Sun Hao, Shen Na, Chen Zhilu, Sheng Junling, Yan Rui, Zou Haowen, Tian Shui, Hua Lingling, Wang Yiwen, Wang Xiaoqin, Lu Qing, Yao Zhijian
Nanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Nanjing, China; The Affliated Xuzhou Eastern Hospital of Xuzhou Medical University, Xuzhou 221004, China.
Nanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Nanjing, China.
J Affect Disord. 2025 Dec 15;391:120077. doi: 10.1016/j.jad.2025.120077. Epub 2025 Aug 18.
This study aims to explore specific biomarkers for the early identification of bipolar disorder (BD) by assessing cortical morphological features.
This study comprised 185 BD patients, 203 unipolar depression (UD) patients, and 257 healthy controls (HC). In addition, through follow-up, a cohort of 86 patients initially diagnosed with major depressive disorder (MDD) who later transitioned to BD were identified as having initial depressive episode BD (IDE-BD). The cortical structural indices were measured for all participants. General linear models were used to assess the deviations in cortical characteristics between each depressive episode group and HC. Cosine similarity was employed to analyze the similarity of cortical thickness deviations across the depressive episode groups. Additionally, differences in cortical thickness between the BD/IDE-BD and UD groups were analyzed, and the association with clinical characteristics was explored.
The BD, IDE-BD, and UD groups share similar cortical thickness deviation patterns. Compared to HC, significant alterations in bilateral entorhinal cortex (EC) thickness were observed specifically in the BD and IDE-BD groups, while no such changes were observed in the UD group. Compared to UD, BD showed significant cortical thinning in the bilateral EC. In contrast, IDE-BD exhibited significant thickening in the bilateral EC compared to UD.
In this transdiagnostic study, we revealed shared and disease-specific cortical thickness deviation patterns between BD and UD. Additionally, we highlight bilateral EC thickening as a predictor for the early identification of BD from depressive episodes. Our findings contribute to the early identification of BD from depressive episodes.
本研究旨在通过评估皮质形态特征来探索用于早期识别双相情感障碍（BD）的特定生物标志物。
本研究纳入了185例BD患者、203例单相抑郁症（UD）患者和257例健康对照（HC）。此外，通过随访，86例最初被诊断为重度抑郁症（MDD）且后来转变为BD的患者被确定为患有初始抑郁发作的双相情感障碍（IDE - BD）。对所有参与者测量皮质结构指标。使用一般线性模型评估每个抑郁发作组与HC之间皮质特征的差异。采用余弦相似度分析各抑郁发作组皮质厚度差异的相似性。此外，分析了BD/IDE - BD组与UD组之间皮质厚度的差异，并探讨了其与临床特征的关联。
BD组、IDE - BD组和UD组具有相似的皮质厚度差异模式。与HC相比，BD组和IDE - BD组双侧内嗅皮质（EC）厚度有显著改变，而UD组未观察到此类变化。与UD相比，BD组双侧EC显著变薄。相反，与UD相比，IDE - BD组双侧EC显著增厚。
在这项跨诊断研究中，我们揭示了BD和UD之间共同的以及疾病特异性的皮质厚度差异模式。此外，我们强调双侧EC增厚可作为从抑郁发作中早期识别BD的预测指标。我们的研究结果有助于从抑郁发作中早期识别BD。
