European College of Neuropsychopharmacology, Networks Initiative, Neuroimaging Network, London, UK.
Eur Neuropsychopharmacol. 2012 Feb;22(2):100-13. doi: 10.1016/j.euroneuro.2011.07.003. Epub 2011 Aug 5.
Neuroimaging studies have consistently shown functional brain abnormalities in patients with Bipolar Disorder (BD) and Major Depressive Disorder (MDD). However, the extent to which these two disorders are associated with similar or distinct neural changes remains unclear. We conducted a systematic review of functional magnetic resonance imaging studies comparing BD and MDD patients to healthy participants using facial affect processing paradigms. Relevant spatial coordinates from twenty original studies were subjected to quantitative Activation Likelihood Estimation meta-analyses based on 168 BD and 189 MDD patients and 344 healthy controls. We identified common and distinct patterns of neural engagement for BD and MDD within the facial affect processing network. Both disorders were associated with increased engagement of limbic regions. Diagnosis-specific differences were observed in cortical, thalamic and striatal regions. Decreased ventrolateral prefrontal cortical engagement was associated with BD while relative hypoactivation of the sensorimotor cortices was seen in MDD. Increased responsiveness in the thalamus and basal ganglia were associated with BD. These findings were modulated by stimulus valence. These data suggest that whereas limbic overactivation is reported consistently in patients with mood disorders, future research should consider the relevance of a wider network of regions in formulating conceptual models of BD and MDD.
神经影像学研究一致表明，双相情感障碍（BD）和重性抑郁障碍（MDD）患者的大脑功能存在异常。然而，这两种疾病与相似或不同的神经变化有多大程度的关联仍不清楚。我们对使用面部情感处理范式比较 BD 和 MDD 患者与健康参与者的功能磁共振成像研究进行了系统综述。根据 168 名 BD 和 189 名 MDD 患者和 344 名健康对照者的 20 项原始研究的相关空间坐标，我们进行了基于激活似然估计的定量荟萃分析。我们确定了在面部情感处理网络中 BD 和 MDD 的共同和独特的神经参与模式。两种疾病都与边缘区域的参与增加有关。在皮质、丘脑和纹状体区域观察到与诊断相关的差异。背外侧前额叶皮质的参与减少与 BD 有关，而感觉运动皮质的相对低激活与 MDD 有关。丘脑和基底神经节的反应性增加与 BD 有关。这些发现受到刺激效价的调节。这些数据表明，虽然情绪障碍患者的边缘系统过度激活是一致的，但未来的研究应该考虑更广泛的区域网络在制定 BD 和 MDD 的概念模型中的相关性。
