Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Psychiatry Res Neuroimaging. 2018 Dec 30;282:143-150. doi: 10.1016/j.pscychresns.2018.06.001. Epub 2018 Jun 4.
Deficits in theory of mind (ToM) processing have been observed in people with bipolar disorder (BD), but the neural basis of these deficits remains unclear. Here, we studied the relations between neural activation, dysfunctional beliefs and behavioral responses in people with BD during a second-order ToM task. Twenty-five patients and 25 healthy-control participants (HC) underwent functional magnetic resonance imaging (fMRI) while performing a novel ToM task. The Dysfunctional Attitudes scale (DAS) and the Brief Hypomanic Attitudes and Positive Predictions Inventory (BHAPPI) were used to assess dysfunctional beliefs. Significant differences in neural activation were observed between HC and BD patients in regions associated with ToM processing: medial frontal, cingulate, anterior cingulate and superior temporal gyri. Correlations between DAS scores and neural activity in medial frontal and cingulate gyri were observed for HC only. Increased activation in brain regions associated with ToM processing in patients compared to HC provides further evidence of disruption in networks controlling social-cognitive processes. Whether this results from compensatory responses to maintain appropriate behavior is unknown.
在双相情感障碍（BD）患者中观察到心理理论（ToM）加工缺陷，但这些缺陷的神经基础仍不清楚。在这里，我们研究了在执行二阶 ToM 任务期间，BD 患者的神经激活、功能失调信念和行为反应之间的关系。25 名患者和 25 名健康对照参与者（HC）接受了功能磁共振成像（fMRI）检查，同时进行了一项新的 ToM 任务。使用功能失调态度量表（DAS）和简短躁狂态度和积极预测清单（BHAPPI）评估功能失调信念。在与 ToM 加工相关的区域中观察到 HC 和 BD 患者之间的神经激活存在显著差异：内侧前额叶、扣带回、前扣带回和颞上回。仅在 HC 中观察到 DAS 评分与内侧前额叶和扣带回神经活动之间的相关性。与 HC 相比，患者的 ToM 加工相关脑区的激活增加，这进一步证明了控制社会认知过程的网络受到干扰。这是否是为了维持适当行为而产生的代偿反应尚不清楚。
