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基于θ-γ 耦合的认知功能与伴有或不伴有重度抑郁症的轻度认知障碍老年人的临床诊断比较。

Cognitive function based on theta-gamma coupling vs. clinical diagnosis in older adults with mild cognitive impairment with or without major depressive disorder.

机构信息

Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.

Adult Neurodevelopment and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, ON, Canada.

出版信息

Transl Psychiatry. 2024 Mar 19;14(1):153. doi: 10.1038/s41398-024-02856-5.

Abstract

Whether individuals with mild cognitive impairment (MCI) and a history of major depressive disorder (MDD) are at a higher risk for cognitive decline than those with MCI alone is still not clear. Previous work suggests that a reduction in prefrontal cortical theta phase-gamma amplitude coupling (TGC) is an early marker of cognitive impairment. This study aimed to determine whether using a TGC cutoff is better at separating individuals with MCI or MCI with remitted MDD (MCI+rMDD) on cognitive performance than their clinical diagnosis. Our hypothesis was that global cognition would differ more between TGC-based groups than diagnostic groups. We analyzed data from 128 MCI (mean age: 71.8, SD: 7.3) and 85 MCI+rMDD (mean age: 70.9, SD: 4.7) participants. Participants completed a comprehensive neuropsychological battery; TGC was measured during the N-back task. An optimal TGC cutoff was determined during the performance of the 2-back. This TGC cutoff was used to classify participants into low vs. high-TGC groups. We then compared Cohen's d of the difference in global cognition between the high and low TGC groups to Cohen's d between the MCI and MCI+rMDD groups. We used bootstrapping to determine 95% confidence intervals for Cohen's d values using the whole sample. As hypothesized, Cohen's d for the difference in global cognition between the TGC groups was larger (0.64 [0.32, 0.88]) than between the diagnostic groups (0.10 [0.004, 0.37]) with a difference between these two Cohen's d's of 0.54 [0.10, 0.80]. Our findings suggest that TGC is a useful marker to identify individuals at high risk for cognitive decline, beyond clinical diagnosis. This could be due to TGC being a sensitive marker of prefrontal cortical dysfunction that would lead to an accelerated cognitive decline.

摘要

患有轻度认知障碍(MCI)且有重度抑郁症(MDD)病史的个体是否比单纯患有 MCI 的个体更容易出现认知能力下降仍不清楚。之前的研究表明,前额叶皮质θ相-γ振幅耦合(TGC)的减少是认知障碍的早期标志物。本研究旨在确定使用 TGC 截止值是否比临床诊断更能区分 MCI 患者或缓解期 MDD 伴 MCI(MCI+rMDD)患者的认知表现。我们的假设是,基于 TGC 的组之间的总体认知差异将大于诊断组之间的差异。我们分析了 128 名 MCI(平均年龄:71.8,标准差:7.3)和 85 名 MCI+rMDD(平均年龄:70.9,标准差:4.7)参与者的数据。参与者完成了全面的神经心理学测试;TGC 在 N-back 任务中进行测量。在执行 2-back 任务期间确定了最佳 TGC 截止值。该 TGC 截止值用于将参与者分为低 TGC 组和高 TGC 组。然后,我们比较了高 TGC 组和低 TGC 组之间的整体认知差异的 Cohen's d 值与 MCI 组和 MCI+rMDD 组之间的 Cohen's d 值。我们使用引导法确定了整个样本中 Cohen's d 值的 95%置信区间。正如假设的那样,TGC 组之间的整体认知差异的 Cohen's d 值(0.64 [0.32,0.88])大于诊断组之间的 Cohen's d 值(0.10 [0.004,0.37]),两者之间的 Cohen's d 值差异为 0.54 [0.10,0.80]。我们的研究结果表明,TGC 是一种有用的标志物,可以识别认知能力下降风险较高的个体,超出了临床诊断。这可能是因为 TGC 是前额叶皮质功能障碍的敏感标志物,会导致认知能力加速下降。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff2e/10951346/10b8c26f64cb/41398_2024_2856_Fig1_HTML.jpg

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