Takei Yuichi, Suda Masashi, Aoyama Yoshiyuki, Sakurai Noriko, Tagawa Minami, Motegi Tomokazu, Yamaguchi Miho, Narita Kosuke, Fukuda Masato
Department of Psychiatry and Neuroscience, Gunma University of Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan.
Department of Psychiatry and Neuroscience, Gunma University of Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan.
J Psychiatr Res. 2014 Oct;57:74-83. doi: 10.1016/j.jpsychires.2014.06.009. Epub 2014 Jun 26.
Major depressive disorder (MDD) and bipolar disorder (BD) patients show speech characteristics that vary greatly according to mood state. In a previous study, we found impaired temporal and right inferior frontal gyrus (IFG) activation in schizophrenia during face-to-face conversation; no study had, however, previously investigated mood disorders during face-to-face conversation. Here, we investigated frontal and temporal lobe activation during conversation in patients with MDD and BD. Frontal and temporal lobe activation was measured using near-infrared spectroscopy (NIRS) in 29 patients with MDD, 31 patients with BD, and 31 normal controls (NC). We compared continuous activation and rapid change of activation with talk/listen phase changes during the conversation and analyzed the correlation between these indices and clinical variables. Both the MDD and BD groups showed decreased continuous activation in the left dorsolateral prefrontal (DLPFC) and left frontopolar cortices (FPCs); they also showed decreased rapid change in bilateral FPC activation. In the MDD group, the rapid change of activation was positively correlated with Global Assessment of Functioning (GAF) scores. In the BD group, continuous activation was negatively correlated with age of onset. These results indicate that frontal activation during conversation decreases in both MDD and BD. However, both continuous activation and rapid change may reflect the pathophysiological character of MDD and BD; in particular, the reduced amount of rapid change in the right FPC may be related to impaired adaptive ability in MDD.
重度抑郁症(MDD)和双相情感障碍(BD)患者的言语特征会根据情绪状态有很大差异。在之前的一项研究中,我们发现精神分裂症患者在面对面交谈时颞叶和右侧额下回(IFG)激活受损;然而,此前尚无研究在面对面交谈期间调查情绪障碍。在此,我们调查了MDD和BD患者交谈期间额叶和颞叶的激活情况。使用近红外光谱(NIRS)测量了29例MDD患者、31例BD患者和31名正常对照(NC)的额叶和颞叶激活情况。我们比较了交谈期间随着说话/倾听阶段变化的持续激活和激活的快速变化,并分析了这些指标与临床变量之间的相关性。MDD组和BD组在左侧背外侧前额叶(DLPFC)和左侧额极皮质(FPC)均表现出持续激活减少;他们在双侧FPC激活方面也表现出快速变化减少。在MDD组中,激活的快速变化与功能总体评定量表(GAF)评分呈正相关。在BD组中,持续激活与起病年龄呈负相关。这些结果表明,MDD和BD患者在交谈期间额叶激活均减少。然而,持续激活和快速变化可能都反映了MDD和BD的病理生理特征;特别是,右侧FPC快速变化量的减少可能与MDD患者的适应能力受损有关。