GERIATRIC DEPRESSION

老年抑郁症

• 批准号: 7378783
• 负责人: John T Little
• 金额: $ 0.03万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-12-01 至 2006-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7378783
• 关键词: GERIATRIC; DEPRESSION

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Among the aged, major depression is a common problem which causes significant morbidity and mortality. While effective treatments exist for major depression in the elderly, the speed, extent, and permanence of treatment response are unpredictable and vary widely, thus leaving considerable residual symptoms and disability. As functional neuroimaging with positron emission tomography (PET) allows for the direct examination of the structure and functioning of the brain, this represents a promising approach to investigate the underlying mechanisms of treatment response variability. In studies with mid-life affective disorder patients, functional neuroimaging is beginning to help clarify the neuroanatomical correlates and circuitry of major depression and treatment response (Drevets 1998, Kennedy et al. 1997, and Mayberg et al. 1997). Among elderly patients, however, the increased risk of medical, cerebrovascular and dementing illnesses, and the pharmacokinetic differences associated with aging challenge the generalizability of these early and mid-life studies to late-life. The relationship between regional cerebral glucose metabolism as measured by 18F-fluorodeoxyglucose (FDG) PET and treatment response variability with paroxetine in elderly depressed patients is being examined. It is hypothesized that in elderly patients (age 60-80) with major depression, pre-treatment anterior cingulate hypermetabolism on glucose PET scans will positively correlate with extent, speed, and permanence of treatment response to the antidepressant paroxetine. An expansion of the K23 project is proposed by examining paroxetine exposure and its relation to clinical response and side effects and to perform repeat FDG PET scans on age-matched normal controls at the same time intervals as the depressed patients in the K23 project (baseline and 11 weeks). Specific aims are: (1) Determine the role of medication compliance and paroxetine exposure in contributing to treatment response variability. (2) Examine the frequency of hyponatremia in relation to antidepressant therapy and medical comorbidity in these elderly depressed patients. (3) Determine in elderly normal controls whether there are retest effects of the FDG PET procedure on regional cerebral metabolism after 11 we

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子弹和调查员（PI）可能已经从其他NIH来源获得了主要资金，因此可以在其他清晰的条目中代表。列出的机构适用于该中心，这不一定是调查员的机构。在老年人中，重度抑郁症是一个常见的问题，会导致明显的发病率和死亡率。尽管对老年人的严重抑郁症存在有效的治疗方法，但治疗反应的速度，程度和持久性是不可预测的，并且差异很大，因此留下了相当大的残留症状和残疾。由于具有正电子发射断层扫描（PET）的功能性神经影像允许直接检查大脑的结构和功能，因此这代表了研究治疗响应变异性的潜在机制的一种有希望的方法。在对中年情感障碍患者的研究中，功能性神经影像学开始有助于阐明重度抑郁症和治疗反应的神经解剖学相关性和回路（Drevets 1998，Kennedy等人，1997年，Mayberg等人1997）。然而，在老年患者中，医学，脑血管和痴呆疾病的风险增加，以及与衰老有关的药代动力学差异挑战这些早期和中期研究对后期生活的普遍性。正在研究正在研究通过18F-氟脱氧葡萄糖（FDG）PET和帕罗西汀在老年人抑郁症患者中测得的区域脑葡萄糖代谢之间的关系。假设在老年患者（60-80岁）中，对葡萄糖PET扫描的前扣带回前扣带回过度代谢将与程度，速度和对抗抑郁药parosoxetine的治疗反应的永久性正相关。 提出了K23项目的扩展，通过检查帕罗西汀的暴露及其与临床反应和副作用的关系，并在年龄匹配的正常对照组上与K23项目中的抑郁症患者（基线和11周）进行重复的FDG PET扫描。具体目的是：（1）确定药物合规性和帕罗西汀暴露在导致治疗反应变异性方面的作用。 （2）检查这些老年抑郁症患者的低钠血症与抗抑郁治疗和医疗合并症有关的频率。 （3）确定老年正常对照中FDG PET手术是否对11之后的区域脑代谢有重新测试作用