Department of Occupational Therapy, I-Shou University, Kaohsiung, Taiwan.
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Prog Brain Res. 2024;290:63-81. doi: 10.1016/bs.pbr.2024.05.008. Epub 2024 Jun 25.
Distinguishing between type 2 bipolar disorder (BD II) and major depressive disorder (MDD) poses a significant clinical challenge due to their overlapping symptomatology. This study aimed to investigate neurobiological markers that differentiate BD II from MDD using multimodal neuroimaging techniques.
Fifty-nine individuals with BD II, 114 with MDD, and 117 healthy controls participated in the study, undergoing structural and functional magnetic resonance imaging. Functional connectivity (FC) analysis used regions from Shen's whole-brain FC-based atlas. Feature selection was carried out using independent t-tests and ReliefF algorithms, followed by classification using Support Vector Machine and wide neural network.
Significant differences in brain structure and function were observed among patients with BD II, MDD, and healthy controls. Both structural and functional alterations were more pronounced in BD II compared to MDD, particularly in regions associated with sensory processing, motor function, and the cerebellum. Classification based on neurobiological markers achieved a mean testing accuracy of 88.24%, with the t-test selected features outperforming those selected by ReliefF. Dysconnectivity patterns correlated with symptom severity and functioning in BD II but not MDD.
Our findings suggest that neurobiological markers derived from multimodal imaging techniques can effectively differentiate patients with BD II from those with MDD. The identified alterations in brain structure and function, particularly in sensory-motor processing networks, may serve as potential biomarkers for distinguishing between these mood disorders. However, the influence of psychotropic medications and daily functioning severity on these neurobiological markers warrants further investigation.
由于 2 型双相情感障碍（BD II）和重度抑郁症（MDD）的症状重叠，因此区分这两种疾病具有重大的临床挑战。本研究旨在使用多模态神经影像学技术，探讨区分 BD II 和 MDD 的神经生物学标志物。
本研究纳入了 59 名 BD II 患者、114 名 MDD 患者和 117 名健康对照者，他们接受了结构和功能磁共振成像检查。功能连接（FC）分析使用了 Shen 的全脑 FC 图谱中的区域。采用独立 t 检验和 ReliefF 算法进行特征选择，然后使用支持向量机和宽神经网络进行分类。
BD II、MDD 患者和健康对照组之间的大脑结构和功能存在显著差异。与 MDD 相比，BD II 患者的大脑结构和功能改变更为明显，特别是在与感觉处理、运动功能和小脑相关的区域。基于神经生物学标志物的分类平均测试准确率为 88.24%，t 检验选择的特征优于 ReliefF 选择的特征。BD II 患者的连接异常模式与症状严重程度和功能相关，但在 MDD 患者中则无相关性。
我们的研究结果表明，源自多模态影像学技术的神经生物学标志物可有效区分 BD II 患者和 MDD 患者。大脑结构和功能的改变，特别是在感觉运动处理网络中，可能成为区分这些心境障碍的潜在生物标志物。然而，精神药物和日常功能严重程度对这些神经生物学标志物的影响需要进一步研究。
