Executive function deficits in patients with the first episode of late-life depression before and after SSRI treatment: A pilot fMRI study

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY International Journal of Geriatric Psychiatry Pub Date : 2024-04-30 DOI:10.1002/gps.6095

Chaomeng Liu, Li Li, Weigang Pan, Peixian Mao, Li Ren, Bing Li, Xin Ma

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Abstract

Background

Executive function deficits (EFD) in late-life depression (LLD) has been reported to be associated with antidepressant treatment resistance, increased disability, and poor quality of life. However, the underlying neutral mechanisms of EFD in patients with the first episode of LLD remains unclear.

Methods

A total of 27 patients with first-episode, drug-naive LLD and 27 non-depressed controls (NC) were recruited for the present research. Participants underwent the Trail Making Test, the 17-item Hamilton depression rating scale (HAMD-17) test, and task-state functional magnetic resonance imaging scans under the neutral Stroop task. LLD patients' executive functions, depressive symptoms, and brain activity were examined again after 6 months of antidepressant treatment.

Results

Of the 27 LLD patients, 16 cases completed 6-month follow-ups. Patients in the LLD baseline group spent more time on the Trail Making Test A test than those in the NC group (p < 0.05). In the presence of an incongruency between the word color and meaning, the accuracy rate of the neutral Stroop task in the LLD baseline group was lower, and the reaction time was greater than that in the NC group, with statistically significant difference (p < 0.05). The HAMD-17 score in the LLD follow-up group was significantly lower than that in the LLD baseline group (p < 0.05). More activated brain regions were present in the LLD baseline group than in the NC group when performing the neutral Stroop task. Compared with the LLD baseline group, abnormal activation of relevant brains in the cingulate-prefrontal-parietal network of LLD patients still existed in the LLD follow-up group.

Conclusions

LLD patients engaged more brain areas than the NC group while performing the neutral Stroop task. Abnormal activation of the cingulate-prefrontal-parietal network could be a contributing factor to EFD in LLD.

Trial registration

ChiCTR, ChiCTR2100042370 (Date of registration: 21/01/2021).

Limits

We didn't enroll enough first-episode, LLD patients, the robustness of the findings need to be confirmed by large sample clinical trials.

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首次发作的晚期抑郁症患者在接受 SSRI 治疗前后的执行功能障碍：fMRI 试验研究

背景据报道，晚期抑郁症（LLD）患者的执行功能障碍（EFD）与抗抑郁治疗抵抗、残疾增加和生活质量低下有关。然而，首次发病的晚期抑郁症患者的EFD的潜在中性机制仍不清楚。方法本研究共招募了27名首次发病、未服药的LLD患者和27名非抑郁对照组（NC）。研究人员对患者进行了 "追踪测试"（Trail Making Test）、17项汉密尔顿抑郁评分量表（HAMD-17）测试以及中性Stroop任务下的任务态功能磁共振成像扫描。经过6个月的抗抑郁治疗后，再次对LLD患者的执行功能、抑郁症状和大脑活动进行检查。结果在27名LLD患者中，有16人完成了6个月的随访。与NC组相比，LLD基线组患者花在 "路径制作测试A "上的时间更长（p <0.05）。在词色与词义不一致的情况下，LLD基线组患者中性Stroop任务的正确率低于NC组，反应时间长于NC组，差异有统计学意义（p <0.05）。LLD 随访组的 HAMD-17 评分明显低于 LLD 基线组（p < 0.05）。在执行中性 Stroop 任务时，LLD 基线组比 NC 组有更多激活的脑区。与 LLD 基线组相比，LLD 随访组中 LLD 患者扣带回-前额叶-顶叶网络中的相关脑区仍存在异常激活。结论 LLD患者在执行中性Stroop任务时比NC组调动了更多的脑区。扣带回-前额叶-顶叶网络的异常激活可能是导致LLD患者EFD的一个因素。试验注册号：ChiCTR，ChiCTR2100042370（注册日期：2021年1月21日）。局限性我们没有招募足够的首次发病的LLD患者，研究结果的稳健性需要通过大样本临床试验来证实。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Geriatric Psychiatry 医学-精神病学

CiteScore

6.10

自引率

2.50%

发文量

168

审稿时长

4-8 weeks

期刊介绍： The rapidly increasing world population of aged people has led to a growing need to focus attention on the problems of mental disorder in late life. The aim of the Journal is to communicate the results of original research in the causes, treatment and care of all forms of mental disorder which affect the elderly. The Journal is of interest to psychiatrists, psychologists, social scientists, nurses and others engaged in therapeutic professions, together with general neurobiological researchers. The Journal provides an international perspective on the important issue of geriatric psychiatry, and contributions are published from countries throughout the world. Topics covered include epidemiology of mental disorders in old age, clinical aetiological research, post-mortem pathological and neurochemical studies, treatment trials and evaluation of geriatric psychiatry services.