内在连接与家庭动态：心境障碍家族风险青少年的纹状体边缘标记物与风险和韧性。
Intrinsic Connectivity and Family Dynamics: Striatolimbic Markers of Risk and Resilience in Youth at Familial Risk for Mood Disorders.
机构信息
Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California.
Department of Neuroscience, Yale University, New Haven, Connecticut.
出版信息
Biol Psychiatry Cogn Neurosci Neuroimaging. 2022 Sep;7(9):855-866. doi: 10.1016/j.bpsc.2022.02.009. Epub 2022 Mar 8.
BACKGROUND
Few studies to date have characterized functional connectivity (FC) within emotion and reward networks in relation to family dynamics in youth at high familial risk for bipolar disorder (HR-BD) and major depressive disorder (HR-MDD) relative to low-risk youth (LR). Such characterization may advance our understanding of the neural underpinnings of mood disorders and lead to more effective interventions.
METHODS
A total of 139 youth (43 HR-BD, 46 HR-MDD, and 50 LR) aged 12.9 ± 2.7 years were longitudinally followed for 4.5 ± 2.4 years. We characterized differences in striatolimbic FC that distinguished between HR-BD, HR-MDD, and LR and between resilience and conversion to psychopathology. We then examined whether risk status moderated FC-family dynamic associations. Finally, we examined whether baseline between-group FC differences predicted resilence versus conversion to psychopathology.
RESULTS
HR-BD had greater amygdala-middle frontal gyrus and dorsal striatum-middle frontal gyrus FC relative to HR-MDD and LR, and HR-MDD had lower amygdala-fusiform gyrus and dorsal striatum-precentral gyrus FC relative to HR-BD and LR (voxel-level p < .001, cluster-level false discovery rate-corrected p < .05). Resilient youth had greater amygdala-orbitofrontal cortex and ventral striatum-dorsal anterior cingulate cortex FC relative to youth with conversion to psychopathology (voxel-level p < .001, cluster-level false discovery rate-corrected p < .05). Greater family rigidity was inversely associated with amygdala-fusiform gyrus FC across all groups (false discovery rate-corrected p = .017), with a moderating effect of bipolar risk status (HR-BD vs. HR-MDD p < .001; HR-BD vs. LR p = .005). Baseline FC differences did not predict resilence versus conversion to psychopathology.
CONCLUSIONS
Findings represent neural signatures of risk and resilience in emotion and reward processing networks in youth at familial risk for mood disorders that may be targets for novel interventions tailored to the family context.
背景
迄今为止，很少有研究描述与双相情感障碍（HR-BD）和重度抑郁症（HR-MDD）高家族风险青年及低风险青年（LR）的家庭动态相关的情绪和奖励网络中的功能连接（FC）。这种特征描述可能会促进我们对情绪障碍神经基础的理解，并导致更有效的干预措施。
方法
共有 139 名年龄在 12.9±2.7 岁的青少年（43 名 HR-BD、46 名 HR-MDD 和 50 名 LR）接受了 4.5±2.4 年的纵向随访。我们描述了区分 HR-BD、HR-MDD 和 LR 以及韧性和向精神病理学转化的纹状体边缘 FC 差异。然后，我们检查了风险状况是否调节了 FC-家庭动态关联。最后，我们检查了基线组间 FC 差异是否预测韧性与向精神病理学转化。
结果
HR-BD 的杏仁核-额中回和背侧纹状体-额中回 FC 大于 HR-MDD 和 LR，而 HR-MDD 的杏仁核-梭状回和背侧纹状体-额前回 FC 小于 HR-BD 和 LR（体素水平 p<.001，簇水平假发现率校正后 p<.05）。与向精神病理学转化的青少年相比，韧性青少年的杏仁核-眶额皮质和腹侧纹状体-背侧前扣带皮质 FC 更大（体素水平 p<.001，簇水平假发现率校正后 p<.05）。在所有组中，家庭刚性与杏仁核-梭状回 FC 呈负相关（假发现率校正后 p=0.017），双相情感障碍风险状况具有调节作用（HR-BD 与 HR-MDD 相比 p<.001；HR-BD 与 LR 相比 p=0.005）。基线 FC 差异不能预测韧性与向精神病理学转化。
结论
这些发现代表了情绪和奖励处理网络中风险和韧性的神经特征，这些特征可能是针对情绪障碍高家族风险青年及其家庭环境的新型干预措施的目标。
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