Atrophy, hypometabolism and implication regarding pathology in late-life major depression with suspected non-alzheimer pathophysiology (SNAP)

Kuan Yi Wu; Kun Ju Lin; Chia Hsiang Chen; Chia Yih Liu; Yi Ming Wu; Tzu Chen Yen; Ing Tsung Hsiao

doi:10.1016/j.bj.2023.03.002

Atrophy, hypometabolism and implication regarding pathology in late-life major depression with suspected non-alzheimer pathophysiology (SNAP)

Kuan Yi Wu, Kun Ju Lin, Chia Hsiang Chen, Chia Yih Liu, Yi Ming Wu, Tzu Chen Yen, Ing Tsung Hsiao^*

^*Corresponding author for this work

Department of Medical Imaging and Radiological Sciences

Research output: Contribution to journal › Journal Article › peer-review

3 Scopus citations

Abstract

Background: A substantial proportion of individuals with late-life major depression could be classified as having a suspected non-Alzheimer disease pathophysiology (SNAP), as indicated by a negative test for the biomarker β-amyloid (Aβ-) but a positive test for neurodegeneration (ND+). This study investigated the clinical features, characteristic patterns of brain atrophy and hypometabolism, and implications regarding pathology in this population. Methods: Forty-six amyloid-negative patients with late-life major depressive disorder (MDD) patients, including 23 SNAP (Aβ-/ND+) and 23 Aβ-/ND- MDD subjects, and 22 Aβ-/ND-healthy control subjects were included in this study. Voxel-wise group comparisons between the SNAP MDD, Aβ-/ND- MDD and control subjects were performed, adjusting for age, gender and level of education. For exploratory comparisons, 8 Aβ+/ND- and 4 Aβ+/ND + MDD patients were included in the Supplementary Material. Results: The SNAP MDD patients had atrophy extending to regions outside the hippocampus, predominately in the medial temporal, dorsomedial and ventromedial prefrontal cortex; hypometabolism involving a large portion of the lateral and medial prefrontal cortex in addition to the bilateral temporal, parietal and precuneus cortex within typical Alzheimer disease regions were observed. Metabolism ratios of the inferior to the medial temporal lobe were significantly elevated in the SNAP MDD patients. We further discussed the implications with regards to underlying pathologies. Conclusion: The present study demonstrated characteristic patterns of atrophy and hypometabolism in patients with late-life major depression with SNAP. Identifying individuals with SNAP MDD may provide insights into currently unspecified neurodegenerative processes. Future refinement of neurodegeneration biomarkers is essential in order to identify potential pathological correlates while in vivo reliable pathological biomarkers are not forthcoming.

Original language	English
Article number	100589
Pages (from-to)	100589
Journal	Biomedical Journal
Volume	46
Issue number	6
DOIs	https://doi.org/10.1016/j.bj.2023.03.002
State	Published - 12 2023

Bibliographical note

Keywords

Amyloid
Atrophy
Late-life major depression
Major depressive disorder (MDD)
Metabolism
Suspected non-alzheimer pathophysiology (SNAP)
Humans
Depression
Positron-Emission Tomography
Magnetic Resonance Imaging
Biomarkers
Depressive Disorder, Major
Alzheimer Disease/diagnostic imaging

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10.1016/j.bj.2023.03.002

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@article{b1f5d9f828954b5f8a10dc90aa184984,

title = "Atrophy, hypometabolism and implication regarding pathology in late-life major depression with suspected non-alzheimer pathophysiology (SNAP)",

abstract = "Background: A substantial proportion of individuals with late-life major depression could be classified as having a suspected non-Alzheimer disease pathophysiology (SNAP), as indicated by a negative test for the biomarker β-amyloid (Aβ-) but a positive test for neurodegeneration (ND+). This study investigated the clinical features, characteristic patterns of brain atrophy and hypometabolism, and implications regarding pathology in this population. Methods: Forty-six amyloid-negative patients with late-life major depressive disorder (MDD) patients, including 23 SNAP (Aβ-/ND+) and 23 Aβ-/ND- MDD subjects, and 22 Aβ-/ND-healthy control subjects were included in this study. Voxel-wise group comparisons between the SNAP MDD, Aβ-/ND- MDD and control subjects were performed, adjusting for age, gender and level of education. For exploratory comparisons, 8 Aβ+/ND- and 4 Aβ+/ND + MDD patients were included in the Supplementary Material. Results: The SNAP MDD patients had atrophy extending to regions outside the hippocampus, predominately in the medial temporal, dorsomedial and ventromedial prefrontal cortex; hypometabolism involving a large portion of the lateral and medial prefrontal cortex in addition to the bilateral temporal, parietal and precuneus cortex within typical Alzheimer disease regions were observed. Metabolism ratios of the inferior to the medial temporal lobe were significantly elevated in the SNAP MDD patients. We further discussed the implications with regards to underlying pathologies. Conclusion: The present study demonstrated characteristic patterns of atrophy and hypometabolism in patients with late-life major depression with SNAP. Identifying individuals with SNAP MDD may provide insights into currently unspecified neurodegenerative processes. Future refinement of neurodegeneration biomarkers is essential in order to identify potential pathological correlates while in vivo reliable pathological biomarkers are not forthcoming.",

keywords = "Amyloid, Atrophy, Late-life major depression, Major depressive disorder (MDD), Metabolism, Suspected non-alzheimer pathophysiology (SNAP), Humans, Depression, Positron-Emission Tomography, Magnetic Resonance Imaging, Biomarkers, Depressive Disorder, Major, Alzheimer Disease/diagnostic imaging",

author = "Wu, {Kuan Yi} and Lin, {Kun Ju} and Chen, {Chia Hsiang} and Liu, {Chia Yih} and Wu, {Yi Ming} and Yen, {Tzu Chen} and Hsiao, {Ing Tsung}",

year = "2023",

month = dec,

doi = "10.1016/j.bj.2023.03.002",

language = "英语",

volume = "46",

pages = "100589",

journal = "Biomedical Journal",

issn = "2319-4170",

publisher = "Elsevier B.V.",

number = "6",

}

TY - JOUR

T1 - Atrophy, hypometabolism and implication regarding pathology in late-life major depression with suspected non-alzheimer pathophysiology (SNAP)

