Clinical, cortical thickness and neural activity predictors of future affective lability in youth at risk for bipolar disorder: initial discovery and independent sample replication
Clinical, cortical thickness and neural activity predictors of future affective lability in youth at risk for bipolar disorder: initial discovery and independent sample replication
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DOI：
10.1038/s41380-018-0273-4
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发表时间：
2019-12-01
影响因子：
11
通讯作者：
Phillips, Mary L.
中科院分区：
文献类型：
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作者：
Bertocci, Michele A.;Hanford, Lindsay;Phillips, Mary L.
我们旨在从匹兹堡双相情感障碍后代研究（BIOS） （n = 41，年龄= 14,SD = 2.30）中确定双相情感障碍风险青年的未来情感不稳定标志物，并在躁狂症状纵向评估研究（rams） （n = 55，年龄= 13.7,SD = 1.9）的独立样本中验证这些预测因子。我们在正则化回归模型中纳入了混合/躁狂、易怒和焦虑/抑郁因素（MRI扫描后29个月）。临床和人口统计学变量，以及奖励和情绪处理过程中的神经活动，以及基线时所有皮质区域的灰质结构，使用正则化回归来预测未来的情感不稳定因素得分。通过基线神经结构、功能和临床特征的独特组合来预测两个样本的未来情感不稳定因子得分。更低的双侧顶叶皮质厚度，更大的左腹外侧前额叶皮质厚度，更低的右下横向颞叶皮质厚度，更大的自我报告抑郁，躁狂严重程度和扫描时的年龄预测了更高的未来混合/躁狂因素评分。较低的双侧顶叶皮质厚度、较大的右内嗅皮质厚度、情绪面部加工过程中较大的右梭状回活动、重度抑郁症的诊断和较大的自我报告抑郁严重程度预示着较高的烦躁因素得分。自我报告的抑郁严重程度越高，焦虑/抑郁因素得分越高。阐明未来特异性情感不稳定因素的独特临床和神经预测因子是确定双相情感障碍风险客观标记的一步，为更好地指导和监测双相情感障碍高危青年的早期干预提供神经靶点。
We aimed to identify markers of future affective lability in youth at bipolar disorder risk from the Pittsburgh Bipolar Offspring Study (BIOS) (n = 41, age = 14, SD = 2.30), and validate these predictors in an independent sample from the Longitudinal Assessment of Manic Symptoms study (LAMS) (n = 55, age = 13.7, SD = 1.9). We included factors of mixed/mania, irritability, and anxiety/depression (29 months post MRI scan) in regularized regression models. Clinical and demographic variables, along with neural activity during reward and emotion processing and gray matter structure in all cortical regions at baseline, were used to predict future affective lability factor scores, using regularized regression. Future affective lability factor scores were predicted in both samples by unique combinations of baseline neural structure, function, and clinical characteristics. Lower bilateral parietal cortical thickness, greater left ventrolateral prefrontal cortex thickness, lower right transverse temporal cortex thickness, greater self-reported depression, mania severity, and age at scan predicted greater future mixed/mania factor score. Lower bilateral parietal cortical thickness, greater right entorhinal cortical thickness, greater right fusiform gyral activity during emotional face processing, diagnosis of major depressive disorder, and greater self-reported depression severity predicted greater irritability factor score. Greater self-reported depression severity predicted greater anxiety/depression factor score. Elucidating unique clinical and neural predictors of future-specific affective lability factors is a step toward identifying objective markers of bipolar disorder risk, to provide neural targets to better guide and monitor early interventions in bipolar disorder at-risk youth.