Zhu Wenjing, Tang Wenxin, Liang Yan, Jiang Xiaoying, Li Yi, Chen Zhiyu, Zhu Cheng
Hangzhou Seventh People's Hospital, Hangzhou, China.
Department of Neurology, School of Medicine, Affiliated ZhongDa Hospital, Institution of Neuropsychiatry, Southeast University, Nanjing, China.
Front Neurosci. 2022 Feb 21;15:823550. doi: 10.3389/fnins.2021.823550. eCollection 2021.
The key pathophysiological mechanism of executive dysfunction in patients with bipolar disorder type I (BD-I) is still unclear. Previous studies have demonstrated that it may be related to the disbalance of the sensory motor network (SMN).
This study was designed to explore the aberrant functional connectivity (FC) of SMN in BD-I patients and its potential associations with executive dysfunction.
Eighteen BD-I patients and 20 healthy controls (HCs) underwent resting-state fMRI scans. The intranetwork and internetwork functional connectivities of SMN were extracted by independent component analysis (ICA). Clinical symptoms were assessed by the Bech-Rafaelsen Mania Rating Scale (BRMS) and Positive and Negative Syndrome Scale (PANSS). Executive function was measured by digit span tasks and a verbal fluency test. Finally, linear regression and correlation analyses were applied to measure the potential associations between clinical symptoms, intranetwork and internetwork functional connectivities, and executive function performance.
(1) Patients with BD-I showed increased connectivity in the right paracentral lobule and the right postcentral gyrus within the SMN, and the increased connectivity value was positively correlated with the BRMS score ( < 0.05) but negatively correlated with digit span forward scores ( < 0.05). (2) Compared with HC, the connectivity value increased between the SMN and dorsal attention network (DAN) ( < 0.01) and between the default mode network (DMN) and DAN ( < 0.05) but decreased between the DAN and auditory network (AN) ( < 0.05) and between the SMN and DMN ( < 0.01) in patients with BD-I. (3) Digit span forward scores and education of all participants were negatively correlated with FC between SMN and DAN. Age of all subjects was positively correlated with FC between SMN and DMN.
Our findings suggest that the sensorimotor network of BD-I has abnormal functional connections within and between networks, and the abnormal FC value correlated with clinical symptoms and executive function, which provide new information for exploring the neural physiopathology of executive dysfunction in BD-I patients.
I型双相情感障碍（BD-I）患者执行功能障碍的关键病理生理机制仍不清楚。既往研究表明，这可能与感觉运动网络（SMN）失衡有关。
本研究旨在探讨BD-I患者SMN的异常功能连接（FC）及其与执行功能障碍的潜在关联。
18例BD-I患者和20名健康对照（HC）接受静息态功能磁共振成像扫描。通过独立成分分析（ICA）提取SMN的网络内和网络间功能连接。采用Bech-Rafaelsen躁狂评定量表（BRMS）和阳性与阴性症状量表（PANSS）评估临床症状。通过数字广度任务和言语流畅性测试测量执行功能。最后，应用线性回归和相关性分析来测量临床症状、网络内和网络间功能连接与执行功能表现之间的潜在关联。
（1）BD-I患者在SMN内右侧中央旁小叶和右侧中央后回的连接性增加，且增加的连接值与BRMS评分呈正相关（<0.05），但与顺背数字广度评分呈负相关（<0.05）。（2）与HC相比，BD-I患者中SMN与背侧注意网络（DAN）之间的连接值增加（<0.01），默认模式网络（DMN）与DAN之间的连接值增加（<0.05），但DAN与听觉网络（AN）之间的连接值降低（<0.05），SMN与DMN之间的连接值降低（<0.01）。（3）所有参与者的顺背数字广度评分和受教育程度与SMN和DAN之间的FC呈负相关。所有受试者的年龄与SMN和DMN之间的FC呈正相关。
我们的研究结果表明，BD-I的感觉运动网络在网络内和网络间存在异常功能连接，且异常FC值与临床症状和执行功能相关，这为探索BD-I患者执行功能障碍的神经生理病理学提供了新信息。
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