Changes in neuronal activation in patients with bipolar disorder during performance of a working memory task
Changes in neuronal activation in patients with bipolar disorder during performance of a working memory task
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DOI：
10.1111/j.1399-5618.2004.00117.x
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发表时间：
2004-12-01
影响因子：
5.4
通讯作者：
Strakowski, SM
中科院分区：
文献类型：
--
作者：
Adler, CM;Holland, SK;Strakowski, SM
目的：多项证据表明，双相情感障碍患者在欣快期持续存在认知缺陷。工作记忆障碍在双相抑郁患者中已被观察到，并被认为是精神障碍功能缺陷的一个重要来源。然而，与这些认知缺陷相关的功能变化仍然知之甚少。我们假设双相情感障碍患者会在构成工作记忆网络的特定区域表现出神经元激活的变化。方法：15名心境愉悦的双相情感障碍患者和15名年龄和性别匹配的健康对照被纳入研究。受试者参加了fMRI扫描，在此期间，两个背部工作记忆任务和零个背部控制/注意任务交替进行，使用区块设计范式。结果：双相情感障碍患者在认知任务中的表现比健康对照组更差(F=3.77，p=0.04)。在任务表现和反应时间相同的情况下，双相患者在额叶-极地前额叶皮质、颞叶皮质、基底节、丘脑和后顶叶皮质等几个区域表现出显著高于健康受试者的激活。与健康对照组相比，双相情感障碍患者各脑区的激活程度无明显差异。结论：双相情感障碍患者的工作记忆成绩下降反映了特定的神经功能缺陷。这些缺陷可能代表了神经病理的主要领域，也可能是工作记忆网络中其他神经病理的次要领域。利用其他成像方式进行的持续研究可能会进一步阐明这些认知缺陷涉及的潜在神经病理。
Objectives: Several lines of evidence suggest that deficits in cognition persist in bipolar patients during periods of euthymia. Working memory impairment has been observed in euthymic bipolar patients and noted to be a significant source of functional deficits in psychiatric disorders. Functional changes associated with these cognitive deficits however, remain poorly understood. We hypothesized that patients with bipolar disorder would demonstrate changes in neuronal activation in specific regions forming part of the working memory network.Methods: Fifteen euthymic bipolar patients and fifteen age- and gender-matched healthy controls were recruited. Subjects participated in fMRI scans during which a two-back working memory task alternated with a zero-back control/attention task using a block-design paradigm. Groups were analyzed separately, and intergroup comparisons were made using an exploratory, voxel-by-voxel analysis.Results: Bipolar patients performed more poorly on the cognitive tasks than did healthy controls (F = 3.77, p = 0.04). After covarying for task performance and reaction time, bipolar patients demonstrated significantly greater activation than healthy subjects in several regions including the fronto-polar prefrontal cortex, temporal cortex, basal ganglia, thalamus, and posterior parietal cortex. No areas showed a significant decrease in activation, compared with healthy controls.Conclusions: Our findings suggest that decreased working memory performance in bipolar patients reflects specific neurofunctional deficits. These deficits may represent primary areas of neuropathology or be secondary to neuropathology elsewhere in the working memory network. Continued research utilizing other imaging modalities may further clarify the underlying neuropathology involved in these cognitive deficits.