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双相情感障碍中的认知表现与白质完整性指标相关。

Cognitive performances associate with measures of white matter integrity in bipolar disorder.

作者信息

Poletti Sara, Bollettini Irene, Mazza Elena, Locatelli Clara, Radaelli Daniele, Vai Benedetta, Smeraldi Enrico, Colombo Cristina, Benedetti Francesco

机构信息

Scientific Institute and University Vita-Salute San Raffaele, Department of Clinical Neurosciences, Via Stamira d׳Ancona 20, San Raffaele Turro Milan, Italy.

Scientific Institute and University Vita-Salute San Raffaele, Department of Clinical Neurosciences, Via Stamira d׳Ancona 20, San Raffaele Turro Milan, Italy.

出版信息

J Affect Disord. 2015 Mar 15;174:342-52. doi: 10.1016/j.jad.2014.12.030. Epub 2014 Dec 18.

Abstract

BACKGROUND

Neuropsychological deficits constitute enduring trait-like features in bipolar disorder (BD), and persist in euthymia. White matter (WM) abnormalities are one of the most consistently reported findings in neuroimaging studies of BD. We hypothesized that neuropsychological performances could correlate with WM integrity in a sample of bipolar patients in core WM tracts.

METHODS

Seventy-eight patients affected by BD were evaluated for verbal memory, working memory, psychomotor coordination, executive functions, attention and information processing, and verbal fluency through the Brief Assessment of Cognition in Schizophrenia. White matter integrity was evaluated using DTI and tract-based spatial statistics with threshold free cluster enhancement (p>0.949).

RESULTS

We observed that cognitive performances in attention and information processing, working memory, executive functions and psychomotor coordination were associated with DTI measures of WM integrity in several association fibres: inferior and superior longitudinal fasciculus, inferior fronto-occipital fasciculus, cingulum bundle, corpus callosum, and corona radiata.

LIMITATION

The drug treatments administered during the course of the illness could have influenced DTI measures and neurocognitive function. Other limitations include issues such as generalizability due to the lack of a control group, possible undetected past comorbidities, population stratification, and the presence of a 28% of patients which previously experienced delusions.

CONCLUSIONS

This is the first study to use a validated cognitive battery to investigate the principal cognitive domains in BD. Our data confirm the importance of WM integrity as a neurobiological underpinning of cognitive deficits.

摘要

背景

神经心理学缺陷是双相情感障碍(BD)的持久特质样特征,且在心境正常期持续存在。白质(WM)异常是BD神经影像学研究中最常报道的发现之一。我们假设在双相情感障碍患者的核心白质束样本中,神经心理学表现可能与白质完整性相关。

方法

通过精神分裂症认知简短评估,对78例双相情感障碍患者的言语记忆、工作记忆、心理运动协调、执行功能、注意力和信息处理以及言语流畅性进行评估。使用弥散张量成像(DTI)和基于束的空间统计学方法以及无阈值聚类增强技术(p>0.949)评估白质完整性。

结果

我们观察到,在注意力和信息处理、工作记忆、执行功能以及心理运动协调方面的认知表现与多条联合纤维的白质完整性DTI测量值相关,这些联合纤维包括:下纵束和上纵束、额枕下束、扣带束、胼胝体以及放射冠。

局限性

疾病过程中给予的药物治疗可能影响了DTI测量和神经认知功能。其他局限性包括:由于缺乏对照组导致的普遍性问题、可能未被发现的既往合并症、人群分层以及28%的患者既往有妄想经历等问题。

结论

这是第一项使用经过验证的认知测试组合来研究双相情感障碍主要认知领域的研究。我们的数据证实了白质完整性作为认知缺陷神经生物学基础的重要性。

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