Global cognitive dysfunction and β -amyloid neuropathology in late-life and treatment-resistant major depression.

Autor: Li, Cheng-Ta, Fuh, Jong-Ling, Yang, Bang-Hung, Hong, Chen-Ji, Chang, Chi-Wei, Tu, Pei-Chi, Jeng, Jia-Shyun, Chen, Mu-Hong, Tsai, Shih-Jen, Bai, Ya-Mei, Su, Tung-Ping, Lee, Hsuan, Huang, Wen-Sheng
Předmět:
Zdroj: Psychological Medicine; Dec2022, Vol. 52 Issue 16, p4116-4126, 11p
Abstrakt: Background: Cognitive impairment is common in late-life depression, which may increase Alzheimer disease (AD) risk. Therefore, we aimed to investigate whether late-life major depressive disorder (MDD) has worse cognition and increases the characteristic AD neuropathology. Furthermore, we carried out a comparison between treatment-resistant depression (TRD) and non-TRD. We hypothesized that patients with late-life depression and TRD may have increased β -amyloid (A β) deposits in brain regions responsible for global cognition. Methods: We recruited 81 subjects, including 54 MDD patients (27 TRD and 27 non-TRD) and 27 matched healthy controls (HCs). Neurocognitive tasks were examined, including Mini-Mental State Examination and Montreal Cognitive Assessment to detect global cognitive functions. PET with Pittsburgh compound-B and fluorodeoxyglucose were used to capture brain A β pathology and glucose use, respectively, in some patients. Results: MDD patients performed worse in Montreal Cognitive Assessment (p = 0.003) and had more A β deposits than HCs across the brain (family-wise error-corrected p < 0.001), with the most significant finding in the left middle frontal gyrus. Significant negative correlations between global cognition and prefrontal A β deposits existed in MDD patients, whereas positive correlations were noted in HCs. TRD patients had significantly more deposits in the left-sided brain regions (corrected p < 0.001). The findings were not explained by APOE genotypes. No between-group fluorodeoxyglucose difference was detected. Conclusions: Late-life depression, particularly TRD, had increased brain A β deposits and showed vulnerability to A β deposits. A detrimental role of A β deposits in global cognition in patients with late-onset or non-late-onset MDD supported the theory that late-life MDD could be a risk factor for AD. [ABSTRACT FROM AUTHOR]
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