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Almira Siddiqui1,2, Joel Ramirez1,2,3, Shankar Tumati2

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La apatía y la depresión comórbidas (A+D) en los trastornos neurocognitivos (TNC) se asocian con una mayor gravedad de las hiperintensidades de la sustancia blanca (HSB), especialmente en los hombres. Los síntomas separados de apatía o depresión no mostraron asociación con las HSB.

Palabras clave:
Trastornos neurocognitivosApatíaDepresiónHiperintensidades de la sustancia blancaEstudios longitudinalesDiferencias sexuales

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Área de la Ciencia:

  • Neurología
  • Neuropsiquiatría
  • Gerontología

Sus antecedentes:

  • La apatía y la depresión a menudo coexisten en los trastornos neurocognitivos (TNC).
  • Las hiperintensidades de la sustancia blanca (HSB), marcadores de daño microvascular, se asocian individualmente con la apatía y la depresión.
  • Existe una comprensión limitada sobre la distribución espacial y los patrones específicos del sexo de estos síntomas coexistentes y su relación con las HSB.

Objetivo del estudio:

  • Investigar la asociación entre la apatía y la depresión comórbidas (A+D) y la gravedad de las hiperintensidades de la sustancia blanca (HSB) en individuos con TNC.
  • Explorar posibles diferencias específicas del sexo en la relación entre apatía, depresión y HSB.

Principales métodos:

  • Se analizaron datos longitudinales de la cohorte COMPASS-ND de 803 participantes con diversos TNC.
  • Los participantes se categorizaron en cuatro grupos: apatía sola (AS), síntomas depresivos solos (DS), A+D y ni apatía ni depresión (NAD).
  • La gravedad de las HSB se evaluó utilizando la escala de Fazekas en regiones periventriculares (PV) y subcorticales (SC); los análisis de regresión ordinal examinaron las diferencias grupales, con análisis separados para patrones específicos del sexo.

Principales resultados:

  • La apatía y la depresión comórbidas (A+D) se asociaron significativamente con una mayor gravedad de las HSB periventriculares (HSBP) (β=0.508, p=0.01), pero no con las HSB subcorticales (HSBS).
  • Ni la apatía sola (AS) ni los síntomas depresivos solos (DS) se asociaron con HSBP o HSBS.
  • En análisis específicos por sexo, los hombres con A+D mostraron una gravedad significativamente mayor de HSBP (β=0.765, p=0.002), mientras que no se encontraron asociaciones significativas en las mujeres.

Conclusiones:

  • El estudio encontró una asociación positiva entre la apatía y la depresión comórbidas (A+D) y las hiperintensidades de la sustancia blanca periventricular (HSBP), particularmente en hombres.
  • No se observaron asociaciones significativas entre la gravedad de las HSB y la apatía o los síntomas depresivos aislados, ni en mujeres con síntomas comórbidos.
  • Los hallazgos resaltan la importancia de los análisis regionales y específicos del sexo para comprender la relación entre las HSB y la apatía/depresión comórbidas en los TNC para posibles implicaciones en el tratamiento.