Tu Pei-Chi, Kuan Yi-Hsuan, Li Cheng-Ta, Su Tung-Ping
Department of Medical Research, Taipei Veterans General Hospital, Taipei 112, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, Taipei 112, Taiwan; Institute of Philosophy of Mind and Cognition, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.
Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.
J Affect Disord. 2017 Jun;215:218-224. doi: 10.1016/j.jad.2017.03.036. Epub 2017 Mar 12.
This study investigated the structural correlates of creative thinking in patients with bipolar disorder (BD) to understand the possible neural mechanism of creative thinking in BD.
We recruited 59 patients with BD I or BD II (35.3±8.5 y) and 56 age- and sex-matched controls (HCs; 34±7.4 y). Each participant underwent structural magnetic resonance imaging and evaluation of creative thinking, which was assessed using two validated tools: the Chinese version of the Abbreviated Torrance Test for Adults for divergent thinking and the Chinese Word Remote Associates Test for remote association. Voxel-based morphometry was performed using SPM12.
In patients with BD, divergent thinking positively correlated with the gray matter volume (GMV) in right medial frontal gyrus (Brodmann area [BA] 9), and remote association positively correlated with the GMV in the medial prefrontal gyrus (BA 10). In the HCs, divergent thinking negatively correlated with the GMV in left superior frontal gyrus (BA 8) and positively correlated with the GMV in the precuneus and occipital regions, and remote association positively correlated with the GMV in the hippocampus.
Patients with BD were receiving various dosages of antipsychotics, antidepressants and mood stabilizer. These medications may confound the GMV-creative thinking relationship in patients with BD.
Our findings indicate that medial prefrontal cortex plays a major and positive role in creative thinking in patients with BD. By contrary, creative thinking involves more diverse structures, and the prefrontal cortex may have an opposite effect in HCs.
本研究调查了双相情感障碍（BD）患者创造性思维的结构相关性，以了解BD患者创造性思维可能的神经机制。
我们招募了59例I型或II型BD患者（35.3±8.5岁）和56例年龄及性别匹配的对照者（HCs；34±7.4岁）。每位参与者均接受了结构磁共振成像和创造性思维评估，创造性思维通过两种经过验证的工具进行评估：中文版成人简式托兰斯发散性思维测验和中文词语远距离联想测验。使用SPM12进行基于体素的形态测量。
在BD患者中，发散性思维与右侧额内侧回（布罗德曼区[BA]9）的灰质体积（GMV）呈正相关，远距离联想与额内侧前回（BA 10）的GMV呈正相关。在HCs中，发散性思维与左侧额上回（BA 8）的GMV呈负相关，与楔前叶和枕叶区域的GMV呈正相关，远距离联想与海马体的GMV呈正相关。
BD患者正在接受各种剂量的抗精神病药、抗抑郁药和心境稳定剂治疗。这些药物可能会混淆BD患者GMV与创造性思维之间的关系。
我们的研究结果表明，额内侧前皮质在BD患者的创造性思维中起主要的积极作用。相反，创造性思维涉及更多样化的结构，前额叶皮质在HCs中可能具有相反的作用。
