双相Ⅱ型障碍重性抑郁发作患者自杀行为相关的脑自发神经活动改变  

Altered brain spontaneous neuronal activity associated with suicidality in bipolar Ⅱ disorder patients with a current major depressive episode

作　　者：朱荣鑫[1] 田水 王欢 陈志璐 卢青[3] 姚志剑[1,2] ZHU Rong-xin;TIAN Shui;WANG Huan;CHEN Zhi-lu;LU Qing;YAO Zhi-jian(Department of psychiatry,the Affiliated Brain Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学附属脑科医院精神科,210029 [2]南京大学医学院 [3]东南大学生物科学与医学工程学院儿童发展与学习科学教育部重点实验室

出　　处：《临床精神医学杂志》2020年第5期289-292,共4页Journal of Clinical Psychiatry

基　　金：国家重点研发计划(2018YFC1314600);国家自然科学基金(81871066);江苏省重点研发计划专项(BE2018609,BE2019675);江苏省科教强卫工程省市共建医学创新团队(CXTDC2016004);江苏省医学科研重点项目(K2019011);南京市医学科技发展重点项目(ZKX18034);南京市医学发展科技项目(YKK16146);南京市科技发展项目(201605039);南京医科大学科技发展项目(NMUB2018204)。

摘　　要：目的:探讨伴自杀未遂行为的双相Ⅱ型障碍(BD-Ⅱ)重性抑郁发作患者大脑自发神经活动改变及其与目前自杀风险的关联。方法:入组116例BD-Ⅱ重性抑郁发作患者(伴自杀未遂组50例,不伴自杀未遂组66例)及62名人口资料匹配的健康对照者。所有受试者完成临床资料采集及静息态功能磁共振扫描。基于全脑体素水平比较受试者脑区低频振幅(ALFF)值,分别检测伴自杀未遂患者的自杀风险、抑郁症状和焦虑症状严重程度与显著差异的脑区ALFF值的相关性。结果:与不伴自杀未遂组相比,伴自杀未遂组左侧前扣带回(ACC)ALFF值显著增高,且与自杀风险呈正相关(P<0.05),而与患者目前抑郁症状及焦虑症状的严重程度无关联(P>0.05)。结论:ACC功能异常可能是BD-Ⅱ重性抑郁发作患者自杀行为特征性生物风险标记,是潜在的自杀防治生物靶点。Objective: To explore altered brain spontaneous neuronal activity in bipolar Ⅱ disorder(BD-Ⅱ) depression patients with suicide attempts and its correlation with the level of suicide risk. Method:A total of 116 BD-Ⅱ patients with a current major depressive episode and 62 demographically matched healthy controls(HC group) were enrolled.The BD-Ⅱ patients were divided into patients with suicide attempt(SA group,n=50) and patients with no prior history of suicide attempts(NSA group,n=66).All participants completed clinical assessments and underwent a resting-state functional magnetic resonance imaging scan.Whole brain amplitude of low-frequency fluctuation(ALFF) values were compared among the three groups.The correlation between abnormal ALFF and the level of suicide risk,severity of depression symptoms,and anxiety symptoms were explored respectively in the SA group. Results:Compared to NSA patients,SA patients showed elevated brain activity in the left anterior cingulate cortex(ACC).Additionally,ALFF of the left ACC was positively correlated with the level of risk in the SA group(P<0.05),but not the severity of depressive or anxiety symptoms(P>0.05). Conclusion:Dysfunction of ACC might be a critical objective feature of suicidality in the BD-Ⅱ depression patients and a potential biological target for suicide prevention.

关 键 词：双相Ⅱ型障碍 自杀未遂 前扣带回 静息态功能磁共振成像 低频振幅 

分 类 号：R749.4[医药卫生—神经病学与精神病学]