Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND) Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA; Division of Child Psychiatry, Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND) Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA.
J Affect Disord. 2019 Mar 1;246:716-726. doi: 10.1016/j.jad.2018.12.068. Epub 2018 Dec 24.
A precision medicine approach to bipolar disorder (BD) requires greater knowledge of neural mechanisms, especially within the BD phenotype. The present study evaluated differences in resting state functional connectivity (RSFC) between young adults followed longitudinally since childhood with full-threshold type I BD (BD-I)-characterized by distinct manic episodes-or a more sub-syndromal presentation of BD (BD Not Otherwise Specified [BD-NOS]), compared to one another and to healthy controls (HC). Independent Components Analysis (ICA), a multivariate data-driven method, and dual regression were used to explore whether connectivity within resting state networks (RSNs) differentiated the groups, especially for characteristic fronto-limbic alterations in BD.
Young adults (ages 18-30) with BD-I (n = 28), BD-NOS (n = 14), and HCs (n = 52) underwent structural and RSFC neuroimaging. ICA derived 30 components from RSFC data; a subset of these components, representing well-characterized RSNs, was used for between-group analyses.
Participants with BD-I had significantly greater connectivity strength between the executive control network and right caudate vs. HCs. Participants with BD-NOS had significantly greater connectivity strength between the sensorimotor network and left precentral gyrus vs. HCs, which was significantly related to psychiatric symptoms.
Limitations included small BD-NOS sample size and variation in BD mood state and medication status.
Results for BD-I participants support prior findings of fronto-limbic alterations characterizing BD. Alterations in the sensorimotor network for adults with BD-NOS aligns with the small but growing body of evidence that sensorimotor network alterations may represent a marker for vulnerability to BD. Further study is required to evaluate specificity.
双相情感障碍(BD)的精准医疗方法需要更多地了解神经机制,尤其是在 BD 表型中。本研究评估了自儿童时期起即接受纵向随访的、伴有明显躁狂发作的全阈值 I 型 BD(BD-I)或更亚综合征 BD(BD-NOS)的年轻成年人与健康对照者(HC)之间的静息态功能连接(RSFC)差异。独立成分分析(ICA)是一种多变量数据驱动方法,双回归用于探索静息态网络(RSN)内的连接是否可以区分这些组,特别是对于 BD 的特征性额-边缘改变。
BD-I(n=28)、BD-NOS(n=14)和 HC(n=52)的年轻成年人接受了结构和 RSFC 神经影像学检查。ICA 从 RSFC 数据中得出 30 个成分;这些成分中的一个子集代表了特征明确的 RSN,用于组间分析。
与 HC 相比,BD-I 患者的执行控制网络与右侧尾状核之间的连接强度显著增加。BD-NOS 患者的感觉运动网络与左侧中央前回之间的连接强度显著增加,与精神病症状显著相关。
局限性包括 BD-NOS 样本量小、BD 情绪状态和药物状况的变化。
BD-I 参与者的结果支持了先前有关特征性额-边缘改变的发现。BD-NOS 成年人的感觉运动网络改变与越来越多的证据一致,即感觉运动网络改变可能代表易患 BD 的标志物。需要进一步研究以评估特异性。