CAJ | 학술논문

目的：探讨晚发性抑郁症（ late-onset depression ，LOD）患者脑白质微结构的改变。方法对20名LOD患者及16名在性别、年龄、教育年限以及血管危险因素评分均相匹配的健康老年人（对照组）进行执行功能测验和磁共振弥散张量成像扫描，在选取的感兴趣区分别对各向异性分数（ fractional anisotropy ，FA）进行组间比较，并分析其与执行功能、病情严重程度之间的相关性。结果 LOD患者执行功能较对照组明显下降，患者右前额叶背外侧白质区及右侧前扣带束FA值较对照组减低（Ps＜0．05）；在病例组，左前扣带束FA值和Stroop测验C卡片耗时、耗时干扰效应量呈负相关（ Ps＜0．05）。结论右前额叶背外侧白质区及右侧前扣带束白质微结构损害可能是LOD患者抑郁症状和执行功能障碍的生物学基础。
목적：탐토만발성억욱증（ late-onset depression ，LOD）환자뇌백질미결구적개변。방법대20명LOD환자급16명재성별、년령、교육년한이급혈관위험인소평분균상필배적건강노년인（대조조）진행집행공능측험화자공진미산장량성상소묘，재선취적감흥취구분별대각향이성분수（ fractional anisotropy ，FA）진행조간비교，병분석기여집행공능、병정엄중정도지간적상관성。결과 LOD환자집행공능교대조조명현하강，환자우전액협배외측백질구급우측전구대속FA치교대조조감저（Ps＜0．05）；재병례조，좌전구대속FA치화Stroop측험C잡편모시、모시간우효응량정부상관（ Ps＜0．05）。결론우전액협배외측백질구급우측전구대속백질미결구손해가능시LOD환자억욱증상화집행공능장애적생물학기출。
Objective To investigate white matter microstructure abnormalities in late -onset depression ( LOD) .Meth-ods Twenty late-onset depressed subjects and 16 elderly non-depressed subjects underwent clinical assessment and diffu-sion tensor imaging.We compared the results between groups while controlling for age , sex, education and Framingham Stroke Risk Profile scores .The fractional anisotropy ( FA) were measured in sixteen regions of interest including dorsal lat-eral prefrontal lobe , anterior cingulum , posterior cingulum , corpus callosum , middle and basal regions of prefrontal lobe , and occipital lobe .Executive function was assessed with the Stroop task and Verbal fluency task .Correlation analysis was used to examine the relationship between FA and severity of depression and executive function .Results Performances in the Stroop test were significantly impaired in the LOD group as compared with the control group (P<0.05).A significant group-hemisphere interaction effect was found on FA value of the dorsal lateral prefrontal region (F1,34 =5.369,P=0.027).The white matter of right dorsal lateral prefrontal lobe and right anterior cingulate bundle shown decreased FA compared to the controls (F1,34 =8.113,P=0.007 and F1,34 =13.980,P=0.001).In the LOD group,correlation analysis revealed negative correlation between FA value in right anterior cingulate bundle and index of Stroop test (P<0.05). Conclusion Regardless of vascular risk factors , white matter microstructure abnormalities in the right dorsal lateral prefron-tal lobe and right anterior cingulate bundle maybe the biological basis of LOD .