AU - Wu, Kuan Yi

AU - Lin, Kun Ju

AU - Chen, Chia Hsiang

AU - Liu, Chia Yih

AU - Wu, Yi Ming

AU - Yen, Tzu Chen

AU - Hsiao, Ing Tsung

PY - 2023/12

Y1 - 2023/12

N2 - Background: A substantial proportion of individuals with late-life major depression could be classified as having a suspected non-Alzheimer disease pathophysiology (SNAP), as indicated by a negative test for the biomarker β-amyloid (Aβ-) but a positive test for neurodegeneration (ND+). This study investigated the clinical features, characteristic patterns of brain atrophy and hypometabolism, and implications regarding pathology in this population. Methods: Forty-six amyloid-negative patients with late-life major depressive disorder (MDD) patients, including 23 SNAP (Aβ-/ND+) and 23 Aβ-/ND- MDD subjects, and 22 Aβ-/ND-healthy control subjects were included in this study. Voxel-wise group comparisons between the SNAP MDD, Aβ-/ND- MDD and control subjects were performed, adjusting for age, gender and level of education. For exploratory comparisons, 8 Aβ+/ND- and 4 Aβ+/ND + MDD patients were included in the Supplementary Material. Results: The SNAP MDD patients had atrophy extending to regions outside the hippocampus, predominately in the medial temporal, dorsomedial and ventromedial prefrontal cortex; hypometabolism involving a large portion of the lateral and medial prefrontal cortex in addition to the bilateral temporal, parietal and precuneus cortex within typical Alzheimer disease regions were observed. Metabolism ratios of the inferior to the medial temporal lobe were significantly elevated in the SNAP MDD patients. We further discussed the implications with regards to underlying pathologies. Conclusion: The present study demonstrated characteristic patterns of atrophy and hypometabolism in patients with late-life major depression with SNAP. Identifying individuals with SNAP MDD may provide insights into currently unspecified neurodegenerative processes. Future refinement of neurodegeneration biomarkers is essential in order to identify potential pathological correlates while in vivo reliable pathological biomarkers are not forthcoming.

AB - Background: A substantial proportion of individuals with late-life major depression could be classified as having a suspected non-Alzheimer disease pathophysiology (SNAP), as indicated by a negative test for the biomarker β-amyloid (Aβ-) but a positive test for neurodegeneration (ND+). This study investigated the clinical features, characteristic patterns of brain atrophy and hypometabolism, and implications regarding pathology in this population. Methods: Forty-six amyloid-negative patients with late-life major depressive disorder (MDD) patients, including 23 SNAP (Aβ-/ND+) and 23 Aβ-/ND- MDD subjects, and 22 Aβ-/ND-healthy control subjects were included in this study. Voxel-wise group comparisons between the SNAP MDD, Aβ-/ND- MDD and control subjects were performed, adjusting for age, gender and level of education. For exploratory comparisons, 8 Aβ+/ND- and 4 Aβ+/ND + MDD patients were included in the Supplementary Material. Results: The SNAP MDD patients had atrophy extending to regions outside the hippocampus, predominately in the medial temporal, dorsomedial and ventromedial prefrontal cortex; hypometabolism involving a large portion of the lateral and medial prefrontal cortex in addition to the bilateral temporal, parietal and precuneus cortex within typical Alzheimer disease regions were observed. Metabolism ratios of the inferior to the medial temporal lobe were significantly elevated in the SNAP MDD patients. We further discussed the implications with regards to underlying pathologies. Conclusion: The present study demonstrated characteristic patterns of atrophy and hypometabolism in patients with late-life major depression with SNAP. Identifying individuals with SNAP MDD may provide insights into currently unspecified neurodegenerative processes. Future refinement of neurodegeneration biomarkers is essential in order to identify potential pathological correlates while in vivo reliable pathological biomarkers are not forthcoming.

KW - Amyloid

KW - Atrophy

KW - Late-life major depression

KW - Major depressive disorder (MDD)

KW - Metabolism

KW - Suspected non-alzheimer pathophysiology (SNAP)

KW - Humans

KW - Depression

KW - Positron-Emission Tomography

KW - Magnetic Resonance Imaging

KW - Biomarkers

KW - Depressive Disorder, Major

KW - Alzheimer Disease/diagnostic imaging

UR - http://www.scopus.com/inward/record.url?scp=85151504124&partnerID=8YFLogxK

U2 - 10.1016/j.bj.2023.03.002

DO - 10.1016/j.bj.2023.03.002

M3 - 文章

C2 - 36914051

AN - SCOPUS:85151504124

SN - 2319-4170

VL - 46

SP - 100589

JO - Biomedical Journal

JF - Biomedical Journal

IS - 6

M1 - 100589

ER -

Atrophy, hypometabolism and implication regarding pathology in late-life major depression with suspected non-alzheimer pathophysiology (SNAP)

Abstract

Bibliographical note

Keywords

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