Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China.
Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, United States.
EBioMedicine. 2020 Apr;54:102742. doi: 10.1016/j.ebiom.2020.102742. Epub 2020 Apr 4.
Bipolar disorder (BD) is a mental disorder characterized by mood fluctuations between an acute episodic state of either mania or depression and a clinically remitted state. Dysfunction of large-scale intrinsic brain networks has been demonstrated in this disorder, but it remains unknown whether those network alterations are related to different states.
In the present study, we performed a meta-analysis of whole-brain seed-based resting-state functional connectivity (rsFC) studies in BD patients to compare the intrinsic function of brain networks between episodic and remitted states. Thirty-nine seed-based voxel-wise rsFC datasets from thirty publications (1047 BD patients vs 1081 controls) were included in the meta-analysis. Seeds were categorized into networks by their locations within a priori functional networks. Seed-based d mapping analysis of between-state effects identified brain systems in which different states were associated with increased connectivity or decreased connectivity within and between each seed network.
We found that BD patients presented decreased connectivity within the affective network (AN) in acute episodes but not in the remitted state of the illness. Similar decreased connectivity within the default-mode network (DMN) was also found in the acute state, but it was replaced by increased connectivity in the remitted state. In addition, different patterns of between-network dysconnectivity were observed between the acute and remitted states.
This study is the first to identify different patterns of intrinsic function in large-scale brain networks between the acute and remitted states of BD through meta-analysis. The findings suggest that a shift in network function between the acute and remitted states may be related to distinct emotional and cognitive dysfunctions in BD, which may have important implications for identifying clinically relevant biomarkers to guide alternative treatment strategies for BD patients during active episodes or remission.
This study was supported by grants from the National Natural Science Foundation of China (81171488, 81671669 and 81820108018) and by a Sichuan Provincial Youth Grant (2017JQ0001).
双相情感障碍（BD）是一种以情绪波动为特征的精神障碍，表现为躁狂或抑郁的急性发作期和临床缓解期之间。该疾病存在大脑内部大规模网络功能障碍，但尚不清楚这些网络改变是否与不同状态有关。
本研究对 BD 患者静息态功能磁共振连接（rsFC）研究进行了元分析，以比较发作期和缓解期的大脑网络内在功能。将 39 项基于种子的全脑 rsFC 数据集（30 项研究，共包括 1047 名 BD 患者和 1081 名对照）纳入元分析。根据种子所在的预先设定的功能网络位置，将种子归类为网络。基于种子的组间效应 d 映射分析确定了不同状态下与各种子网络内和网络间连接性增加或减少相关的脑系统。
我们发现，BD 患者在发作期内，情感网络（AN）内的连接性降低，而在疾病缓解期则没有。默认模式网络（DMN）内也发现了类似的连接性降低，但在缓解期则表现为连接性增加。此外，在发作期和缓解期之间还观察到了不同的网络间连接障碍模式。
本研究通过元分析首次发现 BD 的急性和缓解期之间的大脑网络内在功能存在不同模式。这些发现表明，网络功能在急性和缓解期之间的转变可能与 BD 患者的不同情感和认知功能障碍有关，这可能对确定有临床意义的生物标志物以指导 BD 患者在发作期或缓解期的替代治疗策略具有重要意义。
本研究得到了国家自然科学基金（81171488、81671669 和 81820108018）和四川省青年基金（2017JQ0001）的支持。
