BIPOLAR DISORD ：不同临床亚型双相障碍患的生物学差异
2012-11-30 BIPOLAR DISORD BIPOLAR DISORD
近日，一项发表于《双相障碍》杂志[Bipolar disorders 2012 Dec ; 14 (8): 831-42 ]的研究中,来自台湾的研究人员发现：双相情感障碍I型(BDI)和II型(BDII)患者之间存在执行功能及前扣带回代谢功能方面存在差异。 &
近日，一项发表于《双相障碍》杂志[Bipolar disorders 2012 Dec ; 14 (8): 831-42 ]的研究中,来自台湾的研究人员发现：双相情感障碍I型(BDI)和II型(BDII)患者之间存在执行功能及前扣带回代谢功能方面存在差异。
本研究共纳入34例处于缓解期的双相情感障碍(Bipolar disorder,BD )患者(其中BDI和BDII患者各17例),17例健康对照者。所有受试者均接受18F-FDGPET检测及神经生物学测验，评估其脑区葡萄糖代谢情况及注意、记忆、执行功能。
结果发现：双相障碍不同亚型患者的临床特征存在显著差异。威斯康辛卡片分类测验（WCST）结果显示：BDI患者的执行功能明显低于BDII者及健康对照组，主要表现为：错误应答数百分比高、概念化水平应答百分数低及完成分类数少。三组在注意及记忆测验中未发现差异。
大脑PET分析显示：与BDII患者比较，BDI患者双侧前扣带回、岛叶、纹状体及部分前额皮质区的葡萄糖摄取明显降低，左侧海马旁回的葡萄糖摄取增高。
进一步分析发现，BDI患者的执行功能降低与其它情绪相关脑区的糖代谢异常相关。
“双相障碍不同亚型患者在神经生物学方面存在差异”，研究者说，“BDI患者前扣带回受损程度更严重，这也许可以解释其缓解期执行功能下降这一特点”。他们建议对前扣带回的评估可以作为未来临床中区别双相障碍 I型与II型的重要方法。
Objectives:
The aim of this study was to investigate the relationship between resting brain glucose metabolism and cognitive profiles in patients with remitted bipolar I disorder (BD-I) and bipolar II disorder (BD-II). We hypothesized that BD-I patients (compared to BD-II patients) would perform worse on tests of cognitive function because of abnormal metabolism in the prefrontal cortex and other mood-related brain areas.
Methods:
Thirty-four patients with remitted bipolar disorder (BD) (BD-I = 17, BD-II = 17) under treatment and 17 well-matched healthy controls received both fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) and neuropsychological tests of attention, memory, and executive function.
Results:
Clinical features in patients with BD-I and BD-II were comparable. Executive function, as indicated by performance on the Wisconsin Card Sorting Test, was significantly worse (i.e., higher percentage of errors, lower percentage of conceptual level responses, and fewer categories completed) in BD-I patients than in BD-II patients and healthy subjects. No difference in attention and memory tests was found among these three groups. Brain PET analysis showed that BD-I patients (compared to BD-II patients) had significantly lower glucose uptake in the bilateral anterior cingulum, insula, striatum, and part of the prefrontal cortex, and higher glucose uptake in the left parahippocampus. Further analyses revealed significant correlations between poor executive function and abnormal glucose uptake in other brain areas in BD-I patients.
Conclusions:
There are neurobiological differences between subtypes of BD. BD-I is associated with more impaired fronto-limbic circuitry, which might account for reduced executive function in BD-I patients during remission.
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本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料，版权均属于梅斯医学所有。非经授权，任何媒体、网站或个人不得转载，授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章，或“梅斯号”自媒体发布的文章，仅系出于传递更多信息之目的，本站仅负责审核内容合规，其内容不代表本站立场，本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系，我们将立即进行删除处理。
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#Dis#
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#临床亚型#
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#Disord#
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#双相障碍#
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#IPO#
36
#生物学#
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