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多基因风险评分分析对老年期抑郁症抗抑郁反应的影响,IRL-GRey 研究结果。

Polygenic score analyses on antidepressant response in late-life depression, results from the IRL-GRey study.

机构信息

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

Columbia University Irving Medical Center, New York, NY, USA.

出版信息

Pharmacogenomics J. 2024 Nov 22;24(6):38. doi: 10.1038/s41397-024-00351-0.

Abstract

Late-life depression (LLD) is often accompanied by medical comorbidities such as psychiatric disorders and cardiovascular diseases, posing challenges to antidepressant treatment. Recent studies highlighted significant associations between treatment-resistant depression (TRD) and polygenic risk score (PRS) for attention deficit hyperactivity disorder (ADHD) in adults as well as a negative association between antidepressant symptom improvement with both schizophrenia and bipolar. Here, we sought to validate these findings with symptom remission in LLD. We analyzed the Incomplete Response in Late Life Depression: Getting to Remission (IRL-GRey) sample consisting of adults aged 60+ with major depression (N = 342) treated with venlafaxine for 12 weeks. We constructed PRSs for ADHD, depression, schizophrenia, bipolar disorder, neuroticism, general intelligence, antidepressant symptom remission and antidepressant percentage symptom improvement using summary statistics from the Psychiatric Genomics Consortium and the GWAS Catalog. Logistic regression was used to test the association of PRSs with venlafaxine symptom remission and percentage symptom improvement, co-varying for the genomic principal components, age, sex and depressive symptoms severity at baseline. We found a nominal (i.e., p value ≤ 0.05) association between symptom remission and both PRS for ADHD and (OR = 1.36 [1.07, 1.73], p = 0.011) and PRS for bipolar disorder (OR = 0.75 [0.58, 0.97], p = 0.031), as well as between percentage symptom improvement and PRS for general intelligence (beta = 6.81 (SE = 3.122), p = 0.03). However, the ADHD association was in the opposite direction as expected, and both associations did not survive multiple testing corrections. Altogether, these findings suggest that previous findings regarding ADHD PRS and antidepressant response (measured with various outcomes) do not replicate in older adults.

摘要

老年期抑郁症(LLD)常伴有精神障碍和心血管疾病等医学合并症,给抗抑郁治疗带来挑战。最近的研究强调了成年人群中治疗抵抗性抑郁症(TRD)与注意缺陷多动障碍(ADHD)多基因风险评分(PRS)之间的显著关联,以及抗抑郁症状改善与精神分裂症和双相情感障碍之间的负相关。在这里,我们试图用 LLD 的症状缓解来验证这些发现。我们分析了由年龄在 60 岁及以上的患有重度抑郁症的成年人组成的未完全缓解的老年期抑郁症:达到缓解(IRL-GRey)样本(N=342),这些成年人接受了文拉法辛治疗 12 周。我们使用精神病学基因组学联盟和 GWAS 目录中的汇总统计数据,为 ADHD、抑郁症、精神分裂症、双相情感障碍、神经质、一般智力、抗抑郁症状缓解和抗抑郁症状改善百分比构建了 PRS。逻辑回归用于测试 PRS 与文拉法辛症状缓解和症状改善百分比的关联,同时对基因组主要成分、年龄、性别和基线时的抑郁症状严重程度进行了协方差分析。我们发现,症状缓解与 ADHD PRS 呈显著相关(OR=1.36[1.07, 1.73],p=0.011)和双相情感障碍 PRS 呈显著相关(OR=0.75[0.58, 0.97],p=0.031),而症状改善百分比与一般智力 PRS 呈显著相关(β=6.81[3.122],p=0.03)。然而,ADHD 的关联与预期的相反,并且这两个关联都没有通过多重检验校正。总的来说,这些发现表明,先前关于 ADHD PRS 和抗抑郁反应(用各种结果测量)的发现在老年人中不能重复。

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