Liu Wen, Jiang Xiaowei, Xin Yide, Deng Zijing, Xie Yu, Zhou Yifang, Wu Yifan, Sun Qikun, Kong Lingtao, Wu Feng, Tang Yanqing
Brain Function Research Section, The First Hospital of China Medical University, Shenyang 110001, Liaoning, PR China; Department of Psychiatry, The First Hospital of China Medical University Shenyang 110001, Liaoning, PR China.
Brain Function Research Section, The First Hospital of China Medical University, Shenyang 110001, Liaoning, PR China; Department of Radiology, The First Hospital of China Medical University, Shenyang 110001, Liaoning, PR China.
J Affect Disord. 2023 Nov 1;340:396-404. doi: 10.1016/j.jad.2023.08.041. Epub 2023 Aug 11.
Bipolar disorder (BD) is difficult to discriminate from major depressive disorder (MDD) before the appearance of mania or hypomania. This study was designed to identify whether patients with MDD and those who converted to BD are distinguishable using dynamic amplitude low-frequency fluctuations (dALFF) and describe the sex effects on the identification of the two disorders.
We compared the dALFF values of 35 BD patients who converted from MDD during the 2-year follow-up, 99 MDD patients, and 130 healthy controls (HCs) using two-way ANOVA. Pearson's correlation was used to compare dALFF in dysfunctional brain regions and clinical characteristics.
A main effect of diagnosis was discovered in the frontal and occipital gyrus. For the main effect of sex, both the left middle occipital gyrus and the medial part of the superior frontal gyrus had higher dALFF values in males compared to females. An interaction of sex and diagnosis effect was observed in the right precentral gyrus. Male MDD patients exhibited a higher dALFF value than male BD patients. Additionally, we discovered a higher dALFF value in females than in males in BD patients. WCST scores were positively associated with dALFF values in the frontal and occipital gyrus in MDD patients. Meanwhile, dALFF values in the occipital gyrus positively correlated with WCST in female MDD patients only.
Most of the participants were on medication and the sample size was small.
Our study is the first to find the non-neglectable role of sex effects in differentiating BD and MDD at an early stage.
在躁狂或轻躁狂发作之前，双相情感障碍（BD）很难与重度抑郁症（MDD）区分开来。本研究旨在确定使用动态振幅低频波动（dALFF）是否可以区分MDD患者和转变为BD的患者，并描述性别对这两种疾病识别的影响。
我们使用双向方差分析比较了99例MDD患者、35例在2年随访期间从MDD转变而来的BD患者以及130名健康对照（HCs）的dALFF值。使用Pearson相关性分析来比较功能失调脑区的dALFF值与临床特征。
在额回和枕回发现了诊断的主效应。对于性别的主效应，与女性相比，男性的左枕中回和额上回内侧部分的dALFF值更高。在右中央前回观察到性别与诊断效应的交互作用。男性MDD患者的dALFF值高于男性BD患者。此外，我们发现BD患者中女性的dALFF值高于男性。MDD患者的威斯康星卡片分类测验（WCST）分数与额回和枕回的dALFF值呈正相关。同时，仅在女性MDD患者中，枕回的dALFF值与WCST呈正相关。
大多数参与者正在服药，且样本量较小。
我们的研究首次发现性别效应在早期区分BD和MDD中具有不可忽视的作用。
