專題討論1:失智症診斷與分子影像新發展

程 序 表

S1-3
Diversity of neurodegenerative pathophysiology in late-life depression
吳冠毅
林口長庚醫院精神科

  Systematic review and meta-analysis studies suggested that a history of depression approximately doubles an individual’s risk for developing dementia later in life, particularly Alzheimer’s disease (AD). Some large longitudinal studies suggested that even first depression symptoms occurring more than 20 years before the onset of dementia may still be associated with the development of AD. Moreover, a postmortem study in patients with AD showed that amyloid plaque and neurofibrillary tangle would be more pronounced in patients who have a lifetime history of major depression, as compared with patients without a history of depression. These findings point toward the possibility that the presence of a lifetime history of major depression may be one of risk factors in the progression of AD. Therefore, we launched a cross-sectional study from 2011 to first time compare brain amyloid accumulations using 18F-Florbetapir PET imaging between non-demented patients with lifetime major depression and non-depressed and cognitively healthy comparison subjects. Our preliminary result was published recently, and we found increased 18F-florbetapir uptake in specific brain regions in patients with lifetime depression relative to comparison subjects, despite the fact that there were no differences in demographics, vascular risk factor scores, homocysteine and APOE ε4 genotype