伴与不伴强迫症状双相抑郁患者的脑灰质结构和功能网络拓扑属性比较分析  

A comparative study of gray matter structural and functional network topological properties in bipolar depression patients with and without comorbid obsessive-compulsive symptoms

作　　者：唐鑫悦 杨梓彬 陈观茂 陈盼 郭子玄 孙仕林 贾艳滨[2] 钟舒明[2] 黄力[1] 王颖[1] Tang Xinyue;Yang Zibin;Chen Guanmao;Chen Pan;Guo Zixuan;Sun Shilin;Jia Yanbin;Zhong Shuming;Huang Li;Wang Ying(Medical Imaging Center,First Affiliated Hospital of Jinan University,Guangzhou 510630,China;Department of Psychiatry,First Affiliated Hospital of Jinan University,Guangzhou 510630,China)

机构地区：[1]暨南大学附属第一医院医学影像中心,广州510630 [2]暨南大学附属第一医院精神心理科,广州510630

出　　处：《中华精神科杂志》2025年第2期113-124,共12页Chinese Journal of Psychiatry

基　　金：国家自然科学基金(82472057,81971597);广州市科技计划项目(2024B03J1299)。

摘　　要：目的基于图论分析探究伴与不伴强迫症状双相抑郁患者的脑灰质结构网络和功能网络拓扑属性差异。方法收集2018年3月至2022年12月暨南大学附属第一医院精神科门诊和住院部90例双相抑郁患者,男27例,女63例,年龄[M(Q 1,Q 3)]19.0(22.0,25.0)岁。同期招募健康对照者50名(对照组),其中男19名,女31名,年龄23.0(20.0,27.0)岁。根据患者是否伴强迫症状分为伴强迫症状双相抑郁组53例和不伴强迫症状双相抑郁组37例。采集受试者的静息态磁共振成像结构和功能数据,分别构建脑灰质结构网络和功能网络,应用图论分析方法分别计算小世界属性等网络拓扑属性指标。比较伴强迫症状双相抑郁组、不伴强迫症状双相抑郁组、对照组3组间的脑灰质结构网络拓扑属性和功能网络拓扑属性。将组间差异有统计学意义的网络拓扑属性指标与耶鲁-布朗强迫症状(Yale-Brown Obsessive-Compulsive Scale,Y-BOCS)量表进行偏相关分析。进一步用组间差异有统计学意义的网络拓扑属性指标作为分类特征值,利用支持向量机(support vector machines,SVM)进行3组间的两两分类以提高鉴别诊断正确率。结果脑灰质结构网络分析显示,与对照组比,伴强迫症状双相抑郁组和不伴强迫症状双相抑郁组均存在最短路径长度和标准化特征路径长度增加(最短路径长度:0.78和0.80比0.69,标准化特征路径长度:0.48和0.49比0.43)、全局效率降低(0.21和0.21比0.24)(置换检验,均P<0.05);与不伴强迫症状双相抑郁组和对照组相比,伴强迫症状双相抑郁组在右侧罗兰迪克岛盖和左侧枕上回的节点中心度及介数中心度增高(置换检验,均P<0.05)。脑灰质功能网络分析显示,与不伴强迫症状双相抑郁组比,伴强迫症状双相抑郁组小脑节点效率增高、介数中心度减低(t=2.15、-3.04,均P<0.05);与对照组比,伴强迫症状双相抑郁组小脑和左侧额下回介数中心度减低、�ObjectiveUsing graph theory analysis,this study compares the topological and node attributes of the brain network to explore the differences in gray matter structural and functional network topological properties between bipolar depression(BD)patients with and without obsessive-compulsive symptoms(OCS).MethodsA total of 90 BD patients(27 males,63 females;median age 19.0(22.0,25.0)years)were recruited from the psychiatric outpatient and inpatient departments of the First Affiliated Hospital of Jinan University between March 2018 and December 2022.Fifty healthy controls(19 males,31 females;median age:23.0(20.0,27.0)years)were also enrolled.The BD patients were divided into two groups based on the presence of OCS:53 with OCS(OCS group)and 37 without OCS(NOCS group).Resting-state structural and functional MRI data were collected for all participants to construct gray matter structural and functional networks.Graph therory analysis was applied to calculate network topological metrics such as small-world properties.The structural and functional network topological properties were compared among the BD-OCS,BD-nOCS,and control groups.Partial correlation analysis was conducted to examine the association between network topological metrics with significant group differences and Yale-Brown Obsessive-Compulsive Scale(Y-BOCS)scores.Support vector machines(SVM)were used with these metrics as classification feature values to improve diagnostic accuracy through pairwise group classification.ResultsStructural network analysis of gray matter:compared to HC group,both OCS group and NOCS group showed increased shortest path length and standardized characteristic path length(shortest path length:0.78 and 0.80 vs.0.69;normalized characteristic path length:0.48 and 0.49 vs.0.43),and decreased global efficiency(0.21 and 0.21 vs.0.24)compared to the HC group(permutation test,all P<0.05).Compared to NOCS and HC groups,the OCS group showed increased nodal centrality and betweenness centrality in the right rolandic operculum and left superi

关 键 词：双相情感障碍 双相抑郁 强迫症状 结构协共变网络 静息态功能网络 支持向量机 

分 类 号：R749.4[医药卫生—神经病学与精神病学]