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双相障碍和重性抑郁障碍患者前额叶血液动力学反应的纵向变化与社会适应的关系。

Association between longitudinal changes in prefrontal hemodynamic responses and social adaptation in patients with bipolar disorder and major depressive disorder.

机构信息

Department of Clinical Laboratory, Tokyo Metropolitan Matsuzawa Hospital, Setagaya-ku, Tokyo 156-0057, Japan; Safety and Health Organization, Chiba University, Chiba 263-8522, Japan.

Department of Clinical Laboratory, Tokyo Metropolitan Matsuzawa Hospital, Setagaya-ku, Tokyo 156-0057, Japan; Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Setagaya-ku, Tokyo 156-0057, Japan; Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan.

出版信息

J Affect Disord. 2015 May 1;176:78-86. doi: 10.1016/j.jad.2015.01.042. Epub 2015 Jan 22.

Abstract

BACKGROUND

Patients with affective disorders exhibit changes in regional brain function and show abnormal social adaptation. However, to our knowledge, no near-infrared spectroscopy (NIRS) study has examined the relationship between these two phenomena longitudinally. This study examined the region-specific functional abnormality associated with bipolar disorder (BD) and major depressive disorder (MDD), and the association between particular longitudinal changes in regional activation and social adaptation.

METHODS

We evaluated frontotemporal functioning during a verbal fluency test (VFT) for patients with BD (N=18), those with MDD (N=10), and healthy controls (HCs; N=14) using NIRS. NIRS measurements and the Social Adaptation Self-evaluation Scale (SASS) were administered twice with an interval of approximately 6 months.

RESULTS

The BD and MDD groups showed lesser activation than the HCs in the bilateral ventro-lateral prefrontal cortex and the anterior part of the temporal cortex (VLPFC/aTC). Longitudinal changes in SASS scores were positively associated with the extent of change in left VLPFC/aTC activation in the BD group and with right VLPFC/aTC activation in the MDD group.

LIMITATIONS

Our small sample size limited statistical power, and the effect of medication and multiple comparisons cannot be excluded, although these effects were considered in the interpretation of the present results.

CONCLUSION

Longitudinal increases of VLPFC/aTC activation were associated with improvement in social adaptation in patients with BD and those with MDD. NIRS measurement could be a useful tool for objective evaluation of changes in social adaptation in BD and MDD.

摘要

背景

情感障碍患者表现出区域性大脑功能的变化,并表现出异常的社会适应能力。然而,据我们所知,尚无近红外光谱(NIRS)研究从纵向角度研究这两种现象之间的关系。本研究探讨了与双相情感障碍(BD)和重度抑郁症(MDD)相关的区域性功能异常,以及区域性激活的特定纵向变化与社会适应之间的关系。

方法

我们使用 NIRS 评估了 BD(N=18)、MDD(N=10)患者和健康对照者(HCs;N=14)在言语流畅性测试(VFT)中的额叶功能。NIRS 测量和社会适应自我评估量表(SASS)每隔约 6 个月进行两次评估。

结果

BD 和 MDD 组的双侧腹外侧前额叶皮质和颞叶前部(VLPFC/aTC)的激活程度均低于 HCs。BD 组左 VLPFC/aTC 激活变化与 SASS 评分的纵向变化呈正相关,MDD 组右 VLPFC/aTC 激活变化与 SASS 评分的纵向变化呈正相关。

局限性

我们的小样本量限制了统计效力,不能排除药物治疗和多次比较的影响,尽管在解释本研究结果时考虑了这些影响。

结论

VLPFC/aTC 激活的纵向增加与 BD 和 MDD 患者社会适应能力的改善有关。NIRS 测量可能是客观评估 BD 和 MDD 中社会适应变化的有用工具。

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