Depressive symptoms, antidepressant use, and brain volumes on MRI in a population-based cohort of old persons without dementia.
Depressive symptoms, antidepressant use, and brain volumes on MRI in a population-based cohort of old persons without dementia.
复制标题
DOI：
10.3233/jad-2012-112009
复制
发表时间：
2012
期刊：
影响因子：
--
通讯作者：
Small SA
中科院分区：
文献类型：
--
作者：
Geerlings MI;Brickman AM;Schupf N;Devanand DP;Luchsinger JA;Mayeux R;Small SA
在大型社区无痴呆老年人群中，研究晚年抑郁症（包括抑郁症状和抗抑郁药物的使用）是否与较小的总脑容量、较小的海马体积和较大的白质高信号体积相关。在华盛顿/汉密尔顿高地-因伍德哥伦比亚老龄化项目 (WHICAP) 中，一项位于曼哈顿北部的社区队列研究，对 630 名无痴呆症患者（平均年龄 80 岁，SD=5）进行了 1.5 特斯拉 MRI 下的全脑、海马体和白质高信号 (WMH) 的体积测量，以及当前抑郁症的数据，定义为在 10 项 CES-D 中得分为 4 或更高，或使用抗抑郁药。根据年龄、性别、种族、教育程度、心血管疾病史和 MRI 参数调整后的多元线性回归分析显示，当前患有抑郁症的受试者的相对总脑体积较小（B=-0.86%；95%CI -1.68 至 -0.05%；p<0.05），相对海马体积较小（B=-0.07 ml；95%CI -0.14 至 0.00 ml；p=0.05），相对较大WMH 体积（自然对数转换 B=0.19 ml；95%CI 0.02 至 0.35 ml；p<0.05）。单独检查时，抗抑郁药物的使用与较小的全脑、较小的海马和较大的 WMH 体积显着相关，而高 CES-D 评分与任何大脑测量指标均不显着相关，尽管相关方向与抗抑郁药物的使用相似。需要注意的是，分析是横断面的，而且我们没有对抑郁症进行正式诊断，我们的研究结果表明，在这个以社区为基础的无痴呆老年人样本中，晚年抑郁症与更多的脑萎缩和更多的白质病变有关，这主要是由抗抑郁药物的使用引起的。
To examine whether late-life depression, including depressive symptoms and antidepressant use, was associated with smaller total brain volume, smaller hippocampal volume, and larger white matter hyperintensity volume in a large community-based cohort of old persons without dementia. Within the Washington/Hamilton Height-Inwood Columbia Aging Project (WHICAP), a community-based cohort study in northern Manhattan, 630 persons without dementia (mean age 80 years, SD=5) had volumetric measures of the total brain, hippocampus, and white matter hyperintensities (WMH) at 1.5Tesla MRI and data on current depression, defined as a score of 4 or higher on the 10-item CES-D or use of antidepressants. Multiple linear regression analyses adjusted for age, sex, ethnicity, education, cardiovascular disease history, and MRI parameters showed that subjects with current depression had smaller relative total brain volume (B=−0.86%; 95%CI −1.68 to −0.05%; p<0.05), smaller relative hippocampal volume (B=−0.07 ml; 95%CI −0.14 to 0.00 ml; p=0.05), and larger relative WMH volume (natural logtransformed B=0.19 ml; 95%CI 0.02 to 0.35 ml; p<0.05). When examined separately, antidepressant use was significantly associated with smaller total brain, smaller hippocampal, and larger WMH volume, while high CES-D scores were not significantly associated with any of the brain measures, although the direction of association was similar as for antidepressant use. With the caveat that analyses were cross-sectional and we had no formal diagnosis of depression, our findings suggest that in this community-based sample of old persons without dementia, late-life depression is associated with more brain atrophy and more white matter lesions, which was mainly driven by antidepressant use.