Zhang Gui, Xiao Qian, Wang Chun, Gao Weijia, Su Linyan, Lu Guangming, Zhong Yuan
School of Psychology, Nanjing Normal University, Nanjing 210097, China.
Mental Health Centre of Xiangya Hospital, Central South University, Changsha 410008, Hunan, China.
Neuroscience. 2023 Aug 21;526:185-195. doi: 10.1016/j.neuroscience.2023.06.015. Epub 2023 Jun 28.
Bipolar disorder may begin as depression or mania, which can affect the treatment and prognosis of bipolar disorder. However, the physiological and pathological differences of pediatric bipolar disorder (PBD) patients with different onset symptoms are not clear. The purpose of this study was to investigate the differences of clinical, cognitive function and intrinsic brain networks in PBD patients with first-episode depression and first-episode mania. A total of 63 participants, including 43 patients and 20 healthy controls, underwent resting-state fMRI scans. PBD patients were classified as first-episode depressive and first-episode manic based on their first-episode symptoms. Cognitive tests were used to measure attention and memory of all participants. Independent component analysis (ICA) was used to extract the salience network (SN), default-mode network (DMN), central executive network (ECN) and limbic network (LN) for each participant. Spearman rank correlation analysis was performed between abnormal activation and clinical and cognitive measures. The results showed that there were differences in cognitive functions such as attention and visual memory between first-episode depression and mania, as well as differences activation in anterior cingulate cortex (ACC), posterior cingulate cortex (PCC), precuneus, inferior parietal cortex and parahippocampus. And significant associations of brain activity with clinical assessments or cognition were found in different patients. In conclusion, we found differential impairments in cognitive and brain network activation in first-episode depressive and first-episode manic PBD patients, and correlations were found between these impairments. These evidences may shed light on the different developmental paths of bipolar disorder.
双相情感障碍可能以抑郁或躁狂发作起病，这会影响双相情感障碍的治疗和预后。然而，首发症状不同的儿童双相情感障碍（PBD）患者的生理和病理差异尚不清楚。本研究旨在探讨首发抑郁和首发躁狂的PBD患者在临床、认知功能和内在脑网络方面的差异。共有63名参与者，包括43例患者和20名健康对照，接受了静息态功能磁共振成像扫描。PBD患者根据其首发症状分为首发抑郁组和首发躁狂组。采用认知测试来测量所有参与者的注意力和记忆力。使用独立成分分析（ICA）为每个参与者提取突显网络（SN）、默认模式网络（DMN）、中央执行网络（ECN）和边缘网络（LN）。对异常激活与临床和认知测量指标进行Spearman等级相关分析。结果表明，首发抑郁和躁狂在注意力和视觉记忆等认知功能方面存在差异，前扣带回皮质（ACC）、后扣带回皮质（PCC）、楔前叶、顶下小叶和海马旁回的激活也存在差异。并且在不同患者中发现脑活动与临床评估或认知之间存在显著关联。总之，我们发现首发抑郁和首发躁狂的PBD患者在认知和脑网络激活方面存在差异损伤，并且这些损伤之间存在相关性。这些证据可能有助于揭示双相情感障碍不同的发展路径。
