This study was conducted to clarify patterns of cortico-limbic volume abnormalities in late life depression (LLD) relative to non-depressed (ND) adults matched for amyloid β (Aβ) deposition and to evaluate the relationship of volume abnormalities with cognitive performance. Participants included 116 LLD and 226 ND. Classification accuracy of LLD status was estimated using area under the receiver operator characteristic curve. Twenty-one percent of LLD and ND participants were Aβ positive and the groups did not differ on white matter hyperintensity volume (WMH (logscale); β = 0.12, p = 0.28). Compared to ND, the LLD group exhibited significantly lower bilateral volume in the lateral orbitofrontal cortex, hippocampus, accumbens area, superior temporal lobe, temporal pole, and amygdala after multiple comparison correction (p < 0.009 for all). Cortico-limbic volumes significantly improved classification of LLD beyond demographic characteristics, Aβ status, and WMH (AUC_Vol = 0.71, AUC_WMH, _Aβ = 0.62, AUC difference, 0.09 [0.03 to 0.15]). LLD exhibited poorer performance on measures of global cognition, set shifting, and verbal learning and memory relative to ND. Cognitive function was positively associated with cortico-limbic volumes and these relationships did not differ by group. Secondary analyses with an ND sample additionally matched for Mild Cognitive Impairment (MCI) diagnosis showed a similar but attenuated pattern of volume abnormalities. Overall, our results support LLD as being associated with cortico-limbic volume abnormalities that are distinct from Aβ and white matter pathologies and that these volume abnormalities are important factors associated with cognitive dysfunction in LLD.

进行这项研究是为了阐明与淀粉样蛋白 β （Aβ） 沉积匹配的非抑郁 （ND） 成人晚年抑郁症 （LLD） 皮质边缘容量异常的模式，并评估容量异常与认知能力的关系。参与者包括 116 名 LLD 和 226 名 ND。使用受试者操作员特征曲线下的面积估计 LLD 状态的分类准确性。21% 的 LLD 和 ND 参与者为 Aβ 阳性，两组在白质高信号体积 （WMH（对数标尺）;β = 0.12，p = 0.28）上没有差异。 与 ND 相比，经过多次比较校正，LLD 组在眶额外侧皮层、海马、伏隔区、颞叶上部、颞极和杏仁核的双侧体积显着降低 （p < 0.009）。皮质边缘体积显著改善了 LLD 的分类，超越了人口统计学特征、 Aβ 状态和 WMH （AUC_Vol = 0.71，AUC_WMH，Aβ = 0.62，AUC 差异，0.09 [0.03 至 0.15]）。相对于 ND，LLD 在整体认知、集合移位以及语言学习和记忆的测量上表现较差。认知功能与皮质边缘体积呈正相关，这些关系在组间没有差异。对 ND 样本的二次分析还与轻度认知障碍 （MCI） 诊断相匹配，显示容量异常的相似但减弱模式。总体而言，我们的结果支持 LLD 与不同于 Aβ 和白质病理的皮质边缘容量异常相关，并且这些体积异常是与 LLD 认知功能障碍相关的重要因素。