Lithium monotherapy associated clinical improvement effects on amygdala-ventromedial prefrontal cortex resting state connectivity in bipolar disorder.
Lithium monotherapy associated clinical improvement effects on amygdala-ventromedial prefrontal cortex resting state connectivity in bipolar disorder.
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DOI：
10.1016/j.jad.2017.06.047
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发表时间：
2018-01-01
影响因子：
6.6
通讯作者：
Anand A
中科院分区：
文献类型：
--
作者：
Altinay M;Karne H;Anand A
本研究首次探讨锂单一疗法对双相情感障碍(BP)患者杏仁核-腹内侧额叶皮质(VmPFC)静息状态功能连接的影响及其与临床改善的相关性。36例无药物治疗的受试者−为24BP(12例低躁狂(BPM)和12例抑郁症(BPD))和12例相近匹配的健康对照组(HC)。BP受试者服用锂盐，并在基线、2周和8周后进行扫描。在同一时间点对HC进行扫描，但不进行治疗。在剔除状态影响的同时，采用双因素方差(组、时间)方差分析方法研究了锂对BP组的整体效应。接下来，计算杏仁核-vmPFC静息状态连通性的变化与临床总体印象(CGI)严重程度和总体BP疾病改善量表评分之间的相关性。还分别对BPD和BPM亚组进行了探索性分析。按时间分组的交互作用显示，与健康对照组的重复测试相比，患者单一锂治疗与治疗8周后杏仁核-内侧OFC连接性的增加有关(p=0.05(成组校正))。根据CGI-I量表，在第2周和第8周，杏仁核-vmPFC连接性增加与临床改善相关。结果属于开放标签治疗，不考虑非治疗相关的改善效果。只测量了功能连通性，没有提供关于一个地区对另一个地区的影响的信息。在BP中，锂的单一治疗与杏仁核-vmPFC连接的调节有关，这与状态无关的全球临床改善相关。
This study, for the first time, investigated lithium monotherapy associated effects on amygdala-ventromedial prefrontal cortex (vMPFC) resting-state functional connectivity and correlation with clinical improvement in bipolar disorder (BP) Thirty-six medication-free subjects − 24 BP (12 hypomanic BPM) and 12 depressed (BPD)) and 12 closely matched healthy controls (HC), were included. BP subjects were treated with lithium and scanned at baseline, after 2 weeks and 8 weeks. HC were scanned at same time points but were not treated. The effect of lithium was studied for the BP group as a whole using two way (group, time) ANOVA while regressing out effects of state. Next, correlation between changes in amygdala-vMPFC resting-state connectivity and clinical global impression (CGI) of severity and improvement scale scores for overall BP illness was calculated. An exploratory analysis was also conducted for the BPD and BPM subgroups separately. Group by time interaction revealed that lithium monotherapy in patients was associated with increase in amygdala-medial OFC connectivity after 8 weeks of treatment (p = 0.05 (cluster-wise corrected)) compared to repeat testing in healthy controls. Increased amygdala-vMPFC connectivity correlated with clinical improvement at week 2 and week 8 as measured with the CGI-I scale. The results pertain to open-label treatment and do not account for non-treatment related improvement effects. Only functional connectivity was measured which does not give information regarding one regions effect on the other. Lithium monotherapy in BP is associated with modulation of amygdala-vMPFC connectivity which correlates with state-independent global clinical improvement.
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