双相障碍三种临床相边缘系统网络功能异常的研究  

The investigation of limbic network dysfunction across three clinical phases of bipolar disorder

作　　者：吕东升[1] 林武宏 刘哲宁[1] 蒲唯丹[1] 姚萍 王绪轶[1] 郭文斌[1] 赵靖平[1] Lyu Dongsheng;Lin Wuhong;Liu Zhening;Pu Weidan;Yao Ping;Wang Xuyi;Guo Wenbin;Zhao Jingping(Department of Psychiatry,National Clinical Research Center for Mental Disorders,and National Center for Mental Disorders,the Second Xiangya Hospital of Central South University,Changsha 410011,China;School of Biomedical Engineering,Southern Medical University,Guangzhou 510515,China;Center of Mental Health,Inner Mongolia Autonomous Region,Hohhot 010010,China)

机构地区：[1]中南大学湘雅二医院精神科、国家精神疾病医学中心、国家精神心理疾病临床医学研究中心,长沙410011 [2]南方医科大学生物医学工程学院,广州510515 [3]内蒙古自治区精神卫生中心,呼和浩特010010

出　　处：《中华精神科杂志》2024年第2期78-86,共9页Chinese Journal of Psychiatry

基　　金：国家自然科学基金项目(81401125);国家重点研发计划项目(2017YFC0907800)。

摘　　要：目的探讨静息状态下双相障碍三种临床相边缘系统网络脑区间功能连接及脑区内低频振荡振幅(amplitude of low-frequency fluctuation,ALFF)是否有共性改变。方法于2019年7月至2021年12月纳入中南大学湘雅二医院精神卫生研究所确诊为双相障碍的患者107例(双相障碍组)以及与之年龄、性别、受教育程度等相匹配的健康对照者46名(对照组)。根据杨氏躁狂评定量表(Young Mania Rating Scale,YMRS)及17项汉密尔顿抑郁量表(Hamilton Depression Rating Scale,HAMD17)评分将双相障碍患者分为双相躁狂组、双相抑郁组、双相缓解组。采集所有受试者静息态功能磁共振成像数据,采用基于种子点功能连接和ALFF的方法分析其边缘系统网络脑区间功能连接及脑区内功能活动状态,使用单因素方差分析及事后检验的方法比较组间功能连接值和ALFF值的差异。采用Pearson或Spearman对组间差异有统计学意义的脑区功能连接值和ALFF值与临床量表总分及各因子分进行相关分析。结果与对照组相比,双相障碍三种临床相边缘系统网络中前扣带回皮质与海马区的功能连接显著降低(t=-2.60~-2.07,Bonferroni校正,P<0.05),且三种临床相前扣带回皮质ALFF也显著降低(t=-4.41~-3.51,FDR校正,P<0.05)。双相抑郁组左侧前扣带回与左侧海马功能连接值与HAMD17中工作兴趣因子分呈负相关(r=-0.406,P=0.021)。结论双相障碍边缘系统网络中前扣带回的失连接和功能活动降低可能是双相障碍三种临床相情绪调节障碍的共性改变。Objective The present study aims to investigate whether there is a shared alteration of the resting-state functional connectivity and amplitude of low frequency fluctuation(ALFF)within the limbic network across all three clinical phases of bipolar disorder.Methods From July 2019 to December 2021,107 patients diagnosed with bipolar disorder(bipolar disorder group)were recruited from the Institute of Mental Health at Xiangya Second Hospital,Central South University.Additionally,46 healthy controls matched for age,gender,and education level were enrolled as the control group.According to the total scores of the Young Mania Rating Scale(YMRS)and the Hamilton Depression Rating Scale(HAMD17),individuals with bipolar disorder can be categorized into three groups:bipolar manic group,bipolar depressive group,and bipolar euthymic group.Resting state functional magnetic resonance imaging data were collected from all the participants,and seed-based functional connectivity and ALFF in the limbic network were conducted to compare differences among three mood states and controls using One-way ANOVA and post hoc analysis.Finally,correlation analyses using Pearson or Spearman coefficients were performed between statistically significant intergroup differences in functional connectivity/ALFF values and total scores as well as factor scores on clinical rating scales.Results In comparison to the healthy controls,there was a significant decrease in functional connectivity between the anterior cingulate gyrus and hippocampus across all three clinical phases of bipolar disorder after Bonferroni correction(t=-2.60--2.07,P<0.05).Furthermore,the ALFF in the anterior cingulate gyrus during three phases showed a significantl reduction following false discovery rate correction(t=-4.41--3.51,P<0.05).Moreover,a decreased functional connectivity between the left anterior cingulate gyrus and left hippocampus during the depressive phase demonstrated a significant negative correlation with work interest subscores of the HAMD17(r=-0.406,P=0.021).Co

关 键 词：双相情感障碍 边缘系统 磁共振成像 功能连接 低频振幅 

分 类 号：R749[医药卫生—神经病学与精神病学]