中文摘要：

目的用优化的基于体素的形态学研究方法（VBM）比较首次发作晚发抑郁（LOD）与轻度认知功能损害（MCI）患者的脑萎缩模式，探索LOD患者脑结构与认知功能的关系。方法选择LOD、MCI及正常老人39例，分为LOD组9例，MCI组14例和NC组16例，用简易精神状态检查量表和认知功能筛检工具评估3组总体认知功能，跨文化神经心理成套测验评估不同领域认知功能。用VBM对颅脑高分辨率3DT1Wl进行分析。结果与NC组比较，LOD组双侧额叶、边缘系统和顶叶多个脑区明显萎缩（P〈0．01）。与MCl组比较，L0D组双侧额叶和边缘系统多个脑区明显萎缩（P〈0．01）。LOD组物品记忆功能评分与额叶和边缘系统多个脑区灰质体积呈正相关（r=0．49～0．76，P〈0．01），言语流畅性评分与右侧颞上回呈正相关（r=0．72，P〈0．01）。结论首次发作LOD患者认知相关的脑区灰质萎缩较MCI更广泛和明显；患者额叶与边缘系统灰质萎缩与认知下降相关。

英文摘要：

Objective To compare the brain atrophy patterns measured with optimized voxel-based morphometry（VBM） between patients with first-episode late-onset depression（LOD）and individuals with mild cognitive impairment（MCI）,and to explore the relationship between brain volume and cognitive functions. Methods Nine LOD patients（LOD group）, fourteen MCI subjects（MCI group） ,and 16 healthy controls（NC group） were enrolled. General cognitive function was assessed with MMSE and CASI. All subjects were assessed with cross-cultural neuropsyehological test battery. High-resolution 3D T1 WI images were analyzed using VBM. Results Compared with NC group,there was significant gray matter（GM） atrophy in bilateral frontal and parietal regions and limbic system in LOD group （P〈 0.01）. Compared with MCI group,LOD group showed sig- nificant atrophy in frontal lobe and limbie system （P〈 0. 01）. In LOD group, object memory scores positively correlated with GM volume in multiple brain regions （r = 0.49 -- 0.76,P〈0.01）. Positive correlation was also observed between verbal fluency score and GM density in right superior temporal gyrus （r = 0.72,P〈0.01）. Conclusion LOD presents more severe and pervasive brain atrophy than MCI. Atrophy in frontal lobe and limbic system is closely associated with cognitive decline in LOD.