区间 1.14-1.71）、右侧分子层（OR=1.51，95%置信区间 1.14-2.00）和右侧角回（CA）3 体积越小（OR=0.61，95%置信区间 0.48-0.79）与现患抑郁症状且病程慢性有关。未发现海马亚区体积与新发抑郁症状相关。然而，左侧海马杏仁核过渡区（HATA）体积较小与慢性病程的新发抑郁症状相关（风险比=0.70，95%置信区间 0.55-0.89）。
海马裂、分子层和 CA 体积的差异可能同时发生或随着抑郁症状的出现而出现，特别是病程慢性。较小的 HATA 与新发（慢性）抑郁的风险增加有关。我们的研究结果可能为慢性抑郁症状的发展提供生物学基础，并强调需要区分抑郁症状的亚型，以揭示其生物学基础。
