Wang Xiuli, Long Xipeng, Cheng Bochao, Cao Yuan, Kong Di, Wu Baolin, Xie Hongsheng, Zhao Ziru, Roberts Neil, Zhang Nenghan, Jia Zhiyun
Department of Psychiatry, the Fourth People's Hospital of Chengdu, Chengdu, China.
Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China; Department of Radiology, the Second Affiliated Hospital of Zhejiang University School of Medicine, China.
Prog Neuropsychopharmacol Biol Psychiatry. 2025 Jan 10;136:111229. doi: 10.1016/j.pnpbp.2024.111229. Epub 2024 Dec 22.
The overlap of affective disturbance and psychosis considerably makes it complex to determine the etiology of bipolar disorder (BD) and develop targeted interventions. The present study aimed to determine the white matter microstructural alterations that distinguish between BD with psychosis (BDP) and BD with no psychosis (BDNP) to identify patients who may specifically benefit from appropriately effective treatments.
Diffusion-weighted magnetic resonance images were acquired from 38 participants with BDP, 52 participants with BDNP and 70 healthy controls (HCs). The indices of fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD) and axial diffusivity (AD) were computed and compared among the three groups via tract-based spatial statistics (TBSS).
Analysis of covariance (ANCOVA) revealed the main effects of group on the FA, MD and RD values of the forceps minor (FMI) of the corpus callosum, right anterior thalamic radiation (ATR), and left corticospinal tract (CST). Post hoc analysis revealed that BDP patients had lower FA value in the FMI than HCs did, as well as lower FA and higher RD values in the FMI than BDNP patients did, whereas BDNP patients had lower FA and MD values in the right ATR, as well as higher FA and lower RD values in the left CST than HCs did.
These findings provide further insights into the specific neurobiological mechanisms that underlie the presence of psychosis in BD patients and represent potential objective biomarkers for differentiating between BDP and BDNP.
情感障碍与精神病的重叠使得双相情感障碍（BD）的病因确定和制定针对性干预措施变得相当复杂。本研究旨在确定区分伴有精神病的双相情感障碍（BDP）和不伴有精神病的双相情感障碍（BDNP）的白质微观结构改变，以识别可能从适当有效治疗中特别受益的患者。
对38名BDP参与者、52名BDNP参与者和70名健康对照者（HCs）进行了扩散加权磁共振成像。计算各向异性分数（FA）、平均扩散率（MD）、径向扩散率（RD）和轴向扩散率（AD）指标，并通过基于体素的空间统计学（TBSS）在三组之间进行比较。
协方差分析（ANCOVA）显示，组间差异对胼胝体小钳（FMI）、右侧丘脑前辐射（ATR）和左侧皮质脊髓束（CST）的FA、MD和RD值有主要影响。事后分析显示，BDP患者FMI的FA值低于HCs，且FMI的FA值低于BDNP患者，RD值高于BDNP患者；而BDNP患者右侧ATR的FA和MD值较低，左侧CST的FA值较高，RD值较低。
这些发现为BD患者精神病存在的潜在神经生物学机制提供了进一步的见解，并代表了区分BDP和BDNP的潜在客观生物标志物。
