Chen Pan, Chen Guanmao, Zhong Shuming, Chen Feng, Ye Tao, Gong JiaYing, Tang Guixian, Pan Youling, Luo Zhenye, Qi Zhangzhang, Huang Li, Wang Ying
Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China.
Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China.
J Psychiatr Res. 2022 Jun;150:282-291. doi: 10.1016/j.jpsychires.2022.03.023. Epub 2022 Mar 24.
Accumulating evidence suggests that hypothalamus-pituitary-thyroid (HPT) axis dysfunction is relevant to the neuropsychological and pathophysiology functions of bipolar disorder (BD). However, no research has investigated the inter-relationships among thyroid hormones disturbance, neurocognitive deficits, and aberrant brain function (particularly in the amygdala) in patients with BD.
Data of dynamic resting-state functional connectivity (rs-dFC) were gathered from 59 patients with unmedicated BD II during depressive episodes and 52 healthy controls (HCs). Four seeds were selected (the bilateral lateral amygdala and the bilateral medial amygdala). The sliding-window analysis was applied to investigate dynamic functional connectivity (dFC). Additionally, the serum thyroid hormone (free tri-iodothyronine (FT3), total tri-iodothyronine (TT3), free thyroxin (FT4), total thyroxin (TT4) and thyroid-stimulating hormone (TSH)) levels, and cognitive scores on the MATRICS Consensus Cognitive Battery (MCCB) in patients and HCs were detected.
The BD group exhibited increased dFC variability between the left medial amygdala and right medial prefrontal cortex (mPFC) when compared with the HC group. Additionally, the BD group showed lower FT3, TT3, and TSH level, higher FT4 level, and poorer cognitive score. Moreover, a significant negative correlation was observed between the dFC variability of the left medial amygdala-right mPFC and TSH level, or reasoning and problem solving of MCCB score in BD group. Multiple regression analysis showed that the TSH level × dFC variability of the medial amygdala-mPFC was an independent predictor for cognitive processing speed in BD group.
This study revealed patients with BD II depression had excessive variability in dFC between the medial amygdala and mPFC. Moreover, both HPT axis dysfunction and abnormal dFC of the amygdala-mPFC might be implicated in cognitive impairment in the early stages of BD.
越来越多的证据表明，下丘脑 - 垂体 - 甲状腺（HPT）轴功能障碍与双相情感障碍（BD）的神经心理和病理生理功能相关。然而，尚无研究调查BD患者甲状腺激素紊乱、神经认知缺陷和脑功能异常（特别是杏仁核）之间的相互关系。
收集了59例未用药的BD II型患者抑郁发作期和52名健康对照（HC）的动态静息态功能连接（rs - dFC）数据。选择了四个种子点（双侧外侧杏仁核和双侧内侧杏仁核）。应用滑动窗口分析来研究动态功能连接（dFC）。此外，检测了患者和HC的血清甲状腺激素（游离三碘甲状腺原氨酸（FT3）、总三碘甲状腺原氨酸（TT3）、游离甲状腺素（FT4）、总甲状腺素（TT4）和促甲状腺激素（TSH））水平，以及在MATRICS共识认知成套测验（MCCB）上的认知得分。
与HC组相比，BD组左侧内侧杏仁核与右侧内侧前额叶皮质（mPFC）之间的dFC变异性增加。此外，BD组的FT3、TT3和TSH水平较低，FT4水平较高，认知得分较差。此外，BD组左侧内侧杏仁核 - 右侧mPFC的dFC变异性与TSH水平或MCCB得分的推理和问题解决能力之间存在显著负相关。多元回归分析表明，内侧杏仁核 - mPFC的TSH水平×dFC变异性是BD组认知处理速度的独立预测因子。
本研究表明，BD II型抑郁症患者内侧杏仁核与mPFC之间的dFC存在过度变异性。此外，HPT轴功能障碍和杏仁核 - mPFC的异常dFC可能都与BD早期的认知障碍有关。
