Microstructural Alterations in Bipolar and Major Depressive Disorders: A Diffusion Kurtosis Imaging Study
Microstructural Alterations in Bipolar and Major Depressive Disorders: A Diffusion Kurtosis Imaging Study
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DOI：
10.1002/jmri.27174
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发表时间：
2020-04-23
影响因子：
4.4
通讯作者：
Tha, Khin K.
中科院分区：
文献类型：
--
作者：
Sawamura, Daisuke;Narita, Hisashi;Tha, Khin K.
背景识别双相情感障碍（BD）和重度抑郁障碍（MDD）的结构和功能异常对于理解生物学过程是重要的。假设弥散峰度成像（DKI）能够检测BD和MDD的脑微结构改变以及两者之间的任何差异。研究类型前瞻性。受试者共16例BD患者，19例MDD患者，3.0T场强/序列DKI检测方法：对3组患者的脑DKI主要指标进行逐体素比较。检验了显著不同的体素与临床变量的相关性（即，杨氏躁狂评定量表[YMRS]、17项汉密尔顿抑郁评定量表[17-HDRS]、蒙哥马利-埃格斯特朗斯伯格抑郁评定量表、总疾病持续时间、当前发作持续时间和既往躁狂/抑郁发作次数）。DKI指数在识别微结构改变方面的性能被估计。统计检验单因素方差分析（ANOVA）用于DKI指数的组间比较。通过受试者工作特征（ROC）分析确定这些指标在检测微结构改变方面的性能。结果DKI检查显示各疾病患者脑内微结构均有广泛的改变（P < 0.05）。有些是显着不同的两种疾病。平均峰度（MK）在右侧下顶叶灰质能够区分BD和MDD的准确性为0.906。BD组MK与YMRS（r =-0.641，P = 0.042）、MDD组MK与17-HDRS（r =-0.613，P = 0.030）相关性较强。其他DKI指标与病程也有较强的相关性（r = -0.676或0.626，P < 0.05）。其指标可能有助于区分这两种疾病或反映疾病的严重程度和持续时间。证据等级2技术疗效阶段3
Background Identifying structural and functional abnormalities in bipolar (BD) and major depressive disorders (MDD) is important for understanding biological processes.Hypothesis Diffusion kurtosis imaging (DKI) may be able to detect the brain's microstructural alterations in BD and MDD and any differences between the two.Study Type Prospective.Subjects In all, 16 BD patients, 19 MDD patients, and 20 age- and gender-matched healthy volunteers.Field Strength/Sequence DKI at 3.0T.Assessment The major DKI indices of the brain were compared voxel-by-voxel among the three groups. Significantly different voxels were tested for correlation with clinical variables (ie, Young Mania Rating Scale [YMRS], 17-item Hamilton Depression Rating Scale [17-HDRS], Montgomery-angstrom sberg Depression Rating Scale, total disease duration, duration of current episode, and the number of past manic/depressive episodes). The performance of the DKI indices in identifying microstructural alterations was estimated.Statistical Tests One-way analysis of variance (ANOVA) was used for group comparison of DKI indices. The performance of these indices in detecting microstructural alterations was determined by receiver operating characteristic (ROC) analysis. Pearson's product-moment correlation analyses were used to test the correlations of these indices with clinical variables.Results DKI revealed widespread microstructural alterations across the brain in each disorder (P < 0.05). Some were significantly different between the two disorders. Mean kurtosis (MK) in the gray matter of the right inferior parietal lobe was able to distinguish BD and MDD with an accuracy of 0.906. A strong correlation was revealed between MK in that region and YMRS in BD patients (r = -0.641, corrected P = 0.042) or 17-HDRS in MDD patients (r = -0.613, corrected P = 0.030). There were also strong correlations between a few other DKI indices and disease duration (r = -0.676 or 0.626, corrected P < 0.05).Data Conclusion DKI detected microstructural brain alterations in BD and MDD. Its indices may be useful to distinguish the two disorders or to reflect disease severity and duration.Level of Evidence 2Technical Efficacy Stage 3