Wang Rong, Wang Chun, Zhang Gui, Mundinano Inaki-Carril, Zheng Gang, Xiao Qian, Zhong Yuan
School of Psychology, Nanjing Normal University, Nanjing 210097, China.
Department of Psychiatry, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing 210029, China.
Psychol Med. 2024 Dec 16;54(16):1-12. doi: 10.1017/S0033291724002885.
Pediatric bipolar disorder (PBD) is characterized by abnormal functional connectivity among distributed brain regions. Increasing evidence suggests a role for the limbic network (LN) and the triple network model in the pathophysiology of bipolar disorder (BD). However, the specific relationship between the LN and the triple network in PBD remains unclear. This study aimed to investigate the aberrant causal connections among these four core networks in PBD.
Resting-state functional MRI scans from 92 PBD patients and 40 healthy controls (HCs) were analyzed. Dynamic Causal Modeling (DCM) was employed to assess effective connectivity (EC) among the four core networks. Parametric empirical Bayes (PEB) analysis was conducted to identify ECs associated with group differences, as well as depression and mania severity. Leave-one-out cross-validation (LOOCV) was used to test predictive accuracy.
Compared to HCs, PBD patients exhibited primarily excitatory bottom-up connections from the LN to the salience network (SN) and bidirectional excitatory connections between the default mode network (DMN) and SN. In PBD, top-down connectivity from the triple network to the LN was excitatory in individuals with higher depression severity but inhibitory in those with higher mania severity. LOOCV identified dysconnectivity circuits involving the caudate and hippocampus as being associated with mania and depression severity, respectively.
Disrupted bottom-up connections from the LN to the triple network distinguish PBD patients from healthy controls, while top-down disruptions from the triple network to LN relate to mood state differences. These findings offer insight into the neural mechanisms of PBD.
儿童双相情感障碍（PBD）的特征是大脑不同区域之间的功能连接异常。越来越多的证据表明边缘网络（LN）和三重网络模型在双相情感障碍（BD）的病理生理学中发挥作用。然而，PBD中LN与三重网络之间的具体关系仍不清楚。本研究旨在探讨PBD中这四个核心网络之间异常的因果连接。
分析了92例PBD患者和40名健康对照（HCs）的静息态功能磁共振成像扫描数据。采用动态因果模型（DCM）评估四个核心网络之间的有效连接（EC）。进行参数经验贝叶斯（PEB）分析以确定与组间差异以及抑郁和躁狂严重程度相关的EC。采用留一法交叉验证（LOOCV）来测试预测准确性。
与HCs相比，PBD患者主要表现出从LN到突显网络（SN）的兴奋性自下而上连接以及默认模式网络（DMN）和SN之间的双向兴奋性连接。在PBD中，三重网络到LN的自上而下连接在抑郁严重程度较高的个体中是兴奋性的，但在躁狂严重程度较高的个体中是抑制性的。LOOCV确定涉及尾状核和海马体的断开连接回路分别与躁狂和抑郁严重程度相关。
从LN到三重网络的自下而上连接中断将PBD患者与健康对照区分开来，而从三重网络到LN的自上而下中断与情绪状态差异有关。这些发现为PBD的神经机制提供了见解。
