基于前额叶-纹状体环路gamma频段效能连接寻找早期识别双相障碍的神经电生理特征  

Identifying neurophysiological characteristics for early recognition of bipolar disorder based on gamma band effective connectivity of the prefrontal-striatal circuit

作　　者：尤为 花玲玲[1] 杜易珊 盛俊领 阎锐[1] 卢青[2] 姚志剑[1] You Wei;Hua Lingling;Du Yishan;Sheng Junling;Yan Rui;Lu Qing;Yao Zhijian(Department of Psychiatry,the Affiliated Brain Hospital of Nanjing Medical University,Nanjing 210029,China;School of Biological Sciences&Medical Engineering,Southeast University,Child Development and Learning Science,Key Laboratory of Ministry of Education,Nanjing 210096,China)

机构地区：[1]南京医科大学附属脑科医院精神科,南京210029 [2]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,南京210096

出　　处：《中华精神科杂志》2025年第2期125-133,共9页Chinese Journal of Psychiatry

基　　金：国家自然科学基金(82271568,82101573,82301718);苏州市社会发展科技创新重点项目(2022SS04);江苏省自然科学青年基金(BK20230154)。

摘　　要：目的通过分析处于抑郁状态的有躁狂发作史及无躁狂发作史的双相障碍患者和抑郁症患者在识别正性情绪面孔时前额叶-纹状体环路的gamma频段效能连接特征,寻找能够早期识别双相障碍独特的神经电生理特征。方法采用回顾性研究方法,收集2009年5月至2019年12月期间南京医科大学附属脑科医院住院患者的临床资料及做正性情绪面孔识别任务时的脑磁图影像数据,其中抑郁症患者75例,双相障碍抑郁发作患者(raw bipolar disorder,rBD)29例(rBD组)。同期招募年龄、性别匹配的健康对照者(health control,HC)39名(HC组)。经5年及以上时间随访,75例抑郁症患者中有23例转为双相障碍(converted to bipolar disorder,ctBD)(ctBD组),其余52例未转相者仍诊断为抑郁症(抑郁症组)。选取前额叶、眶额回、扣带回、腹侧纹状体、杏仁核作为感兴趣脑区,将31~48 Hz gamma频段作为感兴趣频段,利用格兰杰因果模型计算各感兴趣脑区之间的效能连接值,通过Kruskal-Wallis H检验统计方法对效能连接值进行统计学分析,探究4组总效能连接值差异,并对差异具有统计学意义的效能连接使用Dunn′s test进行组间post-hoc两两比较,进一步探究各组间效能连接值差异。结果ctBD组、rBD组、抑郁症组、HC组在识别正性情绪面孔时,gamma频段在前额叶-纹状体环路效能连接的差异具有统计学意义(分别为H=9.04、10.30、8.30、13.43、14.38、12.62、9.82、8.94、24.62、7.89、18.53、9.97、9.58、12.79,均P<0.05)。疾病组均在右侧眶部额下回到左侧眶部额下(分别为Z=-1.98、-3.38、-2.88)、右侧眶部额下回到右腹侧纹状体(分别为Z=-2.05、-2.76、-2.11)、左腹侧纹状体到左侧眶部额中回效能连接减弱(分别为Z=-2.76、-1.98、-2.43)(均P<0.05)。疾病组间两两比较发现ctBD组较抑郁症组在右侧杏仁核到左侧眶部额下回[0.04(0.03,0.08)]、右侧杏仁核到左腹侧纹状体[0.05(0.03,0.09ObjectiveThis study aims to analyze the gamma band effective connectivity characteristics of the prefrontal-striatal circuitry in bipolar disorder patients with and without a history of manic episodes,as well as in major depressive disorder patients,during the recognition of positive emotional faces,this study aims to identify unique neurophysiological features that may aid in the early detection of bipolar disorder.MethodsThis retrospective study collected clinical data and magnetoencephalography(MEG)imaging data from patients performing a positive emotional face recognition task at the Affiliated Brain Hospital of Nanjing Medical University from May 2009 to December 2019.The study included 75 patients with major depressive disorder and 29 patients with bipolar disorder in a depressive episode(rBD group).Concurrently,39 age-and gender-matched healthy controls(HC group)were recruited.After a follow-up period of at least 5 years,23 out of the 75 patients with major depressive disorder converted to bipolar disorder(ctBD group),while the remaining 52 who did not convert maintained a diagnosis of major depressive disorder.ResultsThere were statistically significant differences in gamma-band effective connectivity in the prefrontal-striatal circuit when recognizing positive emotional faces among the converted to bipolar disorder(ctBD),raw bipolar disorder,major depressive disorder,and HC groups(H=9.04,10.30,8.30,13.43,14.38,12.62,9.82,8.94,24.62,7.89,18.53,9.97,9.58,12.79,P<0.05).The ctBD group,rBD group,and major depressive group all showed reduction in effective connectivity from the right orbital inferior frontal gyrus(ORBinf.R)to the left orbital inferior frontal gyrus(ORBinf.L)[Z=-1.98,-3.38,-2.88],from the right orbital inferior frontal gyrus to the right ventral striatum(VS.R)(Z=-2.05,-2.76,-2.11;P<0.05)and from the left ventral striatum(VS.L)to the left orbital middle frontal gyrus(ORBmid.L)(Z=-2.76,-1.98,-2.43;P<0.05).Among the disease groups,the ctBD group showed significantly enhanced effective connectivity

关 键 词：双相情感障碍 双相抑郁 抑郁症 脑磁图 前额叶-纹状体环路 Gamma频段 效能连接 

分 类 号：R749.4[医药卫生—神经病学与精神病学]