Matsubara Toshio, Matsuo Koji, Harada Kenichiro, Nakano Masayuki, Nakashima Mami, Watanuki Toshio, Egashira Kazuteru, Furukawa Matakazu, Matsunaga Naofumi, Watanabe Yoshifumi
Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan.
Health Service Center, Yamaguchi University Organization for University Education, Yamaguchi, Yamaguchi, Japan.
PLoS One. 2016 Dec 28;11(12):e0168493. doi: 10.1371/journal.pone.0168493. eCollection 2016.
Little is known about disorder-specific biomarkers of bipolar disorder (BD) and major depressive disorder (MDD). Our aim was to determine a neural substrate that could be used to distinguish BD from MDD. Our study included a BD group (10 patients with BD, 10 first-degree relatives (FDRs) of individuals with BD), MDD group (17 patients with MDD, 17 FDRs of individuals with MDD), and 27 healthy individuals. Structural and functional brain abnormalities were evaluated by voxel-based morphometry and a trail making test (TMT), respectively. The BD group showed a significant main effect of diagnosis in the gray matter (GM) volume of the anterior cingulate cortex (ACC; p = 0.01) and left insula (p < 0.01). FDRs of individuals with BD showed significantly smaller left ACC GM volume than healthy subjects (p < 0.01), and patients with BD showed significantly smaller ACC (p < 0.01) and left insular GM volume (p < 0.01) than healthy subjects. The MDD group showed a tendency toward a main effect of diagnosis in the right and left insular GM volume. The BD group showed a significantly inverse correlation between the left insular GM volume and TMT-A scores (p < 0.05). Our results suggest that the ACC volume could be a distinct endophenotype of BD, while the insular volume could be a shared BD and MDD endophenotype. Moreover, the insula could be associated with cognitive decline and poor outcome in BD.
关于双相情感障碍（BD）和重度抑郁症（MDD）的疾病特异性生物标志物，我们所知甚少。我们的目的是确定一种可用于区分BD和MDD的神经基质。我们的研究包括一个BD组（10例BD患者、10例BD患者的一级亲属（FDR））、MDD组（17例MDD患者、17例MDD患者的FDR）以及27名健康个体。分别通过基于体素的形态学测量和连线测验（TMT）评估脑结构和功能异常。BD组在前扣带回皮质（ACC；p = 0.01）和左侧岛叶（p < 0.01）的灰质（GM）体积中显示出显著的诊断主效应。BD患者的FDR显示左侧ACC的GM体积显著小于健康受试者（p < 0.01），BD患者的ACC（p < 0.01）和左侧岛叶的GM体积（p < 0.01）显著小于健康受试者。MDD组在左右岛叶GM体积中显示出诊断主效应的趋势。BD组左侧岛叶GM体积与TMT-A评分之间存在显著负相关（p < 0.05）。我们的结果表明，ACC体积可能是BD的一种独特的内表型，而岛叶体积可能是BD和MDD共有的内表型。此外，岛叶可能与BD的认知衰退和不良预后有关。
