Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China.
PLA Strategic Support Force Characteristic Medical Center, Beijing, 100101, China.
BMC Psychiatry. 2023 Aug 11;23(1):584. doi: 10.1186/s12888-023-05083-2.
The neural correlate of cognitive deficits in bipolar disorder (BD) is an issue that warrants further investigation. However, relatively few studies have examined the intrinsic functional connectivity (FC) underlying cognitive deficits involving sustained attention and executive function at both the region and network levels, as well as the different relationships between connectivity patterns and cognitive performance, in BD patients and healthy controls (HCs).
Patients with BD (n = 59) and HCs (n = 52) underwent structural and resting-state functional magnetic resonance imaging and completed the Wisconsin Card Sorting Test (WCST), the continuous performance test and a clinical assessment. A seed-based approach was used to evaluate the intrinsic FC alterations in three core neurocognitive networks (the default mode network [DMN], the central executive network [CEN] and the salience network [SN]). Finally, we examined the relationship between FC and cognitive performance by using linear regression analyses.
Decreased FC was observed within the DMN, in the DMN-SN and DMN-CEN and increased FC was observed in the SN-CEN in BD. The alteration direction of regional FC was consistent with that of FC at the brain network level. Decreased FC between the left posterior cingulate cortex and right anterior cingulate cortex was associated with longer WCST completion time in BD patients (but not in HCs).
These findings emphasize the dominant role of the DMN in the psychopathology of BD and provide evidence that cognitive deficits in BD may be associated with aberrant FC between the anterior and posterior DMN.
双相障碍（BD）认知缺陷的神经相关性是一个值得进一步研究的问题。然而，很少有研究在区域和网络水平上检查涉及持续注意力和执行功能的认知缺陷的内在功能连接（FC），以及在 BD 患者和健康对照组（HCs）中连接模式与认知表现之间的不同关系。
59 名 BD 患者和 52 名 HCs 接受了结构和静息状态功能磁共振成像，并完成了威斯康星卡片分类测试（WCST）、连续性能测试和临床评估。采用种子点方法评估了三个核心神经认知网络（默认模式网络[DMN]、中央执行网络[CEN]和突显网络[SN]）内在 FC 的改变。最后，我们通过线性回归分析检查了 FC 与认知表现之间的关系。
BD 中观察到 DMN 内、DMN-SN 和 DMN-CEN 内的 FC 降低，SN-CEN 内的 FC 增加。区域 FC 的改变方向与脑网络水平的 FC 改变方向一致。左后扣带回皮质与右前扣带回皮质之间的 FC 降低与 BD 患者 WCST 完成时间延长有关（但在 HCs 中无此关联）。
这些发现强调了 DMN 在 BD 病理生理学中的主导作用，并提供了证据表明 BD 的认知缺陷可能与 DMN 前后的异常 FC 有关。
