Zhao Lianping, Wang Ying, Jia Yanbin, Zhong Shuming, Sun Yao, Zhou Zhifeng, Zhang Zhongping, Huang Li
Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China.
Department of Radiology, Gansu Provincial Hospital, Gansu, China.
Psychiatry Investig. 2017 Jul;14(4):471-482. doi: 10.4306/pi.2017.14.4.471. Epub 2017 Jul 11.
Bipolar disorder (BD) is often misdiagnosed as unipolar depression (UD), leading to mistreatment and poor clinical outcomes. However, little is known about the similarities and differences in subcorticalgray matter regions between BD and UD.
Thirty-five BD patients, 30 UD patients and 40 healthy controls underwent diffusional kurtosis imaging (DKI) and three dimensional arterial spin labeling (3D ASL). The parameters including mean kurtosis (MK), axial kurtosis (Ka), radial kurtosis (Kr), fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (Da), radial diffusivity (Dr) and cerebral blood flow (CBF) were measured by using regions-of-interest analysis in the caudate, putamen and thalamus of the subcortical gray matter regions.
UD exhibited differences from controls for DKI measures and CBF in the left putamen and caudate. BD showed differences from controls for DKI measures in the left caudate. Additionally, BD showed lower Ka in right putamen, higher MD in right caudate compared with UD. Receiver operating characteristic analysis revealed the Kr of left caudate had the highest predictive power for distinguishing UD from controls.
The two disorders may have overlaps in microstructural abnormality in basal ganglia. The change of caudate may serve as a potential biomarker for UD.
双相情感障碍（BD）常被误诊为单相抑郁（UD），导致治疗不当和临床预后不佳。然而，关于BD和UD在皮质下灰质区域的异同知之甚少。
35例BD患者、30例UD患者和40名健康对照者接受了扩散峰度成像（DKI）和三维动脉自旋标记（3D ASL）检查。通过对皮质下灰质区域的尾状核、壳核和丘脑进行感兴趣区分析，测量包括平均峰度（MK）、轴向峰度（Ka）、径向峰度（Kr）、分数各向异性（FA）、平均扩散率（MD）、轴向扩散率（Da）、径向扩散率（Dr）和脑血流量（CBF）等参数。
UD在左侧壳核和尾状核的DKI测量值和CBF方面与对照组存在差异。BD在左侧尾状核的DKI测量值与对照组存在差异。此外，与UD相比，BD右侧壳核的Ka较低，右侧尾状核的MD较高。受试者工作特征分析显示，左侧尾状核的Kr对区分UD与对照组具有最高的预测能力。
这两种疾病在基底节的微观结构异常方面可能存在重叠。尾状核的变化可能作为UD的潜在生物标志物。
