Brain perfusion during manic episode and at 6-month follow-up period in bipolar disorder patients: Correlation with cognitive functions
Brain perfusion during manic episode and at 6-month follow-up period in bipolar disorder patients: Correlation with cognitive functions
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DOI：
10.1002/brb3.1615
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发表时间：
2020-05-01
影响因子：
3.1
通讯作者：
Flores-Ramos, Monica
中科院分区：
文献类型：
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作者：
Estudillo-Guerra, Maria Anayali;Pacheco-Barrios, Kevin;Flores-Ramos, Monica
背景在双相情感障碍（BD）急性发作和精神状态中描述了脑灌注改变和认知功能障碍的模式。对狂躁状态和状态的认知功能与灌注之间关系的了解仍然有限。目的探讨躁狂症患者狂躁期及狂躁期后6个月脑灌注改变及其与认知功能障碍的关系。方法对10例成人I型BD中重度躁狂发作患者进行观察前瞻性研究。我们通过精神病学认知障碍筛查（SCIP-S）评估社会人口学数据和临床变量以及认知功能。最后，我们使用tc99m -乙基半胱氨酸二聚体进行脑灌注SPECT。结果狂躁发作时，患者表现为认知障碍，平均SCIP-S评分为63.8±17.16。这与右侧颞极相对再摄取指数（RRI）测量的灌注呈正相关（rho = 0.65 p = 0.0435），与右侧眶额皮质（rho = -0.70 p = 0.0077）和右侧亚属扣带皮质（rho = -0.70 p = 0.0256）负相关。青年躁狂症评定量表（YMRS）测量的发作严重程度与右颞极RRI呈正相关（rho = 0.75, p = 0.01）。在随访中，6例患者接受治疗且胸腺正常，我们发现双侧眶额皮质YMRS和RRI呈负相关（rho = -0.8827, p = 0.019）。他们在SCIP-S的认知表现没有显著改善，并且与SCIP-S的以下分量表呈负相关；处理速度与双侧背外侧前额叶、双侧内侧前额叶、左颞极皮质RRI有关，言语流畅性与双侧前扣带皮质RRI有关。结论认知功能障碍与基线及随访时脑灌注模式相关。需要大样本量、长时间随访的研究来描述双相障碍患者灌注和认知功能的变化。
Background Patterns of altered cerebral perfusion and cognitive dysfunction have been described in Bipolar Disorder (BD) acute episodes and euthymia. Knowledge of the relationship between cognitive function and perfusion in a manic state and status when followed up is still limited.Objective To describe brain perfusion alterations and its relationship with cognitive impairment in patients with BD during manic episodes and after 6 months.Methods Observational-prospective study in 10 type I BD adults during moderate-severe manic episodes. We assessed sociodemographic data and clinical variables as well as cognitive function through Screening for Cognitive Impairment in Psychiatry (SCIP-S). Finally, we performed a Brain Perfusion SPECT using a Tc99m-ethyl cysteine dimer.Results During manic episodes, patients showed cognitive impairment with a mean SCIP-S score of 63.8 +/- 17.16. This was positively correlated with perfusion measured as relative reuptake index (RRI) at the right temporal pole (rho = 0.65 p = .0435) and negatively correlated with right the orbitofrontal cortex (rho = -0.70 p = .0077) and the right subgenual cingulate cortex (rho = -0.70 p = .0256). Episode severity measured by the Young Mania Rating Scale (YMRS) positively correlated with RRI at the right temporal pole (rho = 0.75, p = .01). At follow-up, six patients were taking treatment and were euthymic, we found a negative correlation with the YMRS and RRI at the bilateral orbitofrontal cortex (rho = -0.8827, p = .019). They did not show significant improvement in cognitive performance at SCIP-S, and there was negative correlation with the following of the SCIP-S subscales; processing speed with the bilateral dorsolateral prefrontal, the bilateral medial prefrontal, the left temporal pole cortex RRI, and verbal fluency with the bilateral anterior cingulate cortex RRI.Conclusion Cognitive impairment was correlated with brain perfusion patterns at baseline and follow-up. Large sample size studies with longer follow-up are needed to describe the changes in perfusion and cognitive functions in BD.