Intrinsic Functional Network Connectivity Is Associated With Clinical Symptoms and Cognition in Late-Life Depression.
Intrinsic Functional Network Connectivity Is Associated With Clinical Symptoms and Cognition in Late-Life Depression.
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DOI：
10.1016/j.bpsc.2018.09.003
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发表时间：
2019-03
期刊：
影响因子：
--
通讯作者：
Taylor WD
中科院分区：
文献类型：
--
作者：
Gandelman JA;Albert K;Boyd BD;Park JW;Riddle M;Woodward ND;Kang H;Landman BA;Taylor WD
晚年抑郁症 (LLD) 与内在功能网络的改变有关，最典型的是默认模式网络 (DMN)、认知控制网络 (CCN) 和显着网络 (SN)。然而，这些发现通常来自小样本，并且尚不清楚网络发现如何与临床和认知症状学相关。我们研究了 100 名老年人（n = 79 例 LLD，n = 21 例非抑郁症），并收集了静息态功能 MRI、抑郁症的临床测量以及认知测试的表现。我们为每个内在功能网络（DMN、CCN 和 SN）选择规范网络区域作为种子到体素分析的种子。我们比较了抑郁症组和非抑郁症组之间的连通性，并将抑郁症受试者的连通性与抑郁严重程度相关联。然后，我们研究了观察到的连通性发现是否与更严重的常见神经精神症状或较差的认知表现相关。 LLD 的特点是 DMN 与额极（CCN 区域）的连接性降低（Wald χ2=22.33，P<0.001）。 CCN 或 SN 的连通性没有发现显着的组间差异。然而，在 LLD 组中，CCN 连接性增加与抑郁严重程度增加 (Wald χ2>20.14，p<0.001)、更大的快感缺失 (Wald χ2=7.02，p=0.008) 和疲劳 (Wald χ2=6.31，p=0.012) 以及情景记忆测试中较差的表现相关 (Wald χ2>4.65， p<0.031), 执行功能 （Wald χ2=7.18，p=0.007）和工作记忆（Wald χ2>4.29，p<0.038）。 LLD 的特点是 DMN 连接性差异，而 CCN 连接性与 LLD 症状相关，包括在多个认知领域表现较差。
Late Life Depression (LLD) has been associated with alterations in intrinsic functional networks, best characterized in the Default Mode Network (DMN), the Cognitive Control Network (CCN), and the Salience Network (SN). However these findings often derive from small samples and it is not well understood how network findings relate to clinical and cognitive symptomatology. We studied 100 older adults (n=79 with LLD, n=21 nondepressed) and collected resting state functional MRI, clinical measures of depression, and performance on cognitive tests. We selected canonical network regions for each intrinsic functional network (DMN, CCN, and SN) as seeds in seed-to-voxel analysis. We compared connectivity between depressed and non-depressed groups and correlated connectivity with depression severity among depressed subjects. We then investigated whether the observed connectivity findings were associated with greater severity of common neuropsychiatric symptoms or poorer cognitive performance. LLD was characterized by decreased DMN connectivity to the frontal pole, a CCN region (Wald χ2=22.33, P<0.001). No significant group differences in connectivity were found for the CCN or SN. However, in the LLD group increased CCN connectivity was associated with increased depression severity (Wald χ2>20.14, p<0.001), greater anhedonia (Wald χ2=7.02, p=0.008) and fatigue (Wald χ2=6.31, p=0.012), and poorer performance on tests of episodic memory (Wald χ2>4.65, p<0.031), executive function (Wald χ2=7.18, p=0.007), and working memory (Wald χ2>4.29, p<0.038). LLD is characterized by differences in DMN connectivity, while CCN connectivity is associated with LLD symptomology, including poorer performance in several cognitive domains.
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