首发老年抑郁症疗效预测的神经影像学标记

Late-life depression is one of the most common mental disorders characterized by depressed mood in older. Its high prevalence was related to many risky factors, which in turn result in highly heterogeneous symptom profiles. Some of them show an insensitive response to treatment, leading to a severely deteriorated life quality in suffered patients. Yet, the underlying neural mechanism of late-life depression remains unclear. This study will recruit first-episode drug-naive patients with late-life depression and healthy controls, and investigate the alterations of psychometric variables, severity of depressive symptoms, behavioral variables, brain activity and connectivity during the baseline and after anti-depression therapy. Based on the alterations of brain imaging and depressive symptoms pre- and post-drug among the two groups, a longitudinal follow-up study will be carried out to trace the prognosis of all older patients with depression. By doing this, we are aiming at exploring the depression-related and the remission-related biomarker in their brain, and provide scientific evidence for clinical intervention and eventually facilitating effective anti-depressant therapies in patients with late-life depression.

老年抑郁症是一种严重的精神疾病，其患病率高，致残率高，影响因素多，临床表现具有高度异质性，且存在相当一部分患者对药物治疗不敏感，给患者与社会造成严重负担。由于干扰因素繁多，老年抑郁症的发病机制尚不清楚。本研究拟在首发未服药的老年抑郁症患者及正常对照组中追踪实施系列心理与行为学评估，同时通过多模态的神经影像学技术纵向记录基线期及抗抑郁治疗之后的神经影像学数据，以分析老年抑郁症患者抗抑郁治疗前后心理特征、临床症状、行为学指标、神经影像学指标的变化模式，阐明老年抑郁症发病的神经学机制，并探讨哪些指标的改变与老年抑郁症治疗效果及预后有关，寻找能预测老年抑郁症抗抑郁疗效的神经影像学标记，为及早、有效、精确治疗老年抑郁症提供实验依据。

老年抑郁症是一种高发生率与高致残率的精神障碍，其临床表现高度异质，且其临床疗效不理想，给患者与社会造成严重负担，但老年抑郁症的发病机制尚不完全清楚。本研究在首发老年抑郁症患者及正常对照组被试中追踪实施系列心理与行为学评估，纵向采集多模态脑影像数据，深入分析数据。首先，基于心理行为学数据，获得多种可用于评价老年抑郁与情绪调节特征的有效工具；其次，通过分析老年抑郁症患者心理特征（如情绪调节方式）、临床症状（如抑郁焦虑水平）、行为学指标（如情绪任务与认知任务行为表现）、多模态神经影像学指标（皮层厚度、灰质密度、低频振幅、功能连接、有效连接、结构连接、频率段度中心值等）的特征模式，获得若干老年抑郁症的可能标记物；再者，通过构建上述特征指标与老年抑郁症预后之间关系，阐明心理、社会、神经学因素影响老年抑郁发生发展的具体机制。本项目的研究成果为老年抑郁症的病理机制探讨和疗效预测提供了实验依据。本项目发表标注基金资助的学术论文11篇，另有5篇标注基金资助学术论文正在回修中，预计未来两年可再发表标注项目资助的研究论文8-10篇。项目负责人与主要成员积极参加国内外学术会议，加强学术交流，已发表会议论文5篇，参加学术会议9人次。本项目培养研究生8人，其中博士研究生4人。