Department of Psychiatry, Washington University in Saint Louis, 660 South Euclid Avenue, Box 8134, Saint Louis, Missouri 63110, USA.
J Affect Disord. 2013 Sep 5;150(2):601-9. doi: 10.1016/j.jad.2013.01.051. Epub 2013 Mar 13.
Bipolar disorder (BPD) and schizophrenia (SCZ) share clinical characteristics and genetic contributions. Functional dysconnectivity across various brain networks has been reported to contribute to the pathophysiology of both SCZ and BPD. However, research examining resting-state neural network dysfunction across multiple networks to understand the relationship between these two disorders is lacking.
We conducted a resting-state functional connectivity fMRI study of 35 BPD and 25 SCZ patients, and 33 controls. Using previously defined regions-of-interest, we computed the mean connectivity within and between five neural networks: default mode (DM), fronto-parietal (FP), cingulo-opercular (CO), cerebellar (CER), and salience (SAL). Repeated measures ANOVAs were used to compare groups, adjusting false discovery rate to control for multiple comparisons. The relationship of connectivity with the SANS/SAPS, vocabulary and matrix reasoning was investigated using hierarchical linear regression analyses.
Decreased within-network connectivity was only found for the CO network in BPD. Across groups, connectivity was decreased between CO-CER (p<0.001), to a larger degree in SCZ than in BPD. In SCZ, there was also decreased connectivity in CO-SAL, FP-CO, and FP-CER, while BPD showed decreased CER-SAL connectivity. Disorganization symptoms were predicted by connectivity between CO-CER and CER-SAL.
Our findings indicate dysfunction in the connections between networks involved in cognitive and emotional processing in the pathophysiology of BPD and SCZ. Both similarities and differences in connectivity were observed across disorders. Further studies are required to investigate relationships of neural networks to more diverse clinical and cognitive domains underlying psychiatric disorders.
双相情感障碍（BPD）和精神分裂症（SCZ）具有相似的临床特征和遗传贡献。跨多种大脑网络的功能连接失调被认为是导致 SCZ 和 BPD 病理生理学的原因之一。然而，目前缺乏研究使用静息态功能磁共振成像（rs-fMRI）来探究多个神经网络的静息态神经功能连接障碍，以理解这两种疾病之间的关系。
我们对 35 名 BPD 患者、25 名 SCZ 患者和 33 名健康对照者进行了静息态功能连接 fMRI 研究。使用之前定义的感兴趣区，我们计算了五个神经网络（默认模式网络（DMN）、额顶叶网络（FP）、扣带回顶叶网络（CO）、小脑网络（CER）和突显网络（SAL））内和网络间的平均连接。使用重复测量方差分析比较组间差异，并通过虚假发现率校正进行多重比较。使用分层线性回归分析研究连接与 SANS/SAPS、词汇和矩阵推理的关系。
仅在 BPD 患者中发现 CO 网络内连接减少。在各组之间，CO-CER 之间的连接减少（p<0.001），SCZ 中的减少程度大于 BPD。在 SCZ 中，CO-SAL、FP-CO 和 FP-CER 之间的连接也减少，而 BPD 患者中 CER-SAL 之间的连接减少。精神分裂症的紊乱症状与 CO-CER 和 CER-SAL 之间的连接有关。
我们的研究结果表明，在 BPD 和 SCZ 的病理生理学中，参与认知和情感处理的网络之间的连接存在功能障碍。在不同的疾病中观察到连接的相似性和差异性。需要进一步的研究来探究神经网络与精神障碍下更广泛的临床和认知领域之间的关系。
