Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Rd, Shanghai 200030, China.
Department of Psychology, Provincial Hospital Affiliated to Shandong University, Jinan 250021,China.
J Affect Disord. 2020 Dec 1;277:358-367. doi: 10.1016/j.jad.2020.08.007. Epub 2020 Aug 13.
This study aims to explore the changes in functional neuroimaging in bipolar depression patients with anxiety symptoms (BDP-A).
Forty-five BDP-A patients, 22 bipolar depression patients without anxiety symptoms (BDP-NA), and 48 healthy controls (HC) were finally involved. The low-frequency oscillation characteristics, functional connectivity (FC), and network properties among the three groups of participants were analyzed.
Compared with the BDP-NA group, BDP-A patients exhibited significantly decreased amplitude of low-frequency fluctuation (ALFF) in the left middle frontal gyrus (MFG), superior occipital gyrus, and inferior parietal, but supramarginal and angular gyri (IPL). Enhanced FC from left IPL to middle temporal gyrus, from left precentral gyrus (PreCG) to bilateral angular gyri, medial superior frontal gyrus, and left superior frontal gyrus (SFG)/MFG were also revealed. Compared with HC, the BDP-A group showed remarkably increased ALFF in the left MFG/PreCG, right superior parietal gyrus, while decreased ALFF in the left inferior frontal gyrus, opercular part, and SFG. In addition, higher regional homogeneity in the left MFG/PreCG was found.
The limitations are as follows: (1) relatively small sample size; (2) not all the patients were drug-naive; (3) lack of pure anxiety disorder patients as a controlled group; (4) mental health conditions of HC were not systemic evaluated.
BDP-A patients showed significant differences in resting-state fMRI properties when compared with BDP-NA or HC group. These results may infer the dysfunction of the dorsal attention network, the default network, and the fronto-limbic system as well as disrupted brain network efficiency in BDP-A patients.
本研究旨在探讨伴焦虑症状的双相抑郁障碍患者(BDP-A)的功能神经影像学变化。
最终纳入 45 例 BDP-A 患者、22 例无焦虑症状的双相抑郁障碍患者(BDP-NA)和 48 例健康对照者(HC)。分析三组参与者的低频振荡特征、功能连接(FC)和网络特性。
与 BDP-NA 组相比,BDP-A 患者左侧额中回(MFG)、顶枕叶和顶下小叶(IPL)的低频振幅(ALFF)显著降低,而 IPL 的额上回和角回、Supramarginal 和角回、内侧额上回和左额上回/额中回(SFG/MFG)的 FC 增强。与 HC 相比,BDP-A 组的左侧 MFG/PreCG、右侧顶上回的 ALFF 显著增加,而左侧额下回、额下回岛盖部和 SFG 的 ALFF 降低。此外,还发现左侧 MFG/PreCG 的局部一致性较高。
存在以下局限性:(1)样本量相对较小;(2)并非所有患者均为药物初治;(3)缺乏单纯焦虑障碍患者作为对照组;(4)HC 的心理健康状况未进行系统评估。
与 BDP-NA 或 HC 组相比,BDP-A 患者静息态 fMRI 特性存在显著差异。这些结果可能表明 BDP-A 患者的背侧注意网络、默认网络和额眶皮质系统功能障碍以及脑网络效率受损。