Intrinsic Amygdala Functional Connectivity in Youth With Bipolar I Disorder.
Intrinsic Amygdala Functional Connectivity in Youth With Bipolar I Disorder.
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DOI：
10.1016/j.jaac.2015.06.016
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发表时间：
2015-09
影响因子：
13.3
通讯作者：
Gotlib IH
中科院分区：
文献类型：
--
作者：
Singh MK;Kelley RG;Chang KD;Gotlib IH
双相情感障碍（BD）通常在青春期开始，并可能持续到成年。对成人BD患者的研究表明，杏仁核神经回路的中断解释了该疾病的病理生理学基础。然而，重要的是，杏仁核次区域网络尚未在接近躁狂发作的青年中进行检查。本研究的目的是比较静息状态下的功能连接模式在杏仁核亚区的青年与双极-I（BP-1）的模式在健康对照。在静息状态下评估杏仁核的中央内侧、外侧基底和浅表分区，并检查与仅经历过一次躁狂发作的BP-I青年（14至20岁）（n=20，“BD”）和年龄匹配的健康对照青年（n=23，“HC”）的躁狂临床测量的关系。相对于HC青年，青年与BD表现出杏仁核和海马和中央前回的laterobasal细分之间的连接性降低，laterobasal细分和楔前叶之间的连接性增加。右侧基底杏仁核和右侧海马体之间的连接与BD的焦虑水平呈正相关，但在HC青年中则不然，右侧基底杏仁核和右侧楔前叶之间的连接与双相情感障碍的洞察力呈负相关。患有BD的青少年有异常的杏仁核静息状态网络连接到对情绪处理和自我意识至关重要的区域。需要进行纵向研究，以确定这些异常的模式在青少年与BD是否可以改变干预和影响的过程中的障碍。
Bipolar disorder (BD) commonly begins during adolescence and may continue into adulthood. Studies in adults with BD suggest that disruptions in amygdalar neural circuitry explain the pathophysiology underlying the disorder. Importantly, however, amygdala subregion networks have not yet been examined in youth close to mania onset. The goal of this study was to compare resting state functional connectivity patterns in amygdala subregions in youth with bipolar-I (BP-1) disorder with patterns in healthy controls. Centromedial, laterobasal, and superficial amygdala subdivisions were assessed during rest and examined in relation to clinical measures of mania in youth (14 to 20 years old) with BP-I who experienced only a single episode of mania (n=20, “BD”) and age-matched healthy comparison youth without any personal or family history of DSM-IV Axis I disorders (n=23, “HC”). Relative to HC youth, youth with BD exhibited decreased connectivity between the laterobasal subdivision of the amygdala and the hippocampus and precentral gyrus, and increased connectivity between the laterobasal subdivision and the precuneus. Connectivity between the right laterobasal amygdala and right hippocampus was positively correlated with levels of anxiety in BD but not in HC youth, and connectivity between the right laterobasal amygdala and right precuneus was negatively correlated with insight about bipolar illness. Youth with BD have abnormal amygdala resting state network connections to regions that are critical for emotional processing and self-awareness. Longitudinal studies are needed to determine whether these aberrant patterns in youth with BD can be altered with intervention and influence the course of disorder.