Damgaard Viktoria, Fortea Lydia, Schandorff Johanna M, Macoveanu Julian, Little Bethany, Gallagher Peter, Knudsen Gitte M, Kessing Lars V, Miskowiak Kamilla W
Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, Mental Health Services, Capital Region of Denmark, Frederiksberg, Denmark.
Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
Neuropsychopharmacology. 2025 May;50(6):976-982. doi: 10.1038/s41386-024-02047-2. Epub 2025 Jan 9.
Individuals with bipolar disorder (BD) show heterogeneity in clinical, cognitive, and daily functioning characteristics, which challenges accurate diagnostics and optimal treatment. A key goal is to identify brain-based biomarkers that inform patient stratification and serve as treatment targets. The objective of the present study was to apply a data-driven, multivariate approach to quantify the relationship between multimodal imaging features and behavioral phenotypes in BD. We pooled structural, task and resting-state functional magnetic resonance imaging (MRI), and clinical, cognitive, and functioning data from 167 fully or partly remitted patients with BD from three studies conducted at the same site. We performed canonical correlation analysis (CCA) to investigate multivariate relations among the 56 imaging and 23 behavioral features in patients. Data from 46 matched healthy controls were included for covariate-adjusted standardization of patients' scores and for group comparisons. The imaging and behavioral data sets showed a strong canonical correlation (r = 0.84, p = .004). Among the behavioral variables, cognitive test scores across psychomotor speed, verbal memory, and verbal fluency were associated with the multimodal imaging variate comprising task activation within the dorsolateral prefrontal cortex and supramarginal gyrus, also when other clinical and daily functioning variables were considered. Task activation within the dorsal prefrontal and parietal cognitive control areas constitutes a potential pro-cognitive treatment target.
双相情感障碍（BD）患者在临床、认知和日常功能特征方面表现出异质性，这给准确诊断和优化治疗带来了挑战。一个关键目标是确定基于大脑的生物标志物，为患者分层提供依据并作为治疗靶点。本研究的目的是应用一种数据驱动的多变量方法来量化BD患者多模态成像特征与行为表型之间的关系。我们汇总了来自在同一地点进行的三项研究的167名完全或部分缓解的BD患者的结构、任务和静息态功能磁共振成像（MRI），以及临床、认知和功能数据。我们进行了典型相关分析（CCA），以研究患者中56项成像特征和23项行为特征之间的多变量关系。纳入了46名匹配的健康对照的数据，用于对患者分数进行协变量调整标准化以及进行组间比较。成像和行为数据集显示出很强的典型相关性（r = 0.84，p = 0.004）。在行为变量中，跨心理运动速度、言语记忆和言语流畅性的认知测试分数与多模态成像变量相关，该变量包括背外侧前额叶皮质和缘上回内的任务激活，即使在考虑其他临床和日常功能变量时也是如此。背侧前额叶和顶叶认知控制区域内的任务激活构成了一个潜在的促认知治疗靶点。
