Mapping Disease Course Across the Mood Disorder Spectrum Through a Research Domain Criteria Framework.
Mapping Disease Course Across the Mood Disorder Spectrum Through a Research Domain Criteria Framework.
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DOI：
10.1016/j.bpsc.2021.01.004
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发表时间：
2021-07
期刊：
影响因子：
--
通讯作者：
Pizzagalli DA
中科院分区：
文献类型：
--
作者：
Whitton AE;Kumar P;Treadway MT;Rutherford AV;Ironside ML;Foti D;Fitzmaurice G;Du F;Pizzagalli DA
美国国家精神卫生研究所的研究领域标准（RDoC）倡议旨在建立一个神经生物学有效的框架来分类精神疾病。在这里，我们研究了是否RDoC结构的奖励学习和三个方面的潜在神经回路预测症状轨迹的个人情绪病理。与RDoC方法一致，我们招募了80名情绪障碍患者（58名单极，22名双相）和32名对照组; 63.4%为女性），基于他们在基于实验室的奖励学习任务中的表现，而不是临床诊断。然后，我们评估了（1）使用脑电图的前扣带皮层预测错误，（2）使用功能性磁共振成像的纹状体奖励预测错误，（3）使用1H磁共振波谱的内侧前额叶皮层谷氨酸能功能（mPFC Gln/Glu）。在基线、3个月和6个月时测量快感缺乏、（轻）躁狂和冲动的严重程度。更大的同质性方面的大脑功能（mPFC谷氨酰胺/谷氨酸）时，观察到个人根据奖励学习能力，而不是诊断分类。此外，mPFC谷氨酰胺/谷氨酸水平预测更严重的（亚）躁狂症状横截面，恶化（亚）躁狂症状纵向，并解释更大的差异，在未来（亚）躁狂症状比诊断信息。然而，这种效应并不是跨诊断的，而是双相情感障碍患者特有的。预测误差指数与症状严重程度无关。虽然研究结果是初步的，需要复制，他们建议，提高mPFC谷氨酰胺/谷氨酸值得进一步考虑作为未来（低）躁狂症的预测。重要的是，这项工作突出了RDoC方法的价值，该方法与传统诊断框架协同工作，而不是独立于传统诊断框架。
The National Institute of Mental Health Research Domain Criteria (RDoC) initiative aims to establish a neurobiologically valid framework for classifying mental illness. Here, we examined whether the RDoC construct of Reward Learning and three aspects of its underlying neurocircuitry predicted symptom trajectories in individuals with mood pathology. Aligning with the RDoC approach, we recruited individuals [n=80 with mood disorders (58 unipolar, 22 bipolar) and n=32 controls; 63.4% female] based on their performance on a laboratory-based reward learning task, rather than clinical diagnosis. We then assessed (1) anterior cingulate cortex prediction errors using electroencephalography, (2) striatal reward prediction errors using functional magnetic resonance imaging, and (3) medial prefrontal cortex glutamatergic function (mPFC Gln/Glu) using 1H magnetic resonance spectroscopy. Severity of anhedonia, (hypo)mania and impulsivity were measured at baseline, 3 months and 6 months. Greater homogeneity in aspects of brain function (mPFC Gln/Glu) was observed when individuals were classified according to reward learning ability rather than diagnosis. Furthermore, mPFC Gln/Glu levels predicted more severe (hypo)manic symptoms cross-sectionally, worsening (hypo)manic symptoms longitudinally, and explained greater variance in future (hypo)manic symptoms than diagnostic information. However, rather than being transdiagnostic, this effect was specific to individuals with bipolar disorder. Prediction error indices were unrelated to symptom severity. Although findings are preliminary and require replication, they suggest that heightened mPFC Gln/Glu warrants further consideration as a predictor of future (hypo)mania. Importantly, this work highlights the value of an RDoC approach that works in tandem with, rather than independent of, traditional diagnostic frameworks.
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