Changes in Intrinsic Brain Connectivity in Family-Focused Therapy Versus Standard Psychoeducation Among Youths at High Risk for Bipolar Disorder.
Changes in Intrinsic Brain Connectivity in Family-Focused Therapy Versus Standard Psychoeducation Among Youths at High Risk for Bipolar Disorder.
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DOI：
10.1016/j.jaac.2020.07.892
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发表时间：
2021-04
影响因子：
13.3
通讯作者：
Miklowitz DJ
中科院分区：
文献类型：
--
作者：
Singh MK;Nimarko AF;Garrett AS;Gorelik AJ;Roybal DJ;Walshaw PD;Chang KD;Miklowitz DJ
我们比较了双相情感障碍(BD)和健康对照(HC)有症状的高危青年(HR)的内在网络连通性，并在HR青年中，调查了高危青年家庭重点治疗(FFT-HR)与标准化家庭心理教育后内在连通性的治疗相关变化。有抑郁和/或躁狂症状的HR青年(N=34；年龄9-17岁；平均14岁，56%)和至少一名患有BD I或II的一级或二级亲属被随机分配到FFT-HR(12次心理教育、沟通和解决问题技能培训)或加强护理(EC；3次家庭和3次个人心理教育)4个月。在治疗前和治疗4个月后，参与者接受静息状态功能磁共振成像(rS-fMRI)。全脑独立成分分析比较了HR青年和30名年龄匹配的HC青年在治疗前基线的RS-fMRI网络。然后，我们确定了接受FFT-HR(n=16)或EC(n=18)的HR青年在治疗前和治疗后(4个月)网络连接的变化，并将这些变化与抑郁的改善相关联。在基线时，HR青年在腹外侧额叶皮质(VLPFC)和前额叶默认模式网络(ADMN)之间的连通性比HCS更强(p=0.004)。在4个月的治疗中，FFT-HR分配的HR青年从治疗前到治疗后VLPFC-ADMN连接性增加(p=.003)，而EC组的HR青年没有随着时间的推移而显著改变(p=.11)(通过时间交互作用处理，[t(31)=3.33，CI 95%[0.27，1.14]，p=.002]。4个月后抑郁严重程度的降低与前部DMN连接的增强呈负相关(r=−.71)，而EC组(r=−.07)则不相关(z=−2.17，p=.015)。与标准的心理教育相比，FFT-HR与VLPFC和ADMN之间的连接性更强，这表明可能增强了自我意识和疾病意识以及情绪调节。双相情感障碍高危青少年的早期干预；https://clinicaltrials.gov/；NCT01483391。
We compared intrinsic network connectivity in symptomatic youth at high risk (HR) for bipolar disorder (BD) and healthy comparison (HC) youth, and, in HR youth, investigated treatment-related changes in intrinsic connectivity following family focused therapy for high-risk youth (FFT-HR) versus standardized family psychoeducation. HR youth (N=34; age 9–17 years; mean 14 years, 56% girls) with depressive and/or hypomanic symptoms and at least one first- or second-degree relative with BD I or II were randomly assigned to 4 months of FFT-HR (12 sessions of psychoeducation, communication, and problem-solving skills training) or Enhanced Care (EC; 3 family and 3 individual psychoeducation sessions). Before and after 4-months of treatment, participants underwent resting state functional magnetic resonance imaging (rs-fMRI). A whole brain independent component analysis compared rs-fMRI networks in HR youth and 30 age-matched HC youth at a pretreatment baseline. Then, we identified pretreatment to post-treatment (4-month) changes in network connectivity in HR youth receiving FFT-HR (n=16) or EC (n=18) and correlated these changes with depression improvement. At baseline, HR youth had greater connectivity between the ventrolateral prefrontal cortex (VLPFC) and the anterior default mode network (aDMN) than did HCs (p=.004). Over 4 months of treatment, FFT-HR-assigned HR youth had increased VLPFC-aDMN connectivity from pre- to post-treatment (p=.003), whereas HR youth in EC showed no significant change over time (p=.11) (treatment by time interaction, [t(31)=3.33, CI 95% [0.27, 1.14], p=.002]. Reduction in depression severity over 4 months inversely correlated with enhanced anterior DMN (r= −.71) connectivity in the FFT-HR but not in the EC (r=−.07) group (z=−2.17, p=.015). Compared to standard psychoeducation, FFT-HR is associated with stronger connectivity between the VLPFC and aDMN, suggesting possible enhancements of self- and illness awareness and emotion regulation. Early Intervention for Youth at Risk for Bipolar Disorder; https://clinicaltrials.gov/; NCT01483391.
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影响因子：
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作者：
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通讯作者：
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