不同起病年龄双相障碍患者执行工作记忆任务期间前额皮质激活的研究  

A preliminary analysis of effect of onset age on prefrontal activation during working memory task in patients with bipolar disorder

作　　者：朱玥[1] 权文香[1] 马燕桃[1] 田菊[1] 董问天[1] 于欣[1] 

机构地区：[1]北京大学第六医院北京大学精神卫生研究所卫生部精神卫生学重点实验室(北京大学),100191

出　　处：《中华精神科杂志》2017年第2期114-118,共5页Chinese Journal of Psychiatry

基　　金：北京市科委重点项目（D121100005012004）

摘　　要：目的 初步探讨起病年龄对双相障碍患者执行工作记忆任务期间前额皮质激活的影响.方法 纳入2013年10月至2014年5月北京大学第六医院病房连续入组的早发（起病年龄≤24岁）双相Ⅰ型患者16例（早发组）、非早发（起病年龄＞24岁）双相Ⅰ型患者14例（非早发组）,及来源于社区的健康对照者16名（对照组）.经MINI中文版诊断,运用52导联近红外光谱成像（near-infrared spectroscopy,NIRS）技术,采用横断面比较3组执行1-back工作记忆任务期间前额皮质氧合血红蛋白浓度（oxygenated hemoglobin,oxy-Hb）及脱氧血红蛋白浓度（deoxygenated hemoglobin,deoxy-Hb）的相对变化.结果 早发组右侧额下回区域deoxy-Hb激活低于对照组（CH34：-0.091与0.009,Z=-2.542,P=0.033）,右背外侧前额叶（CH13：0.145与-0.025,Z=2.412,P=0.048）及右侧额极区域（CH15：0.053与-0.032,Z=2.890,P=0.012） deoxy-Hb激活程度高于非早发组.3组间oxy-Hb变化在任意导联上差异均无统计学意义.经多因素分析校正年龄因素后,3组右侧额下回、右背外侧前额叶及右侧额极区域激活的差异均无统计学意义.结论 早发组与非早发组双相障碍患者执行1-back工作记忆乙任务期间NIRS前额皮质激活模式相似,提示起病年龄可能对双相障碍患者低记忆负荷下的前额皮质激活无影响. Objectives To assess the effect of onset age on prefrontal activation during a working memory task in patients with bipolar disorder using a 52 multichannel functional near-infrared spectroscopy （NIRS）.Methods Sixteen patients with early-onset （EO,onset age≤24 years old） and 14 with non-early-onset （NEO,onset age〉24 years old） bipolar Ⅰ disorder were consecutively recruited from wards of Peking University Sixth hospital between October 2013 and May 2014,also including 16 healthy controls （HC） from community.Three groups of participants were diagnosed using MINI,then accepted a cross-sectional comparison of the relative changes in oxygenated hemoglobin （oxy-Hb） and deoxygenated hemoglobin （deoxy-Hb） during 1-back working memory task.Results Results from single factor analyses suggested that EO group showed a significantly reduced activation in deoxy-Hb in the right inferior prefrontal gyrus region than HC （CH34：-0.091 vs.0.009,Z=-2.542,P=0.033）,while a significant increase of deoxy-Hb changes in the right dorsolateral prefrontal cortex （CH13：0.145 vs.-0.025,Z=2.412,P=0.048） and right frontopolar cortex （CH15：0.053 vs.-0.032,Z=2.890,P=0.012） regions than NEO group.There were no significant differences in the oxy-Hb changes among three groups in any channel during task.After being adjusted by multiple factor analyses,no significant difference in prefrontal activation among three groups was observed in any channel.Conclusions Similar pattern of prefrontal activity during 1-back working memory task exits between EO and NEO group,indicating that onset age may have no effect on NIRS prefrontal activation under low memory load in patients with bipolar disorder,which provides a reference for further NIRS studies in bipolar disorder.

关 键 词：双相情感障碍 谱学 近红外线 额叶前皮质 起病年龄 

分 类 号：R741.04[医药卫生—神经病学与精神病学]