Beta-amyloid deposition in patients with major depressive disorder with differing levels of treatment resistance: a pilot study.
BACKGROUND
Lack of treatment response in patients with late-life depression is common. The role of brain beta-amyloid (Aβ) deposition in treatment outcome in subjects with late-life depression remains unclear. The present study aimed to investigate brain Aβ deposition in patients with major depressive disorder (MDD) with differing treatment outcomes in vivo using18F-florbetapir imaging. This study included 62 MDD patients and 18 healthy control subjects (HCs).We first employed the Maudsley staging method (MSM) to categorize MDD patients into two groups according to treatment response: mild treatment resistance (n = 29) and moderate-to-severe treatment resistance (n = 33).The standard uptake value ratio (SUVR) of each volume of interest was analysed, and voxel-wise comparisons were made between the MDD patients and HCs. Vascular risk factors, serum homocysteine level, and apolipoprotein E (ApoE) genotype were also determined.


RESULTS
The MDD patients with moderate-to-severe treatment resistance had higher18F-florbetapir SUVRs than the HCs in the parietal region (P < 0.01). Voxel-wise comparisons further demonstrated elevated SUVRs in MDD patients with moderate-to-severe treatment resistance in the precuneus, parietal, temporal, and occipital regions. The MDD patients with mild treatment resistance were found to have increased18F-florbetapir uptake mainly in the left frontal and parietal regions as compared with the HCs. In addition, voxel-to-voxel correlation analysis showed that brain Aβ deposition was correlated positively with MSM score in the occipital region.18F-florbetapir SUVRs were correlated negatively with Mini Mental Status Examination (MMSE) score in the sample of all MDD patients (r = -0.355, P = 0.005).


CONCLUSIONS
This study provided preliminary evidence that region-specific Aβ deposition was present in some (but not all) MDD patients, especially in those with moderate-to-severe treatment resistance, and their depressive symptoms may represent prodromal manifestations of Alzheimer's disease (AD). Depressive symptomatology in old age, particularly in subjects with a poor treatment response, may underscore early changes of AD-related pathophysiology.
Department of Psychiatry, Chang Gung Memorial Hospital and Chang Gung University, 5. Fu-Hsing Street. Kuei Shan Hsiang, Tao-Yuan, Taiwan.
Peng
P
Li
Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan.|Department of Medical Imaging and Radiological Sciences and Healthy Aging Research Center, Chang Gung University, Tao-Yuan, Taiwan.
Ing-Tsung
IT
Hsiao
Department of Psychiatry, Chang Gung Memorial Hospital and Chang Gung University, 5. Fu-Hsing Street. Kuei Shan Hsiang, Tao-Yuan, Taiwan.
Chia-Yih
CY
Liu
Department of Psychiatry, Chang Gung Memorial Hospital and Chang Gung University, 5. Fu-Hsing Street. Kuei Shan Hsiang, Tao-Yuan, Taiwan.
Chia-Hsiang
CH
Chen
Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan.|Department of Medical Imaging and Radiological Sciences and Healthy Aging Research Center, Chang Gung University, Tao-Yuan, Taiwan.
She-Yao
SY
Huang
Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan.|Department of Medical Imaging and Radiological Sciences and Healthy Aging Research Center, Chang Gung University, Tao-Yuan, Taiwan.
Tzu-Chen
TC
Yen
Department of Psychiatry, Chang Gung Memorial Hospital and Chang Gung University, 5. Fu-Hsing Street. Kuei Shan Hsiang, Tao-Yuan, Taiwan. kuanyiwu1@gmail.com.
Kuan-Yi
KY
Wu
Department of Medical Imaging and Radiological Sciences and Healthy Aging Research Center, Chang Gung University, Tao-Yuan, Taiwan. kunjulin@gmail.com.|Department of Nuclear Medicine and Center for Advanced Molecular Imaging and Translation, Chang Gung Memorial Hospital, No. 5, Fuxing St., Guishan Dist, Taoyuan City, 333, Taiwan. kunjulin@gmail.com.
Kun-Ju
http://orcid.org/0000-0003-1933-4564
KJ
Lin
18F-Florbetapir (AV-45/Amyvid); Alzheimer’s disease; Amyloid; Dementia; Major depressive disorder; Treatment resistance