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儿童双相障碍患者苍白球体积缩小与前额叶-纹状体-丘脑功能连接中断。

Pallidal volume reduction and prefrontal-striatal-thalamic functional connectivity disruption in pediatric bipolar disorders.

机构信息

Department of Radiology, Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, China.

Department of Child Psychology, The Children' s Hospital, Zhejiang University School of Medicine, Hangzhou, China.

出版信息

J Affect Disord. 2022 Mar 15;301:281-288. doi: 10.1016/j.jad.2022.01.049. Epub 2022 Jan 11.

Abstract

BACKGROUND

As a crucial node of the corticolimbic model, the striatum has been demonstrated in modulating emotional cues in pediatric bipolar disorders (PBD), the striatal distinction in structure and function between PBD-I and PBD-II remains unclear.

METHODS

MRI data of 36 patients in PBD-I, 22 patients in PBD-II and 19 age-gender matched healthy controls (HCs) were processed. Here, we investigated structural and functional alterations of 8 subregions of striatum (bilateral nucleus accumbens, caudate, putamen and globus pallidus) by analyzing MRI data.

RESULTS

We found volume reduction of the right pallidum, the significant positive correlation between the number of episodes and the functional connectivity between left pallidum and right caudate in PBD-I patients, abrupted prefrontal-striatal-thalamic functional connectivity in PBD-I group and decreased functional connectivity in PBD-II relative to HCs and PBD-I.

LIMITATIONS

Future studies should enroll more subjects and adopt a longitudinal perspective, which could help to discover striatum structural or functional alterations during subject-specific clinical progress in different states.

CONCLUSIONS

Results of the present study confirmed that structural and functional abnormality of striatum may be helpful in identifying PBD clinical types as distinctive biomarkers. The interruptions of the prefrontal-striatal-thalamic circuits may provide advantageous evidence for expounding the role of striatum in bipolar disorders etiology. Thus, potential mechanisms of dysfunction striatum need to be formulated and reconceptualized with multimodal neuroimaging studies in future.

摘要

背景

作为边缘皮质模型的关键节点,纹状体已被证明可调节儿童双相情感障碍(PBD)中的情绪线索,但其在 PBD-I 和 PBD-II 之间的结构和功能上的区别尚不清楚。

方法

对 36 名 PBD-I 患者、22 名 PBD-II 患者和 19 名年龄性别匹配的健康对照者(HCs)的 MRI 数据进行处理。在此,我们通过分析 MRI 数据来研究纹状体 8 个亚区(双侧伏隔核、尾状核、壳核和苍白球)的结构和功能改变。

结果

我们发现 PBD-I 患者右侧苍白球体积减小,左苍白球与右尾状核之间的功能连接与发作次数呈显著正相关,PBD-I 组前额叶-纹状体-丘脑功能连接中断,PBD-II 组与 HCs 和 PBD-I 相比,功能连接减少。

局限性

未来的研究应招募更多的受试者并采用纵向的研究方法,这有助于在不同状态下发现个体特定的临床进展过程中纹状体的结构或功能改变。

结论

本研究结果证实,纹状体的结构和功能异常可能有助于识别 PBD 的临床类型,作为独特的生物标志物。前额叶-纹状体-丘脑回路的中断可能为阐述纹状体在双相情感障碍发病机制中的作用提供有利证据。因此,需要在未来的多模态神经影像学研究中制定和重新构想纹状体功能障碍的潜在机制。

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