The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China; Center for Information in BioMedicine, Key laboratory for Neuroinformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China.
Center for Information in BioMedicine, Key laboratory for Neuroinformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China.
Prog Neuropsychopharmacol Biol Psychiatry. 2019 Mar 2;90:177-185. doi: 10.1016/j.pnpbp.2018.11.009. Epub 2018 Nov 27.
Clinically distinguishing bipolar disorder (BD) from major depressive disorder (MDD) during depressive states is difficult. Neuroimaging findings suggested that patients with BD and those with MDD differed with respect to the gray matter volumes of their subcortical structures, especially in their striatum. However, whether these disorders have different effects on functionally striatal neuronal activity and connectivity is unclear.
Arterial spin labeling and resting-state functional MRI was performed on 25 currently depressive patients with BD, 25 depressive patients with MDD, and 34 healthy controls (HCs). The functional properties of striatal neuronal activity (cerebral blood flow, CBF) and its functional connectivity (FC) were analyzed, and the results from the three groups were compared. The result of the multiple comparisons was corrected on the basis of the Gaussian Random Field theory.
The patients with BD and those with MDD both had higher CBF values than the HCs in the right caudate and right putamen. The hyper-metabolism of right striatum in BD patients was associated with increased average duration per depressive episode. The two disorders showed commonly increased FC between the striatum and dorsolateral prefrontal cortex, whereas the altered FC of the striatum with precuneus/cuneus was observed only in patients with BD.
Patients with BD and those with MDD had a common deficit in their prefrontal-limbic-striatal circuits. The altered striato-precuneus FC can be considered as a marker for the differentiation of patients with BD from those with MDD.
在抑郁状态下，临床上很难将双相情感障碍（BD）与重度抑郁症（MDD）区分开来。神经影像学研究发现，BD 患者和 MDD 患者的皮质下结构，尤其是纹状体的灰质体积存在差异。然而，这些疾病是否对纹状体神经元的功能活动和连接有不同的影响尚不清楚。
对 25 名目前处于抑郁状态的 BD 患者、25 名 MDD 抑郁患者和 34 名健康对照者（HCs）进行动脉自旋标记和静息态功能磁共振成像。分析纹状体神经元活动（脑血流，CBF）及其功能连接（FC）的功能特性，并比较三组的结果。基于高斯随机场理论对多重比较的结果进行了校正。
BD 患者和 MDD 患者的右侧尾状核和右侧壳核的 CBF 值均高于 HCs。BD 患者右侧纹状体的高代谢与抑郁发作的平均持续时间增加有关。两种疾病的纹状体与背外侧前额叶皮层之间的 FC 均增加，而仅在 BD 患者中观察到纹状体与楔前叶/楔叶的改变的 FC。
BD 患者和 MDD 患者的前额叶-边缘-纹状体回路均存在共同缺陷。纹状体-楔前叶 FC 的改变可作为将 BD 患者与 MDD 患者区分开来的标志物。
