Mapping callosal morphology in early- and late-onset elderly depression: An index of distinct changes in cortical connectivity
Mapping callosal morphology in early- and late-onset elderly depression: An index of distinct changes in cortical connectivity
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DOI：
10.1038/sj.npp.1301538
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发表时间：
2008-06-01
影响因子：
7.6
通讯作者：
Toga, Arthur W.
中科院分区：
文献类型：
--
作者：
Ballmaier, Martina;Kumar, Anand;Toga, Arthur W.
有一些证据表明老年抑郁症存在胼胝体异常，但尚不清楚这些缺陷是否具有区域特异性或因抑郁症发病年龄而异。研究对象包括 24 名早发性抑郁症患者（平均年龄 = 68.00，SD +/- 75.83）、22 名晚发性抑郁症患者（平均年龄 = 74.50，SD +/- 78.09）和 34 名老年对照受试者（平均年龄 = 72.38；SD +/- 76.93）。使用 3D MRI 数据，应用新颖的基于网格的几何建模方法，以高空间分辨率比较各组之间胼胝体的中矢状厚度。在受试者子样本中还研究了正中矢状胼胝体区域差异的神经心理学相关性。与对照组相比，抑郁症患者的膝部和压部表现出明显的胼胝体变薄。早发性抑郁症患者的胼胝体显着变薄仅限于膝部，但与对照组相比，晚发性抑郁症患者的膝部和压部均表现出胼胝体显着变薄。与早发性抑郁症患者相比，晚发性抑郁症患者的胼胝体压部也明显变薄。膝部和压部中矢状面区域与晚发性抑郁症患者的记忆和注意力功能显着相关，但与早发性抑郁症患者或对照者无关。胼胝体形态的局限性结构改变可以区分老年人的晚发性抑郁症和早发性抑郁症。这些发现表明晚发和早发老年抑郁症的皮质连接存在明显异常，可能对病程产生影响。与早发性抑郁症患者相比，晚发性抑郁症患者的疾病进展和最终痴呆转化的风险可能更高，这对研究和治疗具有潜在的重要影响。
There is some evidence of corpus callosum abnormalities in elderly depression, but it is not known whether these deficits are region-specific or differ based on age at onset of depression. Twenty-four patients with early-onset depression (mean age = 68.00, SD +/- 75.83), 22 patients with late-onset depression (mean age = 74.50, SD +/- 78.09) and 34 elderly control subjects (mean age = 72.38; SD +/- 76.93) were studied. Using 3D MRI data, novel mesh-based geometrical modeling methods were applied to compare the midsagittal thickness of the corpus callosum at high spatial resolution between groups. Neuropsychological correlates of midsagittal callosal area differences were additionally investigated in a subsample of subjects. Depressed patients exhibited significant callosal thinning in the genu and splenium compared to controls. Significant callosal thinning was restricted to the genu in early-onset patients, but patients with late-onset depression exhibited significant callosal thinning in both the genu and splenium relative to controls. The splenium of the corpus callosum was also significantly thinner in subjects with late- vs early-onset depression. Genu and splenium midsagittal areas significantly correlated with memory and attention functioning among late- onset depressed patients, but not early-onset depressed patients or controls. Circumscribed structural alterations in callosal morphology may distinguish late- from early-onset depression in the elderly. These findings suggest distinct abnormalities of cortical connectivity in late- and early-onset elderly depression with possible influence on the course of illness. Patients with a late onset of depression may be at higher risk of illness progression and eventually dementia conversion than early-onset depression, with potentially important implications for research and therapy.