Department of Neuroscience, Section of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy.
Nuclear Medicine Institute, University Department of Radiological and Hematological Sciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
J Affect Disord. 2024 Jul 15;357:107-115. doi: 10.1016/j.jad.2024.04.044. Epub 2024 Apr 16.
Dopaminergic transmission impairment has been identified as one of the main neurobiological correlates of both depression and clinical symptoms commonly associated with its spectrum such as anhedonia and psychomotor retardation.
We examined the relationship between dopaminergic deficit in the striatum, as measured by I-FP-CIT SPECT imaging, and specific psychopathological dimensions in patients with major depressive disorder.
To our knowledge this is the first study with a sample of >120 subjects. After check for inclusion and exclusion criteria, 121 (67 females, 54 males) patients were chosen retrospectively from an extensive 1106 patients database of 123I-FP-CIT SPECT scans obtained at the Nuclear Medicine Unit of Fondazione Policlinico Universitario Agostino Gemelli IRCCS in Rome. These individuals had undergone striatal dopamine transporter (DAT) assessments based on the recommendation of their referring clinicians, who were either neurologists or psychiatrists. At the time of SPECT imaging, each participant underwent psychiatric and psychometric evaluations. We used the following psychometric scales: Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Snaith Hamilton Pleasure Scale, and Depression Retardation Rating Scale.
We found a negative correlation between levels of depression (p = 0.007), anxiety (p = 0.035), anhedonia (p = 0.028) and psychomotor retardation (p = 0.014) and DAT availability in the left putamen. We further stratified the sample and found that DAT availability in the left putamen was lower in seriously depressed patients (p = 0.027) and in patients with significant psychomotor retardation (p = 0.048).
To our knowledge this is the first study to have such a high number of sample. Our study reveals a pivotal role of dopaminergic dysfunction in patients with major depressive disorder. Elevated levels of depression, anxiety, anhedonia, and psychomotor retardation appear to be associated with reduced DAT availability specifically in the left putamen.
多巴胺能传递损伤已被确定为抑郁症和与其相关的临床症状（如快感缺失和精神运动迟缓）的主要神经生物学相关因素之一。
我们检查了纹状体多巴胺能缺陷与重度抑郁症患者特定精神病理学维度之间的关系，这种缺陷是通过 I-FP-CIT SPECT 成像测量的。
据我们所知，这是第一项涉及>120 名受试者的样本的研究。在检查纳入和排除标准后，我们从罗马核医学单位 Fondazione Policlinico Universitario Agostino Gemelli IRCCS 的 123I-FP-CIT SPECT 扫描的 1106 名患者的广泛数据库中回顾性选择了 121 名（67 名女性，54 名男性）患者。这些个体根据他们的转诊临床医生（神经病学家或精神科医生）的建议接受了纹状体多巴胺转运体（DAT）评估。在 SPECT 成像时，每位参与者都接受了精神病学和心理测量评估。我们使用了以下心理测量量表：汉密尔顿抑郁评定量表、汉密尔顿焦虑评定量表、斯奈特汉密尔顿快感量表和抑郁迟缓评定量表。
我们发现抑郁水平（p=0.007）、焦虑水平（p=0.035）、快感缺失（p=0.028）和精神运动迟缓（p=0.014）与左侧壳核的 DAT 可用性呈负相关。我们进一步对样本进行分层，发现严重抑郁患者（p=0.027）和精神运动迟缓显著的患者（p=0.048）左侧壳核的 DAT 可用性较低。
据我们所知，这是第一项具有如此高样本量的研究。我们的研究揭示了多巴胺能功能障碍在重度抑郁症患者中的关键作用。抑郁、焦虑、快感缺失和精神运动迟缓水平升高似乎与左侧壳核的 DAT 可用性降低有关。
