Bertocci Michele A, Bebko Genna, Dwojak Amanda, Iyengar Satish, Ladouceur Cecile D, Fournier Jay C, Versace Amelia, Perlman Susan B, Almeida Jorge R C, Travis Michael J, Gill Mary Kay, Bonar Lisa, Schirda Claudiu, Diwadkar Vaibhav A, Sunshine Jeffrey L, Holland Scott K, Kowatch Robert A, Birmaher Boris, Axelson David, Horwitz Sarah M, Frazier Thomas, Arnold L Eugene, Fristad Mary A, Youngstrom Eric A, Findling Robert L, Phillips Mary L
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh.
Department of Psychology, University of Pittsburgh.
Biol Psychiatry Cogn Neurosci Neuroimaging. 2017 May;2(4):336-345. doi: 10.1016/j.bpsc.2016.06.009.
Changes in neural circuitry function may be associated with longitudinal changes in psychiatric symptom severity. Identification of these relationships may aid in elucidating the neural basis of psychiatric symptom evolution over time. We aimed to distinguish these relationships using data from the Longitudinal Assessment of Manic Symptoms (LAMS) cohort.
Forty-one youth completed two study visits (mean=21.3 months). Elastic-net regression (Multiple response Gaussian family) identified emotional regulation neural circuitry that changed in association with changes in depression, mania, anxiety, affect lability, and positive mood and energy dysregulation, accounting for clinical and demographic variables.
Non-zero coefficients between change in the above symptom measures and change in activity over the inter-scan interval were identified in right amygdala and left ventrolateral prefrontal cortex. Differing patterns of neural activity change were associated with changes in each of the above symptoms over time. Specifically, from Scan1 to Scan2, worsening affective lability and depression severity were associated with increased right amygdala and left ventrolateral prefrontal cortical activity. Worsening anxiety and positive mood and energy dysregulation were associated with decreased right amygdala and increased left ventrolateral prefrontal cortical activity. Worsening mania was associated with increased right amygdala and decreased left ventrolateral prefrontal cortical activity. These changes in neural activity between scans accounted for 13.6% of the variance; that is 25% of the total explained variance (39.6%) in these measures.
Distinct neural mechanisms underlie changes in different mood and anxiety symptoms overtime.
神经回路功能的变化可能与精神症状严重程度的纵向变化有关。识别这些关系可能有助于阐明精神症状随时间演变的神经基础。我们旨在利用躁狂症状纵向评估（LAMS）队列的数据来区分这些关系。
41名青少年完成了两次研究访视（平均间隔21.3个月）。弹性网回归（多元响应高斯族）确定了与抑郁、躁狂、焦虑、情绪不稳定以及积极情绪和能量失调变化相关的情绪调节神经回路，并对临床和人口统计学变量进行了分析。
在右侧杏仁核和左侧腹外侧前额叶皮层中，上述症状指标的变化与扫描间隔期间活动变化之间存在非零系数关系。不同的神经活动变化模式与上述每种症状随时间的变化相关。具体而言，从扫描1到扫描2，情绪不稳定和抑郁严重程度加重与右侧杏仁核和左侧腹外侧前额叶皮层活动增加有关。焦虑以及积极情绪和能量失调加重与右侧杏仁核活动减少和左侧腹外侧前额叶皮层活动增加有关。躁狂加重与右侧杏仁核活动增加和左侧腹外侧前额叶皮层活动减少有关。扫描间神经活动的这些变化占方差的13.6%；即这些指标中总解释方差（39.6%）的25%。
不同的情绪和焦虑症状随时间变化的背后存在不同的神经机制。
