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首页> 外文期刊>The American journal of geriatric psychiatry: official journal of the American Association for Geriatric Psychiatry >The impact of subcortical white matter disease on mood in euthymic older adults: a diffusion tensor imaging study.
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The impact of subcortical white matter disease on mood in euthymic older adults: a diffusion tensor imaging study.

机译：皮层下白质病对正常人老年人情绪的影响：扩散张量成像研究。

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OBJECTIVES: Clinical depression in the elderly is associated with cerebral small vessel disease. It is less certain whether the endorsement of depressive symptoms in the absence of clinical depression, relatively common in euthymic older adults, is also associated with white matter damage. The majority of studies exploring this issue have produced mixed results, perhaps due, in part, to differences in defining the threshold for depression, notating vascular risk factors, and/or the neuroimaging tools used to quantify white matter damage. We aimed to address these issues with non-demented euthymic older adults. DESIGN AND PARTICIPANTS: We performed diffusion tensor imaging (DTI) and T2-weighted magnetic resonance imaging (MRI) in a population based cohort of 79 individuals (mean age = 68 years). MEASUREMENTS: In addition to neuroimaging, the authors report assessments of overall cognition, executive functioning, and depression. RESULTS: Scores on the Geriatric Depression Scale 15-item (GDS-15) correlated with DTI measures of mean diffusivity (r [77] = 0.23, p = 0.039) and fractional anisotropy (r [77] = -0.22, p = 0.045) but only approached significance for T2-weighted MRI measures of white matter hyperintensities (WMH; r [77] = 0.21, p = 0.053). After adjusting for factors known to influence the development of WMH and depression, including age and vascular risks, DTI-derived indices of white matter integrity remained significantly associated with GDS-15 scores. Furthermore, only DTI-derived measures of white matter integrity contributed to the variance in GDS-15 scores in logistical regression modeling. CONCLUSIONS: These findings demonstrate an association between white matter damage and the endorsement of depressive symptoms in euthymic older adults and suggest that DTI may be more sensitive to this damage than T2-WMH in an aging cohort with multiple vascular risk factors.
机译：目的：老年人临床抑郁症与脑小血管疾病有关。尚不确定在没有临床抑郁症的情况下对抑郁症状的认可是否与白质损害相关联，而抑郁症在正常的老年人中相对普遍。探索该问题的大多数研究产生了不同的结果，可能部分是由于在定义抑郁阈值，指出血管危险因素和/或用于定量白质损害的神经影像工具方面存在差异。我们的目标是与非痴呆的正常人一样解决这些问题。设计和参与者：我们在79名个体（平均年龄= 68岁）的人群中进行了扩散张量成像（DTI）和T2加权磁共振成像（MRI）。测量：除神经影像学外，作者报告了对整体认知，执行功能和抑郁的评估。结果：老年抑郁量表15个项目（GDS-15）的得分与DTI测量的平均扩散率（r [77] = 0.23，p = 0.039）和分数各向异性（r [77] = -0.22，p = 0.045）相关），但仅对T2加权MRI对白质高信号的测量具有重要意义（WMH; r [77] = 0.21，p = 0.053）。在调整了已知的影响WMH和抑郁症发展的因素（包括年龄和血管风险）后，DTI衍生的白质完整性指数仍然与GDS-15得分显着相关。此外，在逻辑回归建模中，仅DTI衍生的白质完整性度量值有助于GDS-15得分的差异。结论：这些发现表明，在正常人中，白质损害与抑郁症状的认可之间存在关联，并表明在具有多种血管危险因素的衰老队列中，DTI比T2-WMH对这种损害更敏感。

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