Estudillo-Guerra Maria Anayali, Linnman Clas, Galvez Victor, Chapa-Koloffon Gina, Pacheco-Barrios Kevin, Morales-Quezada Leon, Flores Ramos Monica
Clínica de Trastornos del Afecto, Instituto Nacional de Psiquiatría "Ramón de la Fuente", Mexico City, Mexico.
Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.
Front Psychiatry. 2023 Oct 4;14:1244134. doi: 10.3389/fpsyt.2023.1244134. eCollection 2023.
Type I Bipolar disorder (BD-I) is a neuropsychiatric disorder characterized by manic or mixed-featured episodes, impaired cognitive functioning, and persistent work and social functioning impairment. This study aimed to investigate within-subject; (i) differences in brain perfusion using Single-photon emission computed tomography (SPECT) between manic and euthymic states in BD-I patients; (ii) explore potential associations between altered brain perfusion and cognitive status; and (iii) examine the relationship between cerebral perfusion and mania symptom ratings. Seventeen adult patients diagnosed with BD-I in a manic episode were recruited, and clinical assessments, cognitive tests, and brain perfusion studies were conducted at baseline (mania state) and a follow-up visit 6 months later. The results showed cognitive impairment during the manic episode, which persisted during the euthymic state at follow-up. However, no significant changes in brain perfusion were observed between the manic and euthymic states. During mania, trends toward decreased perfusion in the left cerebellum and right superior parietal lobule were noted. Additionally, trends indicated a higher perfusion imbalance in the left superior and middle frontal gyrus during mania and the right superior and middle frontal gyrus during euthymia. No significant correlations existed between brain perfusion, mania symptom ratings, and cognitive performance, indicating that symptomatology might represent more than neural hemodynamics. These findings suggest that cognitive impairment may persist in BD-I patients and highlight the need for therapeutic interventions targeting cognitive deficits. More extensive studies with extended follow-up periods are warranted further to investigate brain perfusion and cognitive functioning in BD-I patients.
I型双相情感障碍（BD-I）是一种神经精神疾病，其特征为躁狂或混合发作、认知功能受损以及持续的工作和社会功能障碍。本研究旨在调查BD-I患者在躁狂状态与心境正常状态下的：（i）使用单光子发射计算机断层扫描（SPECT）测量的脑灌注差异；（ii）探讨脑灌注改变与认知状态之间的潜在关联；以及（iii）研究脑灌注与躁狂症状评分之间的关系。招募了17名在躁狂发作期被诊断为BD-I的成年患者，并在基线（躁狂状态）和6个月后的随访时进行了临床评估、认知测试和脑灌注研究。结果显示，躁狂发作期存在认知障碍，随访时心境正常状态下该障碍仍持续存在。然而，躁狂状态与心境正常状态之间未观察到脑灌注的显著变化。在躁狂发作期间，发现左小脑和右顶上小叶灌注有减少趋势。此外，有趋势表明，躁狂发作时左上额回和额中回灌注失衡较高，心境正常时右上额回和额中回灌注失衡较高。脑灌注、躁狂症状评分与认知表现之间不存在显著相关性，这表明症状学可能不仅仅代表神经血液动力学。这些发现提示，认知障碍可能在BD-I患者中持续存在，并突出了针对认知缺陷进行治疗干预的必要性。需要进行更广泛且随访期更长的研究，以进一步调查BD-I患者的脑灌注和认知功能。
