Akihiro Takamiya, Thomas Vande Casteele, Filip Bouckaert, Margot G A Van Cauwenberge, Maarten Laroy, François-Laurent De Winter, Patrick Dupont, Jan Van den Stock, Michel Koole, Koen Van Laere, Louise Emsell, Mathieu Vandenbulcke
{"title":"老年抑郁症患者白质加速老化:来自18f氟替他莫PET成像的证据","authors":"Akihiro Takamiya, Thomas Vande Casteele, Filip Bouckaert, Margot G A Van Cauwenberge, Maarten Laroy, François-Laurent De Winter, Patrick Dupont, Jan Van den Stock, Michel Koole, Koen Van Laere, Louise Emsell, Mathieu Vandenbulcke","doi":"10.1016/j.bpsc.2025.03.013","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Late-life depression (LLD) is associated with white matter (WM) alterations. Current evidence indicates that amyloid positron emission tomography (PET) tracers are 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 between 2 hypothetical models for neurobiology of LLD, the pathological neurodegenerative model and the accelerated aging model.</p><p><strong>Methods: </strong>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 control (HC) participants (age 72.5 ± 7.6 years; 28 female), underwent PET imaging with <sup>18</sup>F-flutemetamol, MRI, and clinical assessment. T2-weighted fluid-attenuated inversion recovery images were segmented into WM hyperintensities (WMHs) and NAWM.</p><p><strong>Results: </strong>The <sup>18</sup>F-flutemetamol standardized uptake value ratio (SUVR) in WMHs was significantly lower than that in NAWM (t<sub>102</sub> = 7.8, p < .001). Compared with HC participants, patients with LLD exhibited higher <sup>18</sup>F-flutemetamol SUVR in both NAWM (p < .001, Cohen's d = 0.91) and WMHs (p = .005, d = 0.56), even after controlling for age and <sup>18</sup>F-flutemetamol SUVR in cortical gray matter.</p><p><strong>Conclusions: </strong>Our result of elevated <sup>18</sup>F-flutemetamol uptake in NAWM is not consistent with the pathological neurodegenerative aging pattern observed in Alzheimer's disease but is consistent with patterns of age-related changes. This distinction is crucial for the development of future targeted treatments.</p>","PeriodicalId":93900,"journal":{"name":"Biological psychiatry. Cognitive neuroscience and neuroimaging","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Accelerated Aging of White Matter in Late-Life Depression: Evidence From <sup>18</sup>F-Flutemetamol Positron Emission Tomography Imaging.\",\"authors\":\"Akihiro Takamiya, Thomas Vande Casteele, Filip Bouckaert, Margot G A Van Cauwenberge, Maarten Laroy, François-Laurent De Winter, Patrick Dupont, Jan Van den Stock, Michel Koole, Koen Van Laere, Louise Emsell, Mathieu Vandenbulcke\",\"doi\":\"10.1016/j.bpsc.2025.03.013\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Late-life depression (LLD) is associated with white matter (WM) alterations. Current evidence indicates that amyloid positron emission tomography (PET) tracers are 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 between 2 hypothetical models for neurobiology of LLD, the pathological neurodegenerative model and the accelerated aging model.</p><p><strong>Methods: </strong>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 control (HC) participants (age 72.5 ± 7.6 years; 28 female), underwent PET imaging with <sup>18</sup>F-flutemetamol, MRI, and clinical assessment. T2-weighted fluid-attenuated inversion recovery images were segmented into WM hyperintensities (WMHs) and NAWM.</p><p><strong>Results: </strong>The <sup>18</sup>F-flutemetamol standardized uptake value ratio (SUVR) in WMHs was significantly lower than that in NAWM (t<sub>102</sub> = 7.8, p < .001). Compared with HC participants, patients with LLD exhibited higher <sup>18</sup>F-flutemetamol SUVR in both NAWM (p < .001, Cohen's d = 0.91) and WMHs (p = .005, d = 0.56), even after controlling for age and <sup>18</sup>F-flutemetamol SUVR in cortical gray matter.</p><p><strong>Conclusions: </strong>Our result of elevated <sup>18</sup>F-flutemetamol uptake in NAWM is not consistent with the pathological neurodegenerative aging pattern observed in Alzheimer's disease but is consistent with patterns of age-related changes. This distinction is crucial for the development of future targeted treatments.</p>\",\"PeriodicalId\":93900,\"journal\":{\"name\":\"Biological psychiatry. 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Accelerated Aging of White Matter in Late-Life Depression: Evidence From 18F-Flutemetamol Positron Emission Tomography Imaging.
Background: Late-life depression (LLD) is associated with white matter (WM) alterations. Current evidence indicates that amyloid positron emission tomography (PET) tracers are 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 between 2 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 control (HC) participants (age 72.5 ± 7.6 years; 28 female), underwent PET imaging with 18F-flutemetamol, MRI, and clinical assessment. T2-weighted fluid-attenuated inversion recovery images were segmented into WM hyperintensities (WMHs) and NAWM.
Results: The 18F-flutemetamol standardized uptake value ratio (SUVR) in WMHs was significantly lower than that in NAWM (t102 = 7.8, p < .001). Compared with HC participants, patients with LLD exhibited higher 18F-flutemetamol SUVR in both NAWM (p < .001, Cohen's d = 0.91) and WMHs (p = .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 is not consistent with the pathological neurodegenerative aging pattern observed in Alzheimer's disease but is consistent with patterns of age-related changes. This distinction is crucial for the development of future targeted treatments.