Depressive symptoms accelerate cognitive decline in amyloid-positive MCI patients.
Depressive symptoms accelerate cognitive decline in amyloid-positive MCI patients.
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DOI：
10.1007/s00259-014-2975-4
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发表时间：
2015-04
影响因子：
9.1
通讯作者：
Alzheimer’s Disease Neuroimaging Initiative
中科院分区：
文献类型：
--
作者：
Brendel M;Pogarell O;Xiong G;Delker A;Bartenstein P;Rominger A;Alzheimer’s Disease Neuroimaging Initiative
晚年抑郁症（LLD），即使在亚综合征阶段显示与阿尔茨海默病（AD）的强关联。此外，脑淀粉样变性描绘了随后患有AD的受试者的早期生物标志物，并且可以通过淀粉样蛋白PET敏感地检测到。因此，我们的目的是比较淀粉样蛋白负荷和葡萄糖代谢的亚综合征抑郁症轻度认知功能障碍（MCI）的受试者。来自ADNI的371例MCI受试者接受了[18 F]-AV45-、[18 F]-FDG-PET和MRI。根据[18 F]-AV45-PET，受试者被判定为β-淀粉样蛋白阳性（Δ β（+）; N = 206）或阴性（Δ β（-）; N = 165）。抑郁症状采用神经精神问卷（NPI-Q）抑郁项目进行评定。65名Ablation（+）和41名Ablation（-）抑郁症状（DEP）受试者与非抑郁（NON-DEP）受试者进行了对比。分析了AD的转化率（平均随访时间：21.5 ± 9.1个月），包括共存的抑郁症状和脑淀粉样蛋白负荷。与NON-DEP相比，AEP（+）DEP受试者在额颞叶和岛叶皮质中表现出较大的簇状体，淀粉样蛋白负荷较高（p <0.001），同时在额叶皮质中表现出高代谢（p <0.001）。在有抑郁症状（p <0.005）或Ablation（+）状态（p <0.001）的受试者中观察到更快进展为AD。同时出现的抑郁症状还缩短了所有Ablation（+）受试者的转换时间（p <0.005），在高淀粉样蛋白负荷的亚组中更大程度上（p <0.001）。我们的研究结果清楚地表明，与认知匹配的非抑郁个体相比，患有抑郁症状的AZN（+）MCI受试者患有淀粉样蛋白负荷升高，并伴有相关脑区的相对高代谢。高淀粉样蛋白负荷和抑郁症状并存的MCI受试者是更快转化为AD的高危人群。
Late-life depression (LLD) even in subsyndromal stages revealed strong associations with Alzheimer’s disease (AD). Furthermore brain amyloidosis depicts an early biomarker in subjects subsequently suffering from AD and is sensitively detectable by amyloid-PET. Therefore we aimed to compare amyloid-load and glucose metabolism in subsyndromally depressed mild cognitive impaired (MCI) subjects. 371 MCI subjects from ADNI underwent [18F]-AV45-, [18F]-FDG-PET, and MRI. Subjects were judged β-amyloid positive (Aß(+); N=206) or negative (Aß(−); N=165) according to [18F]-AV45-PET. Depressive symptoms were assessed by the Neuropsychiatric Inventory Questionnaire (NPI-Q) depression-item. 65 Aß(+) and 41 Aß(−) subjects with depressive symptoms (DEP) were contrasted against their non-depressed (NON-DEP) counterparts. Conversion rates to AD were analysed (mean follow-up time: 21.5±9.1 months) with regard to coexisting depressive symptoms and brain amyloid-load. Aß(+) DEP subjects showed large clusters with higher amyloid-load in frontotemporal and insular cortices (p<0.001) and coincident hypermetabolism (p<0.001) in frontal cortices when contrasted against NON-DEP. Faster progression to AD was observed in subjects with either depressive symptoms (p<0.005) or Aß(+) status (p<0.001). Coincident depressive symptoms additionally shortened the conversion time in all Aß(+) subjects (p<0.005) and to a greater extent in a subgroup with high amyloid-load (p<0.001). Our results clearly indicate that Aß(+) MCI subjects with depressive symptoms suffer from elevated amyloid-load combined with relative hypermetabolism of connected brain areas when contrasted against cognitively-matched non-depressed individuals. MCI subjects with high amyloid-load and coexistent depressive symptoms represent a high-risk group for faster conversion to AD.
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影响因子：
2.1
作者：
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通讯作者：
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影响因子：
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FROST, JJ