Structural Abnormality on Brain Magnetic Resonance Imaging in Late-Onset Major Depressive Disorder

本研究目的為以磁振攝影掃描比較晚發型重度憂鬱症患者的腦部結構異常，並評估這些結構異常與臨床變項的相關性。研究對象為37位診斷為晚發型重度憂鬱症與18位對照組的老人。所有研究參與者接受完整的精神科評估、腦部磁振攝影檢查。比較對照組，晚發型重度憂鬱症的老人有較嚴重的腦部萎縮(p=0.043)及白質高密度顯影的異常(p=0.024)，尤其位在腦室週邊的白質(p=0.012)。超過60%的病人有顯著的白質高密度顯影異常。這些白質高密度顯影的異常與發病年齡有正相關(r=0.49, P=0.002)。腦部萎縮與白質高密度顯影的異常在晚發型老年憂鬱症是普遍的。這兩種影像學上的異常可能代表憂鬱症不同的疾病機轉。高密度顯影的異常可能為晚發型重度憂鬱症的潛存因子(predisposing factors)。

關鍵字

老年；憂鬱症；磁振掃描攝影；腦部萎縮；高密度顯影

並列摘要

The purpose of this study was to examine the structural abnormalities of patients with late-onset major depressive disorder using brain magnetic resonance imaging (MRI) and to assess clinical correlates of these structural abnormalities. Thirty-seven elderly patients with DSM-IV major depressive disorder that first occurred after the age of 50 years, and 18 control subjects without depression were recruited. All participants underwent comprehensive psychiatric assessment and cerebral MRI. Brain ventricular and sulcal sizes and white matter hyperintensities were assessed visually. Relative to control subjects, patients with late-life major depressive disorder showed more severe brain atrophy (p=0.043) and white matter hyperintensities (p=0.024), especially in the periventricular area (p=0.012). Over 60% of the patient group had significant brain MRI hyperintensities. White matter hyperintensity was correlated with later onset of depressive illness (r=0.49, p=0.002) among patients. Brain atrophy and white matter hyperintensities are prevalent in patients with late-onset major depressive disorders. These two abnormalities may represent different pathophysiologic processes of depressive disorders. White matter hyperintensities may be predisposing factors for late-onset major depressive disorder.

並列關鍵字

aged ； depressive disorder ； MRI ； brain atrophy ； hyperintensities

國際替代計量

Structural Abnormality on Brain Magnetic Resonance Imaging in Late-Onset Major Depressive Disorder

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