早期阶段双相Ⅰ型躁狂患者杏仁核静息态功能连接初步研究  

Resting state functional connectivity analysis of the amygdala in the early stage of bipolar Ⅰ disorder

作　　者：崔立谦[1,2] 曹莉萍[3] 邓文皓[3] 邹文锦[3] 林鄞[3] 黄燕萍[1] 宁玉萍[3] 吴华旺[3] 

机构地区：[1]广州医科大学附属第一医院精神医学科,广州510120 [2]中山大学附属第一医院临床心理科 [3]广州市惠爱医院(广州医科大学附属脑科医院)

出　　处：《中国神经精神疾病杂志》2014年第10期601-606,共6页Chinese Journal of Nervous and Mental Diseases

基　　金：广东省自然科学基金博士启动项目(编号:S2011040003729);广东省科技计划项目(编号:2012B031800433)

摘　　要：目的探讨早期阶段双相障碍躁狂患者杏仁核静息态功能磁共振功能连接的改变。方法对23例符合《美国精神障碍诊断与统计手册第四版》(DSM-Ⅳ)的双相障碍Ⅰ型躁狂发作诊断标准且病程小于2年的患者及46名性别、年龄与患者匹配的正常对照进行静息态磁共振扫描;以贝克—拉范森躁狂评定量表(Bech-Rafaelsdn mania rating scale,BRMS)评估患者临床症状;在Matlab平台上应用SPM及DPARSF软件选取双侧杏仁核为种子点进行基于感兴趣区的功能连接分析,并比较两组差异;对功能连接强度及量表分进行相关分析。结果与对照组相比,患者组左侧杏仁核与左侧额叶内侧回和左侧前扣带回的静息态磁共振功能连接降低(P<0.001,未校正);右侧杏仁核与左侧额叶内侧回和左侧前扣带回、双侧颞上回、右侧岛叶和尾状核静息态磁共振功能连接降低(P<0.001,未校正)。未发现患者组功能连接差异脑区的功能连接强度与BRMS分有统计学相关性(均P>0.05)。结论早期阶段双相障碍躁狂患者杏仁核与额叶皮质—边缘结构的功能连接降低,支持双相障碍存在额叶—边缘系统功能障碍的假说。Objective To explore the resting statefunctional connectivity alterations and study the neural underpinnings of patients in the early stage of bipolar disoder. Methods Resting-state fMRI data were collected from 23 patients who meet DSM-IV diagnostic criteria for current manic episode and with duration less than 2 years and from 46 age-and gender-matched healthy control subject. Functional connectivity maps from the amygdala were computed for each subject. Correlation analysis was performed between the FC values and Bech-Rafaelsdn Mania Rating Scale. Results Compared with health controls, bipolar disorder patients had significantly decreased left amygdala connectivity to the left medial frontal cortex and left anterior cingulate cortex（P〈0.001,without correction）as well as decreased right amygdala connectivity to the left medial frontal cortex, left anterior cingulated, bilateral superior temporal gyrus, right insula and the caudate nucleus（P〈0.001,without correction）. There was no correlation between the altered amygdala functional connectivity and clinical symptom scores（P〉0.05）. Conclusions A reduced connectivity between the amygdala and fronto-limbic structure indicates the fronto-limbic network dysfunction in the early stage of bipolar disorder, which suggest that a disruption brain connectivity within frontal–limbic system may be a possible biomarker for bipolar I disorder.

关 键 词：双相障碍 杏仁核 功能连接 

分 类 号：R749.4[医药卫生—神经病学与精神病学]