Regional patterns of brain tissue loss associated with depression in Parkinson disease
Regional patterns of brain tissue loss associated with depression in Parkinson disease
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DOI：
10.1212/wnl.0b013e3181f11c1d
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发表时间：
2010-09-07
期刊：
影响因子：
9.9
通讯作者：
Filippi, M.
中科院分区：
文献类型：
--
作者：
Kostic, V. S.;Agosta, F.;Filippi, M.
目的：使用基于MRI和体素的形态计量学（VBM）研究，帕金森病（PD）患者（PD）的灰质（GM）和白质（WM）损失是否与抑郁症相关。方法：40例PD患者和26名健康受试者。使用DSM-IV标准被诊断出患有抑郁症的患者。汉密尔顿抑郁量表（HDRS）是针对患者的。使用统计参数映射（SPM5）实现的VBM评估了PD患者脑组织损失的地形分布（SPM5）。消除：二十四名PD患者被诊断为不抑郁症（PD-NDEP）和16个患有抑郁症（PD-DEP）。患者组在临床发现方面相似，除了HDRS评分（p <0.001）。与对照组相比，PD患者在右前扣带回（AC）皮层和岛状以及左侧额叶和角度GYRI中显示出常见的GM损失（P <0.001）。没有发现相对于健康对照组的PD-NDEP和PD-DEP患者常见的WM损失区域。 PD-DEP与PD-NDEP患者在右AC束和下眶额（OF）区域的WM损失（P <0.001）。在PD患者中，HDRS评分与区域右下的WM损失相关（r = -0.51，p <0.05）。结论：PD-DEP与PD-NDEP患者的皮质限体网络中几个WM区域的组织损失发生。这种大脑萎缩模式与主要抑郁症的关键区域重叠，这表明PD中这种神经回路的脆弱性增加。这可能部分解释了PD抑郁症的高患病率。神经病学（R）2010; 75：857-863
Objective: To investigate, using MRI and voxel-based morphometry (VBM), whether specific patterns of gray matter (GM) and white matter (WM) loss are associated with depression in patients with Parkinson disease (PD).Methods: Forty patients with PD and 26 healthy subjects were studied. Patients were diagnosed with depression using DSM-IV criteria. The Hamilton Depression Rating Scale (HDRS) was administered to patients. The topographic distribution of brain tissue loss in patients with PD and controls was assessed using VBM as implemented in Statistical Parametric Mapping (SPM5).Results: Twenty-four patients with PD were diagnosed as nondepressed (PD-NDep) and 16 as having depression (PD-Dep). Patient groups were similar in terms of clinical findings, except for the HDRS score (p < 0.001). Compared to controls, patients with PD showed common GM loss in the right anterior cingulate (AC) cortex and insula, and in the left middle frontal and angular gyri (p < 0.001). No regions of WM loss common to PD-NDep and PD-Dep patients relative to healthy controls were found. PD-Dep vs PD-NDep patients showed WM loss in the right AC bundle and inferior orbitofrontal (OF) region (p < 0.001). In patients with PD, HDRS score correlated with WM loss in the right inferior OF region (r = -0.51, p < 0.05).Conclusions: Tissue loss in several WM regions within the cortical-limbic network occurs in PD-Dep vs PD-NDep patients. Such pattern of brain atrophy overlaps with key regions involved in major depressive disorders, suggesting an increased vulnerability of this neural circuit in PD. This may partially account for the high prevalence of depression in PD. Neurology (R) 2010; 75: 857-863