非双相情感障碍的年轻成年人亚临床轻躁狂严重程度恶化的白质预测因子与双相情感障碍个体的异常情况平行。
White matter predictors of worsening of subthreshold hypomania severity in non-bipolar young adults parallel abnormalities in individuals with bipolar disorder.
机构信息
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA.
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA; Department of Radiology, Magnetic Resonance Research Center, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA.
出版信息
J Affect Disord. 2022 Jun 1;306:148-156. doi: 10.1016/j.jad.2022.03.039. Epub 2022 Mar 21.
BACKGROUND
Identifying neural predictors of worsening subthreshold hypomania severity can help identify risk of progression to BD. While diffusion Magnetic Resonance Imaging (dMRI) studies reported white matter microstructural abnormalities in tracts supporting emotional regulation in individuals with BD, it remains unknown whether similar patterns of white matter microstructure predict worsening of subthreshold hypomania severity in non-BD individuals.
METHODS
dMRI data were collected in: 81 non-BD individuals recruited across a range of subthreshold depression and hypomania, and followed for six months; and independent samples of 75 BD and 58 healthy individuals. All individuals were assessed using standardized diagnostic assessments, mood and anxiety symptom rating scales. Global probabilistic tractography and a tract-profile approach examined fractional anisotropy (FA), a measure of fiber collinearity, in tracts supporting emotional regulation shown to have abnormalities in BD: forceps minor (FMIN), anterior thalamic radiation (ATR), cingulum bundle (CB), and uncinate fasciculus (UF).
RESULTS
Lower FA in left CB (middle, β = -0.22, P = 0.022; posterior, β = -0.32, P < 0.001), right CB (anterior, β = -0.30, P = 0.003; posterior, β = -0.27, P = 0.005), and right UF (frontal, β = -0.29, P = 0.002; temporal, β = -0.40, P < 0.001) predicted worsening of subthreshold hypomania severity in non-BD individuals. BD versus healthy individuals showed lower FA in several of these segments: middle left CB (F = 8.7, P = 0.004), anterior right CB (F = 9.8, P = 0.002), and frontal right UF (F = 7.0, P = 0.009). Non-BD individuals with worsening 6-month hypomania had lower FA in these three segments versus HC and non-BD individuals without worsening hypomania, but similar FA to BD individuals.
LIMITATIONS
Relatively short follow-up.
CONCLUSIONS
White matter predictors of worsening subthreshold hypomania in non-BD individuals parallel abnormalities in BD individuals, and can guide early risk identification and interventions.
背景
识别亚临床轻躁狂严重程度恶化的神经预测因子可以帮助识别向双相情感障碍（BD）进展的风险。虽然弥散磁共振成像（dMRI）研究报告称，BD 个体中支持情绪调节的束状白质微观结构异常，但目前尚不清楚类似的白质微观结构模式是否可以预测非 BD 个体亚临床轻躁狂严重程度的恶化。
方法
dMRI 数据采集于：81 名非 BD 个体，这些个体在亚临床抑郁和轻躁狂范围内招募，并随访 6 个月；以及独立的 75 名 BD 个体和 58 名健康个体样本。所有个体均通过标准化诊断评估、情绪和焦虑症状评定量表进行评估。全脑概率追踪和束状轮廓分析方法评估了支持情绪调节的束状白质的各向异性分数（FA），FA 是纤维共线性的度量，该束状白质在 BD 中显示出异常：小钳（FMIN）、前丘脑辐射（ATR）、扣带束（CB）和钩束（UF）。
结果
左 CB（中部，β=-0.22，P=0.022；后部，β=-0.32，P<0.001）、右 CB（前部，β=-0.30，P=0.003；后部，β=-0.27，P=0.005）和右 UF（额部，β=-0.29，P=0.002；颞部，β=-0.40，P<0.001）的 FA 值较低，预示着非 BD 个体亚临床轻躁狂严重程度的恶化。BD 与健康个体在这些区域的几个区域显示出较低的 FA：左 CB 中部（F=8.7，P=0.004）、右 CB 前部（F=9.8，P=0.002）和右 UF 额部（F=7.0，P=0.009）。与 HC 和非恶化轻躁狂的非 BD 个体相比，6 个月时轻躁狂恶化的非 BD 个体在这三个区域的 FA 值较低，但与 BD 个体的 FA 值相似。
局限性
随访时间相对较短。
结论
非 BD 个体亚临床轻躁狂恶化的白质预测因子与 BD 个体的异常相似，可以指导早期风险识别和干预。
Zotero 插件