Persistent depressive symptoms after acute coronary syndrome are associated with compromised white matter integrity in the anterior cingulate: a pilot study.
Persistent depressive symptoms after acute coronary syndrome are associated with compromised white matter integrity in the anterior cingulate: a pilot study.
复制标题
急性冠状动脉综合征后持续的抑郁症状与前扣带回白质完整性受损有关：一项初步研究。
DOI：
10.1159/000286959
复制
发表时间：
2010
影响因子：
22.8
通讯作者：
Davidson,KarinaW
中科院分区：
文献类型：
--
作者：
Rapp,MichaelA;Rieckmann,Nina;Lessman,DavidA;Tang,CheukY;Paulino,Robert;Burg,MatthewM;Davidson,KarinaW
背景：急性冠状动脉综合征（ACS）后持续性抑郁症状很常见，并增加心脏事件复发和死亡的风险。然而，ACS后抑郁症状的神经生物学相关性尚未studied.Methods：3个月后，ACS，22例患者进行了扫描的存在下，大脑深部白色物质的变化和微结构异常的前扣带皮层（ACC）和背外侧前额叶皮层。我们使用了深白色物质变化的Coffey等级量表和来自扩散张量成像的分数各向异性的测量。患者还完成了贝克抑郁量表，心血管并发症的数量以及可修改的心血管危险因素进行了assessed.Results：控制心血管并发症，抑郁症状的严重程度在3个月呈负相关的分数各向异性在ACC（r =-0.72，P < 0.001），但这种关联消失时，控制心血管危险因素（P = 0.21）。与住院后3个月无抑郁的患者（n = 14）相比，持续性抑郁症状的患者（n = 8）总体上表现出更晚期的深部白色物质变化（p < 0.02），但在控制心血管合并症时并非如此。持续性抑郁患者的ACC各向异性分数也较低（p < 0.05），但当控制了可改变的心血管危险因素后，这种效应消失了。结论：本研究首次提供了ACS后持续性抑郁症状与脑血管变化相关的证据。需要纵向研究来确定抑郁症状是否先于这些变化，反之亦然。
Background:Persistent depressive symptoms after acute coronary syndrome (ACS) are common and increase the risk of recurrent cardiac events and mortality. However, the neurobiological correlates of post-ACS depressive symptoms have not yet been studied.Methods:Three months after ACS, 22 patients were scanned for the presence of cerebral deep white matter changes and microstructural abnormalities in the anterior cingulate cortex (ACC) and dorsolateral prefrontal cortex. We used the Coffey Rating Scale of deep white matter changes and measures of fractional anisotropy derived from diffusion tensor imaging. Patients also completed the Beck Depression Inventory, and the number of cardiovascular comorbidities as well as modifiable cardiovascular risk factors were assessed.Results:Controlling for cardiovascular comorbidity, depressive symptom severity at 3 months was negatively related to fractional anisotropy in the ACC (r = –0.72, p < 0.001), but this association disappeared when controlling for cardiovascular risk factors (p = 0.21). In comparison to patients who were non-depressed at 3 months after hospitalization (n = 14), patients with persistent depressive symptoms (n = 8) exhibited more advanced deep white matter changes overall (p < 0.02), but not when controlling for cardiovascular comorbidity. Persistently depressed patients also had lower fractional anisotropy in the ACC (p < 0.05), but this effect disappeared when controlling for modifiable cardiovascular risk factors.Conclusions:This study provides the first evidence that persistent depressive symptoms after ACS are associated with vascular brain changes. Longitudinal studies are needed to determine whether depressive symptoms precede these changes or vice versa.