Abstract:
Late-life depression (LLD) is a relatively common and debilitating mental disorder, also associated with cognitive dysfunctions and an increased risk of mortality. Considering the growing elderly population worldwide, LLD is increasingly emerging as a significant public health issue, also due to the rise in direct and indirect costs borne by healthcare systems. Understanding the neuroanatomical and neurofunctional correlates of LLD is crucial for developing more targeted and effective interventions, both from a preventive and therapeutic standpoint. This ALE meta-analysis aims to evaluate the involvement of specific neurofunctional changes in the neurophysiopathology of LLD by analysing functional neuroimaging studies conducted on patients with LLD compared to healthy subjects (HCs). We included 19 studies conducted on 844 subjects, divided into 439 patients with LLD and 405 HCs. Patients with LLD, compared to HCs, showed significant hypoactivation of the right superior and medial frontal gyri (Brodmann areas (Bas) 8, 9), left cingulate cortex (BA 24), left putamen, and left caudate body. The same patients exhibited significant hyperactivation of the left superior temporal gyrus (BA 42), left inferior frontal gyrus (BA 45), right anterior cingulate cortex (BA 24), right cerebellar culmen, and left cerebellar declive. In summary, we found significant changes in activation patterns and brain functioning in areas encompassed in the cortico-limbic-striatal network in LLD. Furthermore, our results suggest a potential role for areas within the cortico-striatal-cerebellar network in the neurophysiopathology of LLD.
摘要:
晚年抑郁症(LLD)是一种相对常见且使人衰弱的精神障碍,还与认知功能障碍和死亡风险增加有关。考虑到全世界不断增长的老年人口,LLD越来越成为一个重要的公共卫生问题,这也是由于医疗保健系统承担的直接和间接成本的增加。了解LLD的神经解剖学和神经功能相关性对于开发更有针对性和有效的干预措施至关重要。从预防和治疗的角度来看。此ALE荟萃分析旨在通过分析与健康受试者(HC)相比对LLD患者进行的功能神经影像学研究,评估LLD神经生理学病理学中特定神经功能变化的参与。我们纳入了对844名受试者进行的19项研究,分为439例LLD和405例HCs。LLD患者,与HC相比,显示右上和内侧额叶回(Brodmann区(Bas)8,9),左扣带皮质(BA24),左壳核,留下了尾状尸体.相同的患者表现出显著的左颞上回过度激活(BA42),左额下回(BA45),右前扣带回皮质(BA24),右小脑运动员,离开小脑。总之,我们发现LLD中皮质-边缘-纹状体网络所包含区域的激活模式和脑功能发生了显著变化.此外,我们的结果提示皮质-纹状体-小脑网络内的区域在LLD的神经生理病理学中具有潜在作用.