Differential neurometabolite alterations in brains of medication-free individuals with bipolar disorder and those with unipolar depression: a two-dimensional proton magnetic resonance spectroscopy study
Differential neurometabolite alterations in brains of medication-free individuals with bipolar disorder and those with unipolar depression: a two-dimensional proton magnetic resonance spectroscopy study
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DOI：
10.1111/bdi.12445
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发表时间：
2016-11-01
影响因子：
5.4
通讯作者：
Wu, Renhua
中科院分区：
文献类型：
--
作者：
Li, Hui;Xu, Haiyun;Wu, Renhua
目的：双相情感障碍（BD）是一种以情绪升高和抑郁为特征的精神障碍。许多BD患者最初被误诊为单相抑郁症（UD）。在这项研究中，我们报告的直接比较无药物的个人与BD和UD的前扣带皮层（ACC），内侧前额叶皮层（mPFC），顶叶皮层（PC），后扣带皮层（PCC）的brain.Methods：参与者包括无药物的BD或UD患者，和匹配的健康对照。所有患者均处于抑郁状态，症状相似。所有受试者均使用3.0 T GE Signa MR扫描仪进行多体素质子磁共振波谱检查。后处理后，甘油磷酸胆碱+磷酸胆碱的绝对浓度（GPC + PC），磷酸肌酸+肌酸（PCr + Cr），Glx比较三组大鼠上述脑区的谷氨酸+谷氨酰胺、肌醇（MI）和N-乙酰天冬氨酸（NAA）。与正常对照组相比，BD患者ACC中Glx水平显著升高，PC中GPC + PC、PCr + Cr、MI和NAA水平显著降低，mPFC中NAA水平显著降低; UD患者PCC的GPC + PC、PCr + Cr和NAA水平显著降低，mPFC的Glx水平显著降低。所有分析的脑代谢产物，除Glx，均显着降低，而GPC + PC，PCr + Cr，NAA水平显着降低，在PCC的患者UD。结论：这些结果增加了证据的大脑代谢产物的差异，在大脑中的患者UD和BD，这可能有助于区分这两种情绪障碍。
Objectives: Bipolar disorder (BD) is a mental disorder characterