A voxel-based diffusion tensor imaging study in unipolar and bipolar depression
A voxel-based diffusion tensor imaging study in unipolar and bipolar depression
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DOI：
10.1111/bdi.12465
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发表时间：
2017-02-01
影响因子：
5.4
通讯作者：
Dannlowski, Udo
中科院分区：
文献类型：
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作者：
Repple, Jonathan;Meinert, Susanne;Dannlowski, Udo
目的：双相情感障碍（BD）缺乏神经生物学诊断标志物，导致其常被误诊为单相抑郁症（UD）。方法：采用弥散张量成像（DTI）技术，对86例抑郁症患者的各向异性分数（FA）进行了研究（N=39 BD，平均年龄39.2岁; N=43 UD，平均年龄39.0岁）和42名健康对照（HC，平均年龄36.1岁）。这些群体在性别、年龄或总教育时间方面没有差异。在白色物质（FA >.2）和假设驱动的解剖学定义的管道（感兴趣区域[ROI]分析）中研究FA。结果：白色物质分析显示UD与HC的右侧皮质脊髓束FA减少，BD与HC的右侧皮质脊髓束/上级纵束FA减少，BD与UD的FA减少。ROI分析显示BD与UD在胼胝体和扣带回中的FA减少。灰质探索性分析显示FA在左额中回和右额下回UD与HC，并在左上级内侧回BD与HC。结论：这是很少的研究直接显示BD和UD之间的FA差异之一。前额叶灰质FA的变化可能是这些疾病中未来前额叶灰质异常的前兆。
Objective: The absence of neurobiological diagnostic markers of bipolar disorder (BD) leads to its frequent misdiagnosis as unipolar depression (UD). We investigated if changes in fractional anisotropy (FA) could help to differentiate BD from UD in the state of depression.Methods: Using diffusion tensor imaging (DTI) we employed a voxel-based analysis approach to examine fractional anisotropy (FA) in 86 patients experiencing an acute major depressive episode according to DSM-IV (N=39 BD, mean age 39.2 years; N=43 UD, mean age 39.0 years), and 42 healthy controls (HC, mean age 36.1 years). The groups did not differ in sex, age or total education time. FA was investigated in white matter (FA >.2) and hypothesis-driven anatomically defined tracts (region-of-interest [ROI] analysis). Additionally, an exploratory gray matter FA analysis was performed.Results: White matter analysis showed decreased FA in the right corticospinal tract in UD vs HC and in the right corticospinal tract/superior longitudinal fascicle in BD vs HC and also in BD vs UD. ROI analysis revealed decreased FA in BD vs UD in the corpus callosum and in the cingulum. Gray matter exploratory analysis revealed decreased FA in the left middle frontal gyrus and in the right inferior frontal gyrus in UD vs HC, and in the left superior medial gyrus in BD vs HC.Conclusion: This is one of very few studies directly showing differences in FA between BD and UD. Gray matter FA changes in prefrontal areas might be precursors for future prefrontal gray matter abnormalities in these disorders.