Stoddard J, Gotts S J, Brotman M A, Lever S, Hsu D, Zarate C, Ernst M, Pine D S, Leibenluft E
Department of Health and Human Services, Section on Bipolar Spectrum Disorders, Emotion and Development Branch,National Institute of Mental Health, National Institutes of Health,Bethesda,MD,USA.
Department of Health and Human Services, Section on Cognitive Neuropsychology,National Institute of Mental Health, National Institutes of Health,Bethesda, MD,USA.
Psychol Med. 2016 May;46(7):1509-22. doi: 10.1017/S0033291716000143. Epub 2016 Feb 29.
Major questions remain regarding the dysfunctional neural circuitry underlying the pathophysiology of bipolar disorder (BD) in both youths and adults. In both age groups, studies implicate abnormal intrinsic functional connectivity among prefrontal, limbic and striatal areas.
We collected resting-state functional magnetic resonance imaging (fMRI) data from youths and adults (ages 10-50 years) with BD (n = 39) and healthy volunteers (HV; n = 78). We identified brain regions with aberrant intrinsic functional connectivity in BD by first comparing voxel-wise mean global connectivity and then conducting correlation analyses. We used k-means clustering and multidimensional scaling to organize all detected regions into networks.
Across the brain, we detected areas of dysconnectivity in both youths and adults with BD relative to HV. There were no significant age-group × diagnosis interactions. When organized by interregional connectivity, the areas of dysconnectivity in patients with BD comprised two networks: one of temporal and parietal areas involved in late stages of visual processing, and one of corticostriatal areas involved in attention, cognitive control and response generation.
These data suggest that two networks show abnormal intrinsic functional connectivity in BD. Regions in these networks have been implicated previously in BD. We observed similar dysconnectivity in youths and adults with BD. These findings provide guidance for refining models of network-based dysfunction in BD.
关于双相情感障碍（BD）在青少年和成年人病理生理学中潜在的功能失调神经回路，仍存在重大问题。在这两个年龄组中，研究表明前额叶、边缘系统和纹状体区域之间存在异常的内在功能连接。
我们收集了患有BD的青少年和成年人（年龄10 - 50岁，n = 39）以及健康志愿者（HV；n = 78）的静息态功能磁共振成像（fMRI）数据。我们首先通过比较体素层面的平均全局连接性，然后进行相关性分析，来确定BD中具有异常内在功能连接的脑区。我们使用k均值聚类和多维缩放将所有检测到的区域组织成网络。
在全脑范围内，相对于HV，我们在患有BD的青少年和成年人中均检测到了连接性障碍区域。不存在显著的年龄组×诊断交互作用。当按区域间连接性进行组织时，BD患者的连接性障碍区域包括两个网络：一个是涉及视觉处理后期的颞叶和顶叶区域网络，另一个是涉及注意力、认知控制和反应生成的皮质纹状体区域网络。
这些数据表明，在BD中有两个网络显示出异常的内在功能连接。这些网络中的区域先前已被认为与BD有关。我们在患有BD的青少年和成年人中观察到了类似的连接性障碍。这些发现为完善BD中基于网络的功能障碍模型提供了指导。
