Delayed niacin skin flush response identifies cognitive impairment in late-life depression

IF 4.9 2区医学 Q1 CLINICAL NEUROLOGY

Journal of affective disorders Pub Date : 2025-03-18 DOI:10.1016/j.jad.2025.03.095

Yan Chen , You Wu , Dandan Wang , Yang Yang , Qianqian Guo , Qi Qiu , Chunlin Wan , Xia Li

{"title":"Delayed niacin skin flush response identifies cognitive impairment in late-life depression","authors":"Yan Chen , You Wu , Dandan Wang , Yang Yang , Qianqian Guo , Qi Qiu , Chunlin Wan , Xia Li","doi":"10.1016/j.jad.2025.03.095","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>This research aimed to inspect the discriminative and predictive utility of the niacin skin flush response (NSFR) in patients with late-life depression (LLD) with cognitive impairment (CI).</div></div><div><h3>Methods</h3><div>This study consisted of 86 LLD patients (46 with CI and 40 without CI), along with 22 Alzheimer's disease (AD) patients and 32 healthy elderly controls (HCs) as positive and negative controls, respectively. A subset of 74 LLD patients were reassessed after six months. The Montreal Cognitive Assessment (MoCA) was administered to assess cognitive capabilities. NSFR tests were performed using a modified protocol. Group differences in NSFR and clinical parameters were examined using multivariate ANOVA analysis. Model performance was evaluated using receiver operating characteristic (ROC) curves derived from NSFR measurements.</div></div><div><h3>Results</h3><div>NSFR showed a significant inverse correlation with cognitive functions in LLD patients (R = -0.456, <em>P</em> < .001). Moreover, the parameter logEC<sub>50</sub>, which quantifies the NSFR rate, was elevated in the LLD with CI group. LogEC<sub>50</sub> had an AUC of 0.767 (95 % CI: 0.667–0.867) in distinguishing LLD with CI from those without CI, which increased to 0.961 (95%CI:0.925–0.998) when combined with C- reactive protein. The predictive capacity of the baseline logEC<sub>50</sub> for cognitive prognosis (decline versus preservation) in LLD patients was statistically significant (AUC = 0.826, 95 % CI 0.731–0.921), which increased to 0.857 (95%CI:0.775–0.941) when combined with baseline MoCA.</div></div><div><h3>Conclusion</h3><div>A delayed NSFR represents a promising biomarker for identifying CI and predicting cognitive trajectories in patients with LLD. This study elucidates a novel methodology for the precise identification and prognostic evaluation of CI in LLD.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"379 ","pages":"Pages 772-781"},"PeriodicalIF":4.9000,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of affective disorders","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0165032725004434","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

This research aimed to inspect the discriminative and predictive utility of the niacin skin flush response (NSFR) in patients with late-life depression (LLD) with cognitive impairment (CI).

Methods

This study consisted of 86 LLD patients (46 with CI and 40 without CI), along with 22 Alzheimer's disease (AD) patients and 32 healthy elderly controls (HCs) as positive and negative controls, respectively. A subset of 74 LLD patients were reassessed after six months. The Montreal Cognitive Assessment (MoCA) was administered to assess cognitive capabilities. NSFR tests were performed using a modified protocol. Group differences in NSFR and clinical parameters were examined using multivariate ANOVA analysis. Model performance was evaluated using receiver operating characteristic (ROC) curves derived from NSFR measurements.

Results

NSFR showed a significant inverse correlation with cognitive functions in LLD patients (R = -0.456, P < .001). Moreover, the parameter logEC₅₀, which quantifies the NSFR rate, was elevated in the LLD with CI group. LogEC₅₀ had an AUC of 0.767 (95 % CI: 0.667–0.867) in distinguishing LLD with CI from those without CI, which increased to 0.961 (95%CI:0.925–0.998) when combined with C- reactive protein. The predictive capacity of the baseline logEC₅₀ for cognitive prognosis (decline versus preservation) in LLD patients was statistically significant (AUC = 0.826, 95 % CI 0.731–0.921), which increased to 0.857 (95%CI:0.775–0.941) when combined with baseline MoCA.

Conclusion

A delayed NSFR represents a promising biomarker for identifying CI and predicting cognitive trajectories in patients with LLD. This study elucidates a novel methodology for the precise identification and prognostic evaluation of CI in LLD.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of affective disorders 医学-精神病学

CiteScore

10.90

自引率

6.10%

发文量

1319

审稿时长

9.3 weeks

期刊介绍： The Journal of Affective Disorders publishes papers concerned with affective disorders in the widest sense: depression, mania, mood spectrum, emotions and personality, anxiety and stress. It is interdisciplinary and aims to bring together different approaches for a diverse readership. Top quality papers will be accepted dealing with any aspect of affective disorders, including neuroimaging, cognitive neurosciences, genetics, molecular biology, experimental and clinical neurosciences, pharmacology, neuroimmunoendocrinology, intervention and treatment trials.