Distinguishing between unipolar depression and bipolar depression: current and future clinical and neuroimaging perspectives.
Distinguishing between unipolar depression and bipolar depression: current and future clinical and neuroimaging perspectives.
复制标题
DOI：
10.1016/j.biopsych.2012.06.010
复制
发表时间：
2013-01-15
影响因子：
10.6
通讯作者：
Phillips, Mary Louise
中科院分区：
文献类型：
--
作者：
de Almeida, Jorge Renner Cardoso;Phillips, Mary Louise
关键词：
鉴别双相情感障碍（BD）和复发性单极抑郁症（UD）是一个主要的临床挑战。其主要原因包括在双相障碍病程中，抑郁的患病率相对于低/躁狂症状较高，双相障碍和轻度抑郁中阈下躁狂症状的患病率较高。确定双相障碍的客观标志物可能有助于提高区分双相障碍和UD抑郁症的准确性，最终优化所有抑郁症患者的临床和功能结果。然而，到目前为止，只有8项神经影像学研究直接比较了UD和BD抑郁症患者。这些研究结果表明，双相障碍患者的白质连通性异常和白质高信号比普通抑郁症患者更为普遍，双相障碍患者的缰核体积减少，而普通抑郁症患者的缰核体积减少，两种抑郁症患者的情绪调节和注意控制神经回路功能异常模式不同。这些发现提示双相障碍与抑郁障碍的病理生理过程不同，特别是在情绪调节、奖励和注意控制神经回路方面。因此，这篇综述作为一个“行动呼吁”，强调迫切需要更多的神经影像学研究，使用更大的样本量，比较双相障碍和轻度抑郁个体。这些未来的研究还应该包括维度方法，风险个体的研究，以及更新颖的神经成像方法，如连通性分析和机器学习。最终，这些方法可能会提供生物标志物来识别未来双相障碍与UD的风险个体，并为双相障碍和UD抑郁症的更个性化治疗和新治疗发展提供生物学靶点。
Differentiating bipolar disorder (BD) from recurrent unipolar depression (UD) is a major clinical challenge. Main reasons for this include the higher prevalence of depressive relative to hypo/manic symptoms during the course of BD illness and the high prevalence of subthreshold manic symptoms in both BD and UD depression. Identifying objective markers of BD might help improve accuracy in differentiating between BD and UD depression, to ultimately optimize clinical and functional outcome for all depressed individuals. Yet, only eight neuroimaging studies to date directly compared UD and BD depressed individuals. Findings from these studies suggest more widespread abnormalities in white matter connectivity and white matter hyperintensities in BD than UD depression, habenula volume reductions in BD but not UD depression, and differential patterns of functional abnormalities in emotion regulation and attentional control neural circuitry in the two depression types. These findings suggest different pathophysiologic processes, especially in emotion regulation, reward and attentional control neural circuitry in BD versus UD depression. This review thereby serves as a “call to action” to highlight the pressing need for more neuroimaging studies, using larger samples sizes, comparing BD and UD depressed individuals. These future studies should also include dimensional approaches, studies of at risk individuals, and more novel neuroimaging approaches, such as, connectivity analysis and machine learning. Ultimately, these approaches might provide biomarkers to identify individuals at future risk for BD versus UD, and biological targets for more personalized treatment and new treatment developments for BD and UD depression.
登录
查看更多内容
DOI：
10.1080/09540260902962198
发表时间：
2009
期刊：
International review of psychiatry (Abingdon, England)
影响因子：
--
作者：
Beyer JL;Young R;Kuchibhatla M;Krishnan KR
通讯作者：
Krishnan KR
影响因子：
6.6
作者：
Cassano, G. B.;Mula, M.;Fagiolini, A.
通讯作者：
Fagiolini, A.
影响因子：
10.6
作者：
Cardoso de Almeida, Jorge Renner;Versace, Amelia;Mechelli, Andrea;Hassel, Stefanie;Quevedo, Karina;Kupfer, David Jerome;Phillips, Mary Louise
通讯作者：
Phillips, Mary Louise
影响因子：
10.6
作者：
Almeida, Jorge R. C.;Versace, Amelia;Hassel, Stefanie;Kupfer, David J.;Phillips, Mary L.
通讯作者：
Phillips, Mary L.
DOI：
10.1176/appi.ajp.2010.09071011
发表时间：
2010-10
期刊：
The American journal of psychiatry
影响因子：
--
作者：
Angst J;Cui L;Swendsen J;Rothen S;Cravchik A;Kessler RC;Merikangas KR
通讯作者：
Merikangas KR