Background Depression is reported as a risk factor, prodromal feature and late consequence of Parkinson’s disease (PD). We aimed to evaluate the timing, neuroanatomy and prognostic implications of depression in PD. Methods We used data from 434 023 participants from UK Biobank with 14.1 years of follow-up. Multivariable regression models established associations of depression with incident PD and regional brain volumes. Cox proportional hazards models assessed prognostic associations of depression in PD with incident dementia and all-cause mortality. Results Of 2632 individuals with incident PD, 539 (20.5%) were diagnosed with depression at some point. Depression was associated with an increased risk of subsequent PD (risk ratio 1.53, 95% CI 1.37 to 1.72). Among incident PD cases, depression prevalence rose progressively from 10 years pre-PD diagnosis (OR 2.10, 95% CI 1.57 to 2.83) to 10 years postdiagnosis (OR 3.51, 95% CI 1.33 to 9.22). Depression severity in PD was associated with reduced grey matter volume in structures including the thalamus and amygdala. Depression prior to PD diagnosis increased risk of dementia (HR 1.47, 95% CI 1.05 to 2.07) and mortality (HR 1.30, 95% CI 1.07 to 1.58). Conclusions This large-scale prospective study demonstrated that depression prevalence increases from 10 years before PD diagnosis and is a marker of cortical and subcortical volume loss. Depression before PD diagnosis signals a worse prognosis in terms of dementia and mortality. This has clinical implications in stratifying people with poorer cognitive and prognostic trajectory in PD. Data may be obtained from a third party and are not publicly available. Data may be obtained from a third party and are not publicly available. Data include a range of demographic, clinical and neuroimaging information on over 500 000 participants recruited from across the UK. These data are held by the UK Biobank () and access is available to any bona fide researcher proposing a health-related project that is in the public’s interest. Researchers must be registered with the UK Biobank’s Access Team.

中文翻译：

---

帕金森病抑郁症的神经解剖学和预后关联

背景 据报道，抑郁症是帕金森病 (PD) 的危险因素、前驱特征和晚期后果。我们的目的是评估 PD 中抑郁的发生时间、神经解剖学和预后影响。方法 我们使用了来自 UK Biobank 的 434 023 名参与者的数据，并进行了 14.1 年的随访。多变量回归模型建立了抑郁症与帕金森病事件和区域脑容量的关联。 Cox 比例风险模型评估了 PD 抑郁症与痴呆事件和全因死亡率的预后关联。结果 在 2632 名 PD 患者中，有 539 名 (20.5%) 在某个时候被诊断出患有抑郁症。抑郁症与后续 PD 风险增加相关（风险比 1.53，95% CI 1.37 至 1.72）。在PD病例中，抑郁症患病率从PD诊断前10年（OR 2.10，95% CI 1.57至2.83）逐渐上升至诊断后10年（OR 3.51，95% CI 1.33至9.22）。 PD 抑郁症的严重程度与丘脑和杏仁核等结构中灰质体积的减少有关。 PD 诊断前抑郁会增加痴呆风险（HR 1.47，95% CI 1.05 至 2.07）和死亡率（HR 1.30，95% CI 1.07 至 1.58）。结论 这项大规模前瞻性研究表明，抑郁症患病率从 PD 诊断前 10 年开始增加，并且是皮质和皮质下体积减少的标志。 PD 诊断前的抑郁症预示着痴呆症和死亡率的预后较差。这对于对 PD 认知和预后轨迹较差的人群进行分层具有临床意义。数据可能从第三方获得，并且不公开。数据可能从第三方获得，并且不公开。数据包括从英国各地招募的超过 500,000 名参与者的一系列人口统计、临床和神经影像信息。这些数据由英国生物银行（）并且任何提出符合公众利益的健康相关项目的真正研究人员都可以访问。研究人员必须在英国生物银行的访问团队注册。