双相情感障碍患者抑郁和缓解状态脑功能稳定性的比较  

Comparison of brain functional stability in patients with bipolar disorder in depressive and euthymic mood states

作　　者：张志芳 薄奇静 李峰 赵蕾 王赟 刘瑞 陈熊鹰 陈真竹 李田 王怡梦 周媛 王传跃[1,2,5] Zhang Zhifang;Bo Qijing;Li Feng;Zhao Lei;Wang Yun;Liu Rui;Chen Xiongying;Chen Zhenzhu;Li Tian;Wang Yimeng;Zhou Yuan;Wang Chuanyue(The National Clinical Research Center for Mental Disorders&Beijing Key Laboratory of Mental Disorders,Beijing Anding Hospital,Capital Medical University,Beijing 100088,China;Beijing Institute for Brain Disorders Center of Schizophrenia,Beijing 100088,China;Advanced Innovation Center for Human Brain Protection,Capital Medical University,Beijing 100069,China;CAS Key Laboratory of Behavioral Science,Institute of Psychology,Beijing 100101,China;Department of Psychology,University of Chinese Academy of Sciences,Beijing 100049,China)

机构地区：[1]首都医科大学附属北京安定医院,国家精神心理疾病临床医学研究中心,精神疾病诊断与治疗北京市重点实验室,100088 [2]北京脑重大疾病研究院精神分裂症研究所,100088 [3]中国科学院所行为科学重点实验室,中国科学院心理研究所,北京100101 [4]中国科学院大学心理学系,北京100049 [5]首都医科大学人脑保护高精尖创新中心,北京100069

出　　处：《神经疾病与精神卫生》2022年第9期629-634,共6页Journal of Neuroscience and Mental Health

基　　金：国家自然科学基金(81901355);国家科技支撑计划项目(2007BAI17B05);北京市科技计划项目(D121100005012002);首都医科大学附属北京安定医院院级课题(YJ201901)。

摘　　要：目的分析处于双相情感障碍(BD)缓解期的患者(EP)和BD抑郁期的患者(DP)脑功能稳定性的特点。方法选取2009年2月至2016年6月于首都医科大学附属北京安定医院就诊的56例BD患者为研究组,并根据患者所处的情绪状态分为EP组(n=30)和DP组(n=26)。招募与研究组患者匹配的71名健康对照者作为健康对照组。采用17项汉密尔顿抑郁量表(HAMD-17)比较EP组、DP组、健康对照组之间的抑郁程度。采集所有受试者的静息态功能性磁共振成像数据,采用DPABI软件对数据进行预处理和功能稳定性指标的计算并比较3组功能稳定性差异,变换不同窗宽、步长和窗的类型进行重复验证。采用Pearson相关分析患者右侧小脑后叶的功能稳定性与HAMD-17总分之间的相关性。结果EP组、DP组、健康对照组受试者HAMD-17总分比较[2.00(0,4.00)分比14.00(10.75,19.50)分比0(0,1.00)分],差异有统计学意义(P<0.01)。不同窗宽/步长/窗类型的3组受试者右侧小脑后叶功能稳定性比较,差异均有统计学意义(均P<0.05);EP组患者右侧小脑后叶的功能稳定性低于DP组和健康对照组,差异有统计学意义(P<0.05);DP组和健康对照组功能稳定性比较,差异无统计学意义(P>0.05)。研究组、EP组和DP组右侧小脑后叶的功能稳定性与HAMD-17总分无相关性(P>0.05)。结论EP、DP患者表现出不同的脑功能活动模式,仅EP患者表现出右侧小脑后叶的功能稳定性降低。Objective To analyze the difference of brain function stability among patients with bipolar disorder(BD) in remission(EP),patients with BD depression(DP) and healthy controls.Methods A total of56 patients with BD treated in Beijing Anding Hospital Affiliated to Capital Medical University from February2009 to June 2016 were selected as the study group,and were divided into EP group(n=30) and DP group(n=26)according to their emotional state.Another 71 healthy controls matched with patients in the study group were recruited as the healthy control group.The degree of depression among EP group,DP group and healthy control group were compared by Hamilton Depression Scale(HAMD-17).Resting state functional magnetic resonance imaging(fMRI) data of all subjects were collected.DPABI software was used to preprocess the data and calculate the functional stability index,to compare the differences of the three groups of functional stability.Repeated verification was carried out using different window width,step size and window type.Pearson correlation was used to analyze the correlation between the functional stability of the right posterior cerebellar lobe and the total score of HAMD-17.Results The total score of HAMD-17 in the EP group,the DP group,and the healthy control group was [2.00(0,4.00) points vs 14.00(10.75,19.50) points vs 0(0,1.00) points],and the difference was statistically significant(P <0.01).The functional stability of the right posterior cerebellar lobe of the three groups of subjects with different window width/step size/window type was compared,and the difference was statistically significant(P <0.05).The functional stability of the right posterior cerebellar lobe in EP group was significantly lower than that in DP group and healthy control group(P <0.05).There was no statistical significance in the difference of functional stability between DP group and healthy control group(P> 0.05).There was no correlation between the functional stability of the right posterior cerebellar lobe and the total score of HAM

关 键 词：双相情感障碍 功能磁共振成像 静息态 功能稳定性 小脑后叶 

分 类 号：R749.4[医药卫生—神经病学与精神病学]