Frontal Dysfunction Underlies Depression in Mild Cognitive Impairment: A FDG-PET Study
Frontal Dysfunction Underlies Depression in Mild Cognitive Impairment: A FDG-PET Study
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DOI：
10.4306/pi.2010.7.3.208
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发表时间：
2010-09-01
影响因子：
2.7
通讯作者：
Woo, Jong Inn
中科院分区：
文献类型：
--
作者：
Lee, Hye Sook;Choo, Il Han;Woo, Jong Inn
目的抑郁症是阿尔茨海默病(AD)的临床前阶段轻度认知功能障碍(MCI)患者和临床明显AD患者的常见症状。此外，有抑郁的MCI个体向临床AD的转化率高于无抑郁的个体。本研究旨在阐明抑郁症的功能神经解剖学基础。方法36例患者来自大学医院队列，其中18例为MCI伴抑郁(MCI_D)，其余18例为年龄和性别匹配的MCI无抑郁(MCI_ND)。作为对比，16名认知正常(CN)的老年人也被包括在内。所有受试者都接受了正电子发射断层扫描(FDG-PET)，并通过基于体素的方法比较了三组之间的局部脑葡萄糖代谢。结果MCI_D组右侧额上回的糖代谢低于MCI_ND组。在整体MCI受试者中，HRSD评分与同一额区的葡萄糖代谢呈显著负相关。与CN相比，MCI_D和MCI_ND均表现为楔前叶糖代谢降低，而MCI_D在其他弥漫性脑区域的代谢也降低。结论根据先前对AD抑郁的观察，我们的结果表明额区功能障碍是临床前AD和临床明显AD抑郁的基础。《精神病学研究》2010；7：208-214
Objective Depression is a very common symptom in people with mild cognitive impairment (MCI), a preclinical stage of Alzheimer's disease (AD), and in those with clinically evident AD. Moreover, MCI individuals with depression show a higher conversion rate to clinical AD than those without depression. This study aimed to elucidate the functional neuroanatomical substrate of depression in MCI.Methods Thirty-six patients were recruited from a University Hospital-based cohort; 18 of these subjects had MCI with depression (MCI_D); the remaining 18 subjects were age- and gender-matched, and had MCI with no depression (MCI_ND). For comparison, 16 cognitively normal (CN) elderly individuals were also included. All subjects underwent Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) scanning and regional cerebral glucose metabolism was compared among the three groups by a voxel-based method. The relationship between severity of depression, as measured by Hamilton Rating Scale for Depression (HRSD) scores, and glucose metabolism was also investigated.Results MCI_D showed lower glucose metabolism in the right superior frontal gyrus than MCI_ND. There was a significant negative correlation between HRSD score and glucose metabolism at the same frontal region for overall MCI subjects. When compared with CN, both MCI_D and MCI_ND showed decreased glucose metabolism in the precuneus, while MCI_D had, in addition, reduced metabolism in other diffuse brain regions.Conclusion Given previous observations on depression in AD, our results suggest that functional disruption of the frontal region, known to be associated with primary or other secondary depression, underlies depression in preclinical AD as well as clinically evident AD. Psychiatry Investig 2010;7:208-214