Akihiro Takamiya, Thomas Vande Casteele, Filip Bouckaert, Margot Ga Van Cauwenberge, Maarten Laroy, François-Laurent De Winter, Patrick Dupont, Jan Van den Stock, Michel Koole, Koen Van Laere, Louise Emsell, Mathieu Vandenbulcke
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引用次数: 0
Abstract
Background: Late-life depression (LLD) is associated with white matter (WM) alterations. Current evidence indicates amyloid PET tracers as sensitive and reliable markers for evaluating normal-appearing WM (NAWM) on magnetic resonance imaging (MRI), showing an association between lower uptake and Alzheimer's disease pathology and higher uptake with age-related changes. Utilizing this novel and reliable technique, we aimed to distinguish two hypothetical models for neurobiology of LLD: the pathological neurodegenerative model and the accelerated aging model.
Methods: In this monocentric cross-sectional study, a total of 103 participants, including 61 patients with LLD (age 73.8±7.0 years, 41 female) and 42 healthy controls (age 72.5±7.6 years, 28 female), underwent PET imaging with 18F-flutemetamol, MRI, and clinical assessment. T2-weighted fluid-attenuated inversion recovery (FLAIR) images were segmented into WM hyperintensities (WMH) and NAWM.
Results: 18F-flutemetamol standardized uptake value ratio (SUVR) in WMH was significantly lower than that in NAWM (t=7.8, df=102, p<0.001). Compared to healthy controls, patients with LLD exhibited higher 18F-flutemetamol SUVR in both NAWM (p<0.001, Cohen's d=0.91) and WMH (p=0.005, d=0.56), even after controlling for age and 18F-flutemetamol SUVR in cortical gray matter.
Conclusions: Our result of elevated 18F-flutemetamol uptake in NAWM does not align with the pathological neurodegenerative aging pattern observed in Alzheimer's disease but is in line with patterns of age-related changes. This distinction is crucial for the development of future targeted treatments.
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