Abnormal amygdala-prefrontal effective connectivity to happy faces differentiates bipolar from major depression.
Abnormal amygdala-prefrontal effective connectivity to happy faces differentiates bipolar from major depression.
复制标题
DOI：
10.1016/j.biopsych.2009.03.024
复制
发表时间：
2009-09-01
影响因子：
10.6
通讯作者：
Phillips, Mary Louise
中科院分区：
文献类型：
--
作者：
Cardoso de Almeida, Jorge Renner;Versace, Amelia;Mechelli, Andrea;Hassel, Stefanie;Quevedo, Karina;Kupfer, David Jerome;Phillips, Mary Louise
关键词：
双相情感障碍经常被误诊为严重的抑郁障碍，延误了适当的治疗，并使许多双相情感障碍患者的预后恶化。情绪失调是双相情感障碍的一个核心特征。因此，支持情绪调节的神经系统功能障碍的测量可能有助于区分双相情感障碍和重度抑郁障碍。31名抑郁个体，15名双相抑郁(BD)和16名重度抑郁(MDD)，按照DSM-IV诊断标准，年龄18-55岁，年龄、发病年龄、病程、抑郁严重程度匹配，16名年龄和性别匹配的健康对照组(HC)进行了两种事件相关范式：分别标记快乐和悲伤面孔的情绪强度。我们使用动态因果模型来检查支持情绪调节的右侧和左侧神经区域：杏仁核和眶内侧前额叶皮质(OMPFC)之间的有效连接(EC)组间的显著变化。在对快乐面孔进行分类的过程中，我们发现OMPFC和杏仁核在有效连接方面存在深刻且不对称的差异。左侧差异涉及自上而下的联系，并区分抑郁和对照受试者。此外，更大的药物负荷与这种自上而下的异常EC的改善有关。相反，右侧的异常是双相情感障碍特有的自下而上的EC。当我们只考虑女性受试者时，这些效应会重复出现。快乐标记时异常的左侧自上而下杏仁核和右侧自下而上杏仁核-OMPFC EC区分了BD和MDD，提示两种抑郁症的病理生理机制不同。
Bipolar disorder is frequently misdiagnosed as major depressive disorder delaying appropriate treatment and worsening outcome for many bipolar individuals. Emotion dysregulation is a core feature of bipolar disorder. Measures of dysfunction in neural systems supporting emotion regulation may therefore help discriminate bipolar from major depressive disorder. Thirty-one depressed individuals, 15 bipolar depressed (BD) and 16 major depressed (MDD), DSM-IV diagnostic criteria, aged 18–55 years, matched for age, age of illness onset, illness duration, depression severity, and 16 age- and gender-matched healthy controls (HC) performed two event-related paradigms: labeling the emotional intensity of happy and sad faces, respectively. We employed dynamic causal modeling to examine significant among-group alterations in effective connectivity (EC) between right-and left-sided neural regions supporting emotion regulation: amygdala and orbitomedial prefrontal cortex (OMPFC). During classification of happy faces, we found profound and asymmetrical differences in effective connectivity between the OMPFC and amygdala. Left-sided differences involved top-down connections and discriminated between depressed and control subjects. Furthermore, greater medication load was associated with an amelioration of this abnormal top-down EC. Conversely, on the right side the abnormality was in bottom-up EC that was specific to bipolar disorder. These effects replicated when we considered only female subjects. Abnormal left-sided top-down OMPFC-amygdala and right-sided bottom-up amygdala-OMPFC EC during happy labeling distinguish BD and MDD, suggesting different pathophysiological mechanisms associated with the two types of depression.
登录
查看更多内容
DOI：
10.1176/appi.neuropsych.19.3.274
发表时间：
2007-06-01
影响因子：
2.9
作者：
Anand, Amit;Li, Yu;Lowe, Mark J.
通讯作者：
Lowe, Mark J.
影响因子：
3.8
作者：
Bowden, CL
通讯作者：
Bowden, CL
影响因子：
10.6
作者：
Chen, CH;Lennox, B;Bullmore, ET
通讯作者：
Bullmore, ET
影响因子：
11
作者：
Houenou, J.;Wessa, M.;Paillere-Martinot, M-L
通讯作者：
Paillere-Martinot, M-L
影响因子：
10.6
作者：
Keedwell, PA;Andrew, C;Phillips, ML
通讯作者：
Phillips, ML