School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, 518060, China.
Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging, Shenzhen University, Shenzhen, 518060, China.
Brain Imaging Behav. 2019 Aug;13(4):905-913. doi: 10.1007/s11682-018-9915-z.
Numerous functional magnetic resonance imaging studies have been conducted to elucidate emotion processing of patients with bipolar disorder (BD), but due to different inclusion criteria used, especially for the history of medication use, the results for euthymic BD patients are inconsistent. For this reason, brain functional effects of psychopharmacological treatments on BD patients have been investigated by numerous fMRI studies, but there is no existing report for brain functional effects of different mood stabilizers. In this study, we compared the emotion processing in BD patients treated by two popularly used mood stabilizer, lithium (N = 13; 30 ± 9 years) and valproate (N = 16; 33 ± 8 years), as well as healthy controls (HC; N = 16; 29 ± 7 years). Two emotional tasks were applied in this study: one used emotional pictures of everyday objects and scenes, and another used emotional facial expression pictures. The main findings were that BD on lithium showed increased fMRI activation in the right dorsal anterior cingulate cortex and bilateral lingual gyrus in response to the positive pictures relative to neutral pictures compared with BD on valproate and HC. Besides, no abnormal activation was observed in the amygdala. Limitations of this study comprise the small sample size and the cross-sectional design. Therefore, the results were suggestive of a different effect of lithium and valproate on brain activities during emotion processing but no causal role can be proposed. The enduring impairments in euthymic state could provide clues to the brain regions involved in the primary pathology of BD.
大量功能磁共振成像研究已经开展，以阐明双相情感障碍（BD）患者的情绪处理过程，但由于使用的纳入标准不同，尤其是药物使用史，对于病情稳定的 BD 患者的研究结果并不一致。出于这个原因，许多 fMRI 研究调查了精神药理学治疗对 BD 患者的大脑功能影响，但对于不同心境稳定剂的大脑功能影响尚无现有报道。在这项研究中，我们比较了两种常用心境稳定剂锂（N = 13；30 ± 9 岁）和丙戊酸盐（N = 16；33 ± 8 岁）治疗的 BD 患者与健康对照者（HC；N = 16；29 ± 7 岁）的情绪处理。本研究应用了两种情绪任务：一种使用日常物体和场景的情绪图片，另一种使用情绪面部表情图片。主要发现是，与丙戊酸盐和 HC 相比，锂治疗的 BD 在对正性图片的反应中右侧背侧前扣带皮层和双侧舌回的 fMRI 激活增加。此外，杏仁核未观察到异常激活。本研究的局限性包括样本量小和横断面设计。因此，结果提示锂和丙戊酸盐对情绪处理过程中大脑活动的影响不同，但不能提出因果关系。在病情稳定状态下的持续损伤可能为 BD 的主要病理学涉及的脑区提供线索。
