Singh Manpreet K, Chang Kiki D, Kelley Ryan G, Saggar Manish, Reiss Allan L, Gotlib Ian H
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
Bipolar Disord. 2014 Nov;16(7):678-89. doi: 10.1111/bdi.12221. Epub 2014 Jun 17.
Bipolar disorder (BD) has been associated with dysfunctional brain connectivity and with family chaos. It is not known whether aberrant connectivity occurs before illness onset, representing vulnerability for developing BD amidst family chaos. We used resting-state functional magnetic resonance imaging (fMRI) to examine neural network dysfunction in healthy offspring living with parents with BD and healthy comparison youth.
Using two complementary methodologies [data-driven independent component analysis (ICA) and hypothesis-driven region-of-interest (ROI)-based intrinsic connectivity], we examined resting-state fMRI data in 8-17-year-old healthy offspring of a parent with BD (n = 24; high risk) and age-matched healthy youth without any personal or family psychopathology (n = 25; low risk).
ICA revealed that, relative to low-risk youth, high-risk youth showed increased connectivity in the ventrolateral prefrontal cortex (VLPFC) subregion of the left executive control network (ECN), which includes frontoparietal regions important for emotion regulation. ROI-based analyses revealed that high-risk versus low-risk youth had decreased connectivities between the left amygdala and pregenual cingulate, between the subgenual cingulate and supplementary motor cortex, and between the left VLPFC and left caudate. High-risk youth showed stronger connections in the VLPFC with age and higher functioning, which may be neuroprotective, and weaker connections between the left VLPFC and caudate with more family chaos, suggesting an environmental influence on frontostriatal connectivity.
Healthy offspring of parents with BD show atypical patterns of prefrontal and subcortical intrinsic connectivity that may be early markers of resilience to or vulnerability for developing BD. Longitudinal studies are needed to determine whether these patterns predict outcomes.
双相情感障碍（BD）与大脑功能连接障碍以及家庭混乱有关。尚不清楚异常连接是否在疾病发作之前就已出现，这表明在家庭混乱的情况下患BD的易感性。我们使用静息态功能磁共振成像（fMRI）来检查与患有BD的父母一起生活的健康后代以及健康对照青年的神经网络功能障碍。
我们使用两种互补的方法[数据驱动的独立成分分析（ICA）和基于假设驱动的感兴趣区域（ROI）的内在连接性分析]，检查了8至17岁的患有BD的父母的健康后代（n = 24；高风险）和年龄匹配的无任何个人或家庭精神病理学的健康青年（n = 25；低风险）的静息态fMRI数据。
ICA显示，相对于低风险青年，高风险青年在左执行控制网络（ECN）的腹外侧前额叶皮层（VLPFC）子区域的连接性增加，该区域包括对情绪调节重要的额顶叶区域。基于ROI的分析显示，高风险青年与低风险青年相比，左杏仁核与膝前扣带回之间、膝下扣带回与辅助运动皮层之间以及左VLPFC与左尾状核之间的连接性降低。高风险青年的VLPFC与年龄和较高功能之间的连接更强，这可能具有神经保护作用，而左VLPFC与尾状核之间的连接在家庭混乱更多的情况下更弱，这表明环境对额纹状体连接性有影响。
患有BD的父母的健康后代表现出前额叶和皮层下内在连接的非典型模式，这可能是发展为BD的恢复力或易感性的早期标志。需要进行纵向研究以确定这些模式是否能预测结果。
