Altered functioning of the executive control circuit in late-life depression: episodic and persistent phenomena.
Altered functioning of the executive control circuit in late-life depression: episodic and persistent phenomena.
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DOI：
10.1097/jgp.0b013e31817b60af
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发表时间：
2009-01
影响因子：
7.2
通讯作者：
Carter, Cameron S.
中科院分区：
文献类型：
--
作者：
Aizenstein, Howard J.;Butters, Meryl A.;Wu, Minjie;Mazurkewicz, Laura M.;Stenger, V. Andrew;Gianaros, Peter J.;Becker, James T.;Reynolds, Cbarles F., III;Carter, Cameron S.
通过探测老年人执行控制回路的偶发性和持续性改变，表征晚年抑郁症（LLD）的功能神经解剖学。在参与者执行执行控制任务时收集与事件相关的fMRI数据。参与者是通过匹兹堡晚期情绪障碍干预研究中心的抑郁症治疗研究招募的，13名非抑郁症老年人和13名LLD患者进行比较。抑郁症患者在开始使用帕罗西汀之前和完成12周后接受影像学检查。在背外侧前额叶皮层（dLPFC: BA9和BA46双侧）和背前扣带皮层（dACC）评估区域fMRI活动。通过关联dLPFC和dACC的fMRI时间序列来评估功能连通性。抑郁和对照组的参与者都按照预期完成了任务，在高负荷和低负荷试验中，他们的反应延迟时间更长。反应-潜伏期负载-效应组间无差异。与行为数据的无效发现相比，治疗前，抑郁症患者dLPFC的活动减弱（BA46左，t(25)=1.9, p= 0.035）， dLPFC和dACC之间的功能连接减弱。治疗后右侧dLPFC （BA46, t(25)=2.17, p< 0.02）活性增加。这些结果支持LLD的发作性和持续性神经生物学成分模型。功能连接的改变，可能是由于额叶白质的血管损伤，似乎是持久的。此外，至少部分前额叶功能减退（在右侧dLPFC）似乎是急性抑郁症的发作性特征，是可以治疗的。
To characterize the functional neuroanatomy of late-life depression (LLD) by probing for both episodic and persistent alterations in the executive-control circuit of elderly adults. Event-related fMRI data were collected while participants performed an executive-control task. Participants were recruited through a depression-treatment study within the Pittsburgh Intervention Research Center for Late-Life Mood Disorders. 13 non-depressed elderly comparison participants and 13 LLD patients. The depressed patients underwent imaging before initiating and after completing 12 weeks of paroxetine. Regional fMRI activity was assessed in the dorsolateral prefrontal cortex (dLPFC: BA9 and BA46 bilaterally) and the dorsal anterior cingulate cortex (dACC). Functional connectivity was assessed by correlating the fMRI time-series in the dLPFC and dACC. Both depressed and comparison participants performed the task as expected, with greater response latency during high versus low-load trials. The response-latency load-effect did not differ between groups. In contrast to the null findings for behavioral data, pre-treatment, depressed patients showed diminished activity in the dLPFC (BA46 left, t(25)=1.9, p=.035) and diminished functional connectivity between the dLPFC and dACC. Moreover, right dLPFC (BA46 right, t(25)=2.17, p<.02) showed increased activity after treatment. These results support a model of both episodic and persistent neurobiologic components of LLD. The altered functional connectivity, perhaps due to vascular damage to frontal white matter, appears to be persistent. Further, at least some of the pre-frontal hypoactivity (in the right dLPFC) appears to be an episodic characteristic of acute depression amenable to treatment.