双相障碍Ⅱ型抑郁患者静息态背外侧前额叶皮质功能连接的异常  

Abnormal functional connectivity of dorsolateral prefrontal cortex in patients with bipolar H depression under the resting state

作　　者：颜峰[1] 王丽[2] 李科[3] 曾亚伟[3] 苏允爱[2] 金真[3] 司天梅[2] Yan Feng, Wang Li, Li Ke, Zeng Yawei, Su Yunai, Jin Zhen, Si Tianrnei.(Beijing Hui-long-guan Hospital, Peking University, Beijing 100096, Chin)

机构地区：[1]北京回龙观医院,100096 [2]北京大学第六医院北京大学精神卫生研究所国家精神心理疾病临床医学研究中心卫生部精神卫生学重点实验室(北京大学) [3]解放军306医院

出　　处：《中华精神科杂志》2018年第2期93-97,共5页Chinese Journal of Psychiatry

基　　金：国家科技支撑计划项目（2015BAI13B01）;首都发展基金联合攻关项目（2016-1-4111）

摘　　要：目的探讨双相障碍Ⅱ型抑郁发作患者背外侧前额叶皮质（dorsolateral prefrontal cortex, DLPFC）的脑功能连接模式。方法选取30例符合DSM-Ⅳ双相障碍Ⅱ型抑郁发作诊断标准的患者（患者组）和与之性别、年龄等匹配的30名健康对照者（对照组），进行一般人口学及临床资料采集，以及静息态脑fMRI扫描，影像学数据经预处理后，以DLPFC为感兴趣区，采用REST软件进行图像的统计学分析，采用单样本t检验分析每个DLPFC感兴趣区在组内的连接分布模式，采用独立样本t检验，以年龄、性别为协变量，比较2组DLPFC功能连接的差异，并与疾病严重程度HAMD17总分进行Pearson相关分析。结果与对照组比较，患者组左侧DLPFC种子点与右内侧额上回、左侧颞下回、左侧颞中回、左侧颞上回以及右侧颞上回/海马旁回的功能连接增强（t=4.809、4.689、4.912，均P〈0.05），而与左侧顶下小叶/左侧角回、左侧额上回的功能连接减弱（t=-4.065、-4.625，均P〈0.05）。患者组右侧DLPFC与右侧额中回（MNI：x=42、y=36、z=30，t=-5.093）、右侧额下回（MNI：x=6、y=21、z=45，t=-4.553）的功能连接减弱（均P〈0.05）。上述差异脑区的连接均值与HAMD17总分均无相关性。结论双相障碍Ⅱ型抑郁发作患者存在静息态双侧DLPFC功能连接异常，其特异性仍有待于进一步研究。Objective To explore the changes of functional connectivity patterns of dorsolateral prefrontal cortex （DLPFC） related to emotion management in patients with bipolar Ⅱ depression under the resting state. Methods The general demographic and clinical data of 30 patients with bipolar Ⅱ depression and gender- and age-matched healthy controls were collected. All subjects completed the resting- state functional magnetic resonance scans. After the imaging preprocessing, seed-based functional connectivity analysis was performed on the bilateral DLPFC using REST software. The single sample t test was used to analyze the connection distribution pattern of each DLPFC region of interest in the group. The independent sample t test was used to compare the differences between two groups of DLPFC functional connections with age and sex covariate. Subsequently, Pearson correlation analysis was performed between the mean connectivity values of regions showing significant group differences and depressive severity （HAMD17 scores）. Results Compared with healthy controls, patients with bipolar Ⅱ depression showed abnormally increased functional connectivity between the left DLPFC seed and the right superior medial frontal gyrns, left superior, middle, inferior temporal gyri, right superior temporal gyrus and right parahippocampal gyrus （t=4.809, 4.689, 4.912; all P〈0.05）, while the functional connectivity was abnormally decreased between the left DLPFC and the left inferior parietal lobule, left superior medial frontal gyrns （t=-4.065,4.625; both P〈 0.05）. The right DLPFC showed abnormally reduced functional connectivity with the right middle frontal gyrns （MNI： x=42, y=36, z=30; t=-5.093, P 〈 0.05） and the right inferior frontal gyrns （MNI： x=6, y=21, z=45; t=-4.553, P 〈 0.05）. No significant correlations were found between the mean connectivity values of the regions showing significant group differences and depressive severity （HAMD17 scores）. Conclusion The results suggest that patients

关 键 词：双相情感障碍 磁共振成像 静息态 背外侧前额叶 

分 类 号：R445.2[医药卫生—影像医学与核医学] R749.4[医药卫生—诊断学]