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Association of trajectories of depressive symptoms with vascular risk, cognitive function and adverse brain outcomes: The Whitehall II MRI sub-study
medRxiv - Psychiatry and Clinical Psychology Pub Date : 2020-05-26 , DOI: 10.1101/2020.05.20.20106963
Naiara Demnitz , Melis Anatürk , Charlotte L Allan , Nicola Filippini , Ludovica Griffanti , Clare E Mackay , Abda Mahmood , Claire E Sexton , Sana Suri , Anya G Topiwala , Eniko Zsoldos , Mika Kivimäki , Archana Singh-Manoux , Klaus P Ebmeier

Background: Trajectories of depressive symptoms over the lifespan vary between people, but it is unclear whether these differences exhibit distinct characteristics in brain structure and function. Methods: In order to compare indices of white matter microstructure and cognitive characteristics of groups with different trajectories of depressive symptoms, we examined 774 participants of the Whitehall II Imaging Sub-study, who had completed the depressive subscale of the General Health Questionnaire up to nine times over 25 years. Twenty-seven years after the first examination, participants underwent magnetic resonance imaging to characterize white matter hyperintensities (WMH) and microstructure and completed neuropsychological tests to assess cognition. Twenty-nine years after the first examination, participants completed a further cognitive screening test. Results: Using K-means cluster modelling, we identified five trajectory groups of depressive symptoms: consistently low scorers ("low"; n=505, 62.5%), a subgroup with an early peak in depression scores ("early"; n=123, 15.9%), intermediate scorers ("middle"; n=89, 11.5%), a late symptom subgroup with an increase in symptoms towards the end of the follow-up period ("late"; n=29, 3.7%), and consistently high scorers ("high"; n=28, 3.6%). The late, but not the consistently high scorers, showed higher mean diffusivity, larger volumes of WMH and impaired executive function. In addition, the late subgroup had higher Framingham Stroke Risk scores throughout the follow-up period, indicating a higher load of vascular risk factors. Conclusions: Our findings suggest that tracking depressive symptoms in the community over time may be a useful tool to identify phenotypes that show different etiologies and cognitive and brain outcomes.

中文翻译:

抑郁症状的轨迹与血管风险,认知功能和不良脑结局的关联:Whitehall II MRI子研究

背景:人们在整个人生过程中抑郁症状的轨迹各不相同,但尚不清楚这些差异是否在大脑结构和功能上表现出明显的特征。方法:为了比较不同抑郁症状轨迹组的白质微观结构指标和认知特征,我们检查了774名参加Whitehall II影像亚项研究的参与者,他们完成了《一般健康状况调查表》的抑郁症分量表,最多达到9项超过25年。第一次检查后的第二十七年,参加者进行了磁共振成像以表征白质高强度(WMH)和微结构,并完成了神经心理学测试以评估认知能力。第一次检查后的第二十九年,参与者完成了进一步的认知筛查测试。结果:使用K-means聚类建模,我们确定了五个抑郁症状的轨迹组:得分始终低的人(“低”; n = 505,62.5%),抑郁得分早高峰的子组(“早期”; n = 123,占15.9%,中级评分者(“中”; n = 89,11.5%),晚期症状亚组,在随访期结束时症状有所增加(“晚期”; n = 29,3.7%) )和得分高的人(“高”; n = 28,3.6%)。晚期但并非始终如一的高得分者表现出较高的平均扩散率,较大的WMH量和执行功能受损。此外,在整个随访期间,晚期亚组的Framingham中风风险评分较高,表明血管危险因素负荷较高。结论:
更新日期:2020-05-26
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