Lima Santos João Paulo, Bertocci Michele, Bebko Genna, Goldstein Tina, Kim Tae, Iyengar Satish, Bonar Lisa, Gill MaryKay, Merranko John, Yendiki Anastasia, Birmaher Boris, Phillips Mary L, Versace Amelia
Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15260, USA.
Magnetic Resonance Research Center, Department of Radiology, University of Pittsburgh, Pittsburgh, PA 15260, USA.
J Clin Med. 2022 Jun 15;11(12):3432. doi: 10.3390/jcm11123432.
Diffusion Magnetic Resonance Imaging (dMRI) studies have reported abnormalities in emotion regulation circuits in BD; however, no study has examined the contribution of previous illness on these mechanisms. Using global probabilistic tractography, we aimed to identify neural correlates of previous BD illness and the extent to which these can help predict one-year recurrence of depressive episodes. dMRI data were collected in 70 adults with early-onset BD who were clinically followed for up to 18 years and 39 healthy controls. Higher number of depressive episodes during childhood/adolescence and higher percentage of time with syndromic depression during longitudinal follow-up was associated with lower fractional anisotropy (FA) in focal regions of the forceps minor (left, F = 4.4, p = 0.003; right, F = 3.1, p = 0.021) and anterior cingulum bundle (left, F = 4.7, p = 0.002; right, F = 7.0, p < 0.001). Lower FA in these regions was also associated with higher depressive and anxiety symptoms at scan. Remarkably, those having higher FA in the right cluster of the forceps minor (AOR = 0.43, p = 0.017) and in a cluster of the posterior cingulum bundle (right, AOR = 0.50, p = 0.032) were protected against the recurrence of depressive episodes. Previous depressive symptomatology may cause neurodegenerative effects in the forceps minor that are associated with worsening of BD symptomatology in subsequent years. Abnormalities in the posterior cingulum may also play a role.
扩散磁共振成像（dMRI）研究报告了双相情感障碍（BD）患者情绪调节回路存在异常；然而，尚无研究考察既往疾病对这些机制的影响。我们采用全局概率纤维束成像技术，旨在确定既往双相情感障碍疾病的神经关联，以及这些关联在多大程度上有助于预测抑郁发作的一年复发率。我们收集了70例早发性双相情感障碍成年患者的dMRI数据，这些患者接受了长达18年的临床随访，同时收集了39名健康对照者的数据。童年/青少年时期抑郁发作次数较多以及纵向随访期间症状性抑郁持续时间百分比更高，与胼胝体小钳局部区域（左侧，F = 4.4，p = 0.003；右侧，F = 3.1，p = 0.021）和前扣带回束（左侧，F = 4.7，p = 0.002；右侧，F = 7.0，p < 0.001）的较低各向异性分数（FA）相关。这些区域较低的FA也与扫描时较高的抑郁和焦虑症状相关。值得注意的是，胼胝体小钳右侧簇（优势比[AOR] = 0.43，p = 0.017）和后扣带回束一簇（右侧，AOR = 0.50，p = 0.032）中FA较高的患者可预防抑郁发作的复发。既往抑郁症状可能会在胼胝体小钳中引起神经退行性效应，这与随后几年双相情感障碍症状的恶化有关。后扣带回异常也可能起作用。
