Department of Psychiatry, First Affiliated Hospital, Jinan University, No. 613 West Huangpu Avenue Tianhe District, Guangzhou 510630, China.
Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou 510630, China.
J Affect Disord. 2018 Dec 1;241:282-290. doi: 10.1016/j.jad.2018.08.031. Epub 2018 Aug 8.
Executive dysfunction and biochemical abnormalities using proton magnetic resonance spectroscopy (H-MRS) have been reported in bipolar disorder (BD). Much less is known about the information from BD with suicidal ideation (SI). This study aimed to assess alterations of execution function and biochemical metabolism in BD with SI, in BD without SI, and in healthy controls. The associations between execution function and biochemical metabolism in the two BD patient groups were also been studied.
92 patients with bipolar disorder during a depressive episode (50 with current SI, and 42 without SI), as well as, 43 healthy controls were recruited in our study. Executive function was assessed by Wisconsin Card Sorting Test (WCST). Bilateral metabolite levels of prefrontal cortex (PFC), anterior cingulated cortex (ACC), lenticular nucleus (LN) of basal ganglia and thalamus were obtained by H-MRS at 3.0 T, then determined the ratios of N-acetyl aspartate (NAA), choline-containing compounds (Cho), myo-inositol (mI) to creatine (Cr).
Number of categories completed (CC) in BD with SI was significantly less than healthy controls. NAA/Cr ratios of left PFC in the two BD patient groups (with or without SI) were significantly lower than healthy controls, and NAA/Cr ratios of left thalamus were significantly higher than healthy controls. Moreover, NAA/Cr ratio of right LN in BD without SI was higher than BD with SI and healthy controls. For BD with SI, NAA/Cr ratio of left thalamus was negatively correlated with number of CC.
These results suggested that BD with or without SI may have abnormal NAA metabolism, and NAA/Cr ratio of right LN may distinguish SI from the BD patients. Further, BD with SI may have executive function impairment, which may be associated with the abnormal NAA metabolism in the left thalamus.
执行功能障碍和生化异常使用质子磁共振波谱（H-MRS）已在双相障碍（BD）中报道。关于有自杀意念（SI）的 BD 患者的信息则知之甚少。本研究旨在评估有 SI 和无 SI 的 BD 患者的执行功能和生化代谢变化，并研究两组 BD 患者之间执行功能与生化代谢之间的关系。
本研究共纳入 92 名处于抑郁发作期的双相障碍患者（50 名有当前 SI，42 名无 SI）和 43 名健康对照者。执行功能采用威斯康星卡片分类测试（WCST）评估。在 3.0T 上获得双侧前额叶皮层（PFC）、前扣带回皮层（ACC）、基底节豆状核和丘脑的代谢物水平，然后确定 N-乙酰天冬氨酸（NAA）、胆碱化合物（Cho）、肌醇（mI）与肌酸（Cr）的比值。
有 SI 的 BD 患者的完成分类数（CC）明显少于健康对照组。两组 BD 患者（有或无 SI）左 PFC 的 NAA/Cr 比值明显低于健康对照组，左丘脑的 NAA/Cr 比值明显高于健康对照组。此外，BD 无 SI 患者右 LN 的 NAA/Cr 比值高于 BD 有 SI 和健康对照组。对于有 SI 的 BD 患者，左丘脑的 NAA/Cr 比值与 CC 数呈负相关。
这些结果表明，有或无 SI 的 BD 患者可能存在 NAA 代谢异常，右 LN 的 NAA/Cr 比值可能有助于将 SI 与 BD 患者区分开。此外，有 SI 的 BD 患者可能存在执行功能障碍，这可能与左丘脑的 NAA 代谢异常有关。
