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未用药双相情感障碍 II 型患者静息状态下局部一致性异常。

Abnormal resting-state regional homogeneity in unmedicated bipolar II disorder.

机构信息

Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China.

Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China.

出版信息

J Affect Disord. 2019 Sep 1;256:604-610. doi: 10.1016/j.jad.2019.06.037. Epub 2019 Jun 30.

Abstract

BACKGROUND

Previous studies demonstrated that patients with bipolar disorder (BD) exhibited abnormal neural activity in multiple brain regions. However, no study has been conducted to identify regional intrinsic neural activity changes in BD II. In the present study, we used the regional homogeneity (ReHo) approach to explore the regional abnormal neural activity in bipolar II disorder METHODS: One hundred unmedicated patients with BD II depression and 100 healthy controls (HC) underwent the resting-state functional magnetic resonance imaging. The ReHo values of each voxel was calculated in the whole brain. The two-sample t-test and threshold-free cluster enhancement (TFCE) correction were applied for the ReHo analysis.

RESULTS

Compared with the HC group, the BD II group showed significantly decreased ReHo in the left orbitofrontal cortex, and increased ReHo in the right precentral gyrus, right supplementary motor area and bilateral middle occipital gyrus (P < .05, TFCE corrected).

LIMITATIONS

This study lacks the evidence of brain structural changes, and used the cross-sectional design which did not explore local alterations of remitted and manic patients.

CONCLUSION

Our findings revealed abnormal local intrinsic neural activity during resting state which may contribute to the pathophysiology of bipolar II disorder. Particularly the disrupted balance between the prefrontal cortex and primary sensorimotor regions provides evidence for the unique pathological mechanism underlying BD.

摘要

背景

先前的研究表明,双相情感障碍(BD)患者在多个脑区表现出异常的神经活动。然而,目前还没有研究来确定双相情感障碍 II 型患者的局部内在神经活动变化。在本研究中,我们使用局部一致性(ReHo)方法来探索双相情感障碍 II 型的局部异常神经活动。

方法

100 名未经药物治疗的双相情感障碍 II 型抑郁患者和 100 名健康对照者(HC)接受了静息态功能磁共振成像。在全脑范围内计算每个体素的 ReHo 值。采用两样本 t 检验和无阈值聚类增强(TFCE)校正进行 ReHo 分析。

结果

与 HC 组相比,BD II 组左侧眶额皮质的 ReHo 值显著降低,右侧中央前回、右侧辅助运动区和双侧中枕叶的 ReHo 值显著升高(P<.05,TFCE 校正)。

局限性

本研究缺乏脑结构变化的证据,且采用横断面设计,未探讨缓解期和躁狂期患者的局部改变。

结论

我们的研究结果显示,在静息状态下存在异常的局部内在神经活动,这可能有助于双相情感障碍 II 型的病理生理学。特别是前额叶皮层和初级感觉运动区之间的平衡被打破,为双相情感障碍的独特病理机制提供了证据。

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