Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, Los Angeles, CA, USA.
Psychiatry Res. 2010 Apr 30;182(1):22-9. doi: 10.1016/j.pscychresns.2009.11.010. Epub 2010 Mar 15.
Neuropsychological studies of subjects with bipolar disorder suggest impairment of working memory not only in acute mood states, but also while subjects are euthymic. Using fMRI to probe working memory regions in bipolar subjects in different mood states, we sought to determine the functional neural basis for these impairments. Typical working memory areas in normal populations include dorsolateral prefrontal cortex (BA9/46) and the posterior parietal cortex (BA40). We evaluated the activation in these regions using an n-back task in 42 bipolar subjects (13 manic, 15 euthymic and 14 depressed subjects) and 14 control subjects. While both control and bipolar subjects performed similarly on the task, bipolar subjects in all three mood states showed a significant reduction in activation in right BA9/46 and right BA40. Patients with bipolar disorder exhibit significantly attenuated neural activation in working memory circuits, independent of mood state. The reduction of neural activation may suggest a trait-related deficit. Subjects with bipolar disorder activated other additional frontal and temporal regions, perhaps as a compensatory mechanism, but this remains to be further explored.
神经心理学研究表明,双相情感障碍患者的工作记忆受损不仅出现在急性情绪状态下,而且在病情稳定期也会出现。本研究采用 fMRI 技术来探测双相情感障碍患者在不同情绪状态下的工作记忆相关脑区,旨在探讨这些缺陷的功能神经基础。正常人群的典型工作记忆脑区包括背外侧前额叶皮层(BA9/46)和顶后皮质(BA40)。我们采用 n-back 任务评估了 42 名双相情感障碍患者(13 名躁狂,15 名病情稳定,14 名抑郁)和 14 名对照组被试在这些脑区的激活情况。尽管对照组和双相情感障碍组在任务中表现相似,但所有三种情绪状态的双相情感障碍患者右侧 BA9/46 和右侧 BA40 的激活明显减少。双相情感障碍患者在工作记忆回路中表现出明显的神经激活减弱,与情绪状态无关。神经激活的减少可能表明存在与特质相关的缺陷。双相情感障碍患者激活了其他额外的额颞叶区域,可能是一种代偿机制,但这仍有待进一步探讨。