Brain grey matter volume alterations in late-life depression
Brain grey matter volume alterations in late-life depression
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DOI：
10.1503/jpn.130275
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发表时间：
2014-11-01
影响因子：
4.3
通讯作者：
Gong, Qiyong
中科院分区：
文献类型：
--
作者：
Du, Mingying;Liu, Jia;Gong, Qiyong
背景资料：基于体素的形态测量学（VBM）研究表明，灰质异常参与了晚年抑郁症（LLD）的病理生理学，但研究结果不一致，尚未进行定量审查。本研究的目的是进行一项荟萃分析，整合报告的VBM研究，以确定一致的灰质改变与LLD的个人。方法：进行系统检索，以确定比较LLD患者和健康对照的VBM研究。我们进行了一项荟萃分析，使用效应量符号差分映射法定量估计LLD患者的区域灰质异常。结果：在我们的荟萃分析中，我们纳入了9项研究，11个数据集，包括292例LLD患者和278例健康对照。汇总和亚组荟萃分析显示，右侧豆状核的灰质明显减少，延伸至海马旁、海马和杏仁核、双侧内侧额回和右侧胼胝体下回，右侧舌回的灰质增加。荟萃回归分析显示，平均年龄和女性患者的比例与LLD的灰质变化没有显着相关。局限性：所纳入研究的分析技术、患者特征和临床变量是异质性的，大多数参与者接受了药物治疗。结论：目前的荟萃分析是，据我们所知，第一次克服以前的不一致的VBM研究LLD，并提供了有力的证据，灰质改变额-纹状体-边缘系统网络，从而暗示他们在LLD的病理生理。平均年龄和女性LLD患者的百分比似乎对灰质变化没有可测量的影响，尽管我们不能排除药物的贡献作用。
Background: Voxel-based morphometry (VBM) studies have demonstrated that grey matter abnormalities are involved in the pathophysiology of late-life depression (LLD), but the findings are inconsistent and have not been quantitatively reviewed. The aim of the present study was to conduct a meta-analysis that integrated the reported VBM studies, to determine consistent grey matter alterations in individuals with LLD. Methods: A systematic search was conducted to identify VBM studies that compared patients with LLD and healthy controls. We performed a meta-analysis using the effect size signed differential mapping method to quantitatively estimate regional grey matter abnormalities in patients with LLD. Results: We included 9 studies with 11 data sets comprising 292 patients with LLD and 278 healthy controls in our meta-analysis. The pooled and subgroup meta-analyses showed robust grey matter reductions in the right lentiform nucleus extending into the parahippocampus, the hippocampus and the amygdala, the bilateral medial frontal gyrus and the right subcallosal gyrus as well as a grey matter increase in the right lingual gyrus. Meta-regression analyses showed that mean age and the percentage of female patients with LLD were not significantly related to grey matter changes. Limitations: The analysis techniques, patient characteristics and clinical variables of the studies included were heterogeneous, and most participants were medicated. Conclusion: The present meta-analysis is, to our knowledge, the first to overcome previous inconsistencies in the VBM studies of LLD and provide robust evidence for grey matter alterations within fronto-striatal-limbic networks, thereby implicating them in the pathophysiology of LLD. The mean age and the percentage of female patients with LLD did not appear to have a measurable impact on grey matter changes, although we cannot rule out the contributory effects of medication.