Atrophy, hypometabolism and implication regarding pathology in late-life major depression with suspected non-alzheimer pathophysiology (SNAP)

IF 4.1 3区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY Biomedical Journal Pub Date : 2023-12-01 DOI:10.1016/j.bj.2023.03.002

Kuan-Yi Wu , Kun-Ju Lin , Chia-Hsiang Chen , Chia-Yih Liu , Yi-Ming Wu , Tzu-Chen Yen , Ing-Tsung Hsiao

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引用次数: 2

Abstract

Background

A substantial proportion of individuals with late-life major depression could be classified as having a suspected non-Alzheimer disease pathophysiology (SNAP), as indicated by a negative test for the biomarker β-amyloid (Aβ-) but a positive test for neurodegeneration (ND+). This study investigated the clinical features, characteristic patterns of brain atrophy and hypometabolism, and implications regarding pathology in this population.

Methods

Forty-six amyloid-negative patients with late-life major depressive disorder (MDD) patients, including 23 SNAP (Aβ-/ND+) and 23 Aβ-/ND- MDD subjects, and 22 Aβ-/ND-healthy control subjects were included in this study. Voxel-wise group comparisons between the SNAP MDD, Aβ-/ND- MDD and control subjects were performed, adjusting for age, gender and level of education. For exploratory comparisons, 8 Aβ+/ND- and 4 Aβ+/ND + MDD patients were included in the Supplementary Material.

Results

The SNAP MDD patients had atrophy extending to regions outside the hippocampus, predominately in the medial temporal, dorsomedial and ventromedial prefrontal cortex; hypometabolism involving a large portion of the lateral and medial prefrontal cortex in addition to the bilateral temporal, parietal and precuneus cortex within typical Alzheimer disease regions were observed. Metabolism ratios of the inferior to the medial temporal lobe were significantly elevated in the SNAP MDD patients. We further discussed the implications with regards to underlying pathologies.

Conclusion

The present study demonstrated characteristic patterns of atrophy and hypometabolism in patients with late-life major depression with SNAP. Identifying individuals with SNAP MDD may provide insights into currently unspecified neurodegenerative processes. Future refinement of neurodegeneration biomarkers is essential in order to identify potential pathological correlates while in vivo reliable pathological biomarkers are not forthcoming.

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疑似非阿尔茨海默病生理(SNAP)的晚期重度抑郁症的萎缩、低代谢及其病理意义

相当大比例的老年重度抑郁症患者可被归类为疑似非阿尔茨海默病病理生理学(SNAP)，如生物标志物β-淀粉样蛋白(a β-)检测呈阴性，但神经变性(ND+)检测呈阳性。本研究调查了该人群的临床特征、脑萎缩和低代谢的特征模式及其病理意义。方法选取46例淀粉样蛋白阴性的晚期重度抑郁症(MDD)患者，包括23例SNAP (Aβ-/ND+)和23例Aβ-/ND- MDD患者，以及22例Aβ-/ND健康对照。在调整年龄、性别和受教育程度后，对SNAP MDD、Aβ-/ND- MDD与对照组进行体素组比较。为了进行探索性比较，补充资料中纳入了8例Aβ+/ND-和4例Aβ+/ND + MDD患者。结果SNAP MDD患者萎缩延伸至海马外区域，以颞叶内侧、背内侧和前额叶腹内侧皮层为主;在典型的阿尔茨海默病区，除了双侧颞叶、顶叶和楔前叶皮层外，还观察到大部分外侧和内侧前额叶皮层的代谢降低。SNAP MDD患者的下内侧颞叶代谢率显著升高。我们进一步讨论了潜在病理的含义。结论本研究显示了晚期重度抑郁症SNAP患者的萎缩和低代谢的特征性模式。识别患有SNAP型重度抑郁症的个体可能为目前未明确的神经退行性过程提供见解。为了确定潜在的病理相关性，神经变性生物标志物的未来改进是必不可少的，而体内可靠的病理生物标志物尚未出现。

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

Biomedical Journal Medicine-General Medicine

CiteScore

11.60

自引率

1.80%

发文量

128

审稿时长

42 days

期刊介绍： Biomedical Journal publishes 6 peer-reviewed issues per year in all fields of clinical and biomedical sciences for an internationally diverse authorship. Unlike most open access journals, which are free to readers but not authors, Biomedical Journal does not charge for subscription, submission, processing or publication of manuscripts, nor for color reproduction of photographs. Clinical studies, accounts of clinical trials, biomarker studies, and characterization of human pathogens are within the scope of the journal, as well as basic studies in model species such as Escherichia coli, Caenorhabditis elegans, Drosophila melanogaster, and Mus musculus revealing the function of molecules, cells, and tissues relevant for human health. However, articles on other species can be published if they contribute to our understanding of basic mechanisms of biology. A highly-cited international editorial board assures timely publication of manuscripts. Reviews on recent progress in biomedical sciences are commissioned by the editors.