评估双相情感障碍认知障碍的神经基础：图片编码范式及方法学经验教训。
Assessment of the neuronal underpinnings of cognitive impairment in bipolar disorder with a picture encoding paradigm and methodological lessons learnt.
机构信息
Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
出版信息
J Psychopharmacol. 2021 Aug;35(8):983-991. doi: 10.1177/02698811211008569. Epub 2021 Apr 22.
BACKGROUND
Mood disorders are often associated with persistent cognitive impairments. However, pro-cognitive treatments are essentially lacking. This is partially because of poor insight into the neurocircuitry abnormalities underlying these deficits and their change with illness progression.
AIMS
This functional magnetic resonance imaging (fMRI) study investigates the neuronal underpinnings of cognitive impairments and neuronal change after mood episodes in remitted patients with bipolar disorder (BD) using a hippocampus-based picture encoding paradigm.
METHODS
Remitted patients with BD (=153) and healthy controls (=52) were assessed with neuropsychological tests and underwent fMRI while performing a strategic picture encoding task. A subgroup of patients (=43) were rescanned after 16 months. We conducted data-driven hierarchical cluster analysis of patients' neuropsychological data and compared encoding-related neuronal activity between the resulting neurocognitive subgroups. For patients with follow-up data, effects of mood episodes were assessed by comparing encoding-related neuronal activity change in BD patients with and without episode(s).
RESULTS
Two neurocognitive subgroups were revealed: 91 patients displayed cognitive impairments while 62 patients were cognitively normal. No neuronal activity differences were observed between neurocognitive subgroups within the dorsal cognitive control network or hippocampus. However, exploratory whole-brain analysis revealed lower activity within a small region of middle temporal gyrus in impaired patients, which significantly correlated with poorer neuropsychological performance. No changes were observed in encoding-related neuronal activity or picture recall accuracy with the occurrence of mood episode(s) during the follow-up period.
CONCLUSION
Memory encoding fMRI paradigms may not capture the neuronal underpinnings of cognitive impairment or effects of mood episodes.
背景
情绪障碍常与持续的认知障碍有关。然而，促进认知的治疗方法基本缺乏。这部分是因为对这些缺陷的神经回路异常及其随疾病进展的变化的了解不足。
目的
本功能磁共振成像（fMRI）研究使用基于海马的图片编码范式，调查缓解期双相情感障碍（BD）患者在心境发作后认知障碍和神经元变化的神经基础。
方法
使用神经心理学测试评估缓解期 BD 患者（n=153）和健康对照者（n=52），并在执行策略性图片编码任务时进行 fMRI。对亚组患者（n=43）进行 16 个月后的再扫描。我们对患者的神经心理学数据进行数据驱动的层次聚类分析，并比较由此产生的神经认知亚组之间的编码相关神经元活动。对于具有随访数据的患者，通过比较有和无发作的 BD 患者的编码相关神经元活动变化来评估心境发作的影响。
结果
揭示了两个神经认知亚组：91 名患者表现出认知障碍，而 62 名患者认知正常。在背侧认知控制网络或海马内，神经认知亚组之间没有观察到神经元活动差异。然而，探索性全脑分析显示，在受损患者的中颞叶的一个小区域内活动降低，这与较差的神经心理学表现显著相关。在随访期间，发作期间没有观察到编码相关神经元活动或图片回忆准确性的变化。
结论
记忆编码 fMRI 范式可能无法捕捉认知障碍或心境发作的神经元基础。
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