单双相抑郁障碍前额叶-纹状体通路gamma频段效能连接差异  

The study on the differences of effective connectivity in the fronto-striatum pathways of gamma band between unipolar and bipolar disorders

作　　者：贾凤南 汤浩[2] 刘晓雪[2] 张思启 卢青[3] 姚志剑[2] JIA Fengnan;TANG Hao;LIU Xiaoxue;ZHANG Siqi;LU Qing;YAO Zhijian(Department of Psychiatry,the Affiliated Brain Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]苏州广济医院,苏州215008 [2]南京医科大学附属脑科医院 [3]东南大学生物科学与医学工程学院

出　　处：《中国神经精神疾病杂志》2020年第3期149-153,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：国家自然科学基金(编号:81871066,81571639);江苏省科教强卫工程省市共建医学创新团队(编号:CXTDC2016004);江苏省重点研发计划专项(编号:BE2018609);江苏省卫生健康委科研项目(编号:LGY2019013);苏州市临床重点病种诊疗技术专项(编号:LCZX201719);苏州市科技局关键技术应用研究(编号:SS201882);苏州市精神疾病临床医学中心(编号:Szzx201509)。

摘　　要：目的探究单、双相抑郁障碍患者前额叶—纹状体通路gamma频段效能连接的差异性。方法利用脑磁图(magnetoencephalogram,MEG)检测23例单相抑郁(unipolar disorder,UD)、11例双相抑郁(bipolar disorder,BD)患者和21名健康对照者静息闭眼状态下脑活动。选取眶额回(orbitalfrontal cortex,OFC)、前扣带回(anterior cingulated cortex,ACC)、腹侧纹状体(ventral striatum,VS)、腹内侧前额叶(ventromedial prefrontal cortex,VmPFC)作为感兴趣脑区,以gamma(30~48 Hz)波为感兴趣频段,利用格兰杰因果模型(Granger causal model,GCM)计算各感兴趣脑区之间的效能连接值。结果3组gamma频段效能连接值比较有统计学差异的是:右侧VS-ACC效能连接(F=3.300,P=0.045),其中双相抑郁组高于单相抑郁组(P<0.05),二者与对照组相比无统计学差异(P>0.05);左侧ACC-VS效能连接(F=3.453,P=0.039),其中双相抑郁组高于单相抑郁组及对照组(P<0.05),单相抑郁组与对照组差异无统计学意义(P>0.05);左侧ACC-OFC效能连接(F=5.042,P=0.010),其中双相抑郁组高于单相抑郁组(P<0.05),单相抑郁组高于对照组(P<0.05)。结论单、双相抑郁障碍患者静息态前额叶—纹状体环路活动异常,单相抑郁障碍患者高级皮层的调控能力下降,而双相抑郁障碍患者皮层下脑区功能活动异常增强,gamma波异常效能连接可能是区分单双相抑郁障碍的潜在电生理学指标。Objective To explore the differences of effective connectivity in the cortico-limbic frontal-striatum pathways among unipolar depressive patients,bipolar depressive patients and healthy controls.Methods The magnetoencephalgraph(MEG)was used to record the brain activity under the resting eye closed state in 23 unipolar,11 bipolar depressive patients and 21 healthy controls.The interested regions were the orbital frontal cortex(OFC),the anterior cingulated cortex(ACC),the ventral striatum(VS)and the ventromedial prefrontal cortex(VmPFC).The interest frequency was gamma band.The effective connectivity of the interested brain areas was computed based on Granger causality model(GCM).The parameters of effective connectivity were compared among the patients and control groups.Results The effective connections of the right VS to the ACC(F=3.300,P=0.045),the left ACC to the VS(F=3.453,P=0.039),the left ACC to the OFC(F=5.042,P=0.010)were significantly different among three groups.Compared with unipolar depressive group,bipolar depressive group showed increased effective connection from the left ACC to the OFC and the right VS to the ACC(P<0.05).Compared with controls,unipolar depressive group showed increased effective connection from the left ACC to the OFC(P<0.05).Compared with controls,bipolar depressive group showed enhanced effective connection from the left ACC to the OFC(P<0.05).Conclusion The activity of prefrontal-striatal circuit is disruptive in patients with either unipolar or bipolar depression in the resting state.The unipolar depression patients show weakened regulation of the frontal lobe and the bipolar depression patients have enhanced subcortical brain function.The effective connectivity in gamma frequency band may be a potential electrophysiological marker to distinguish unipolar and bipolar depression.

关 键 词：抑郁症 双相障碍 脑磁图 格兰杰因果模型 

分 类 号：R749.4[医药卫生—神经病学与精神病学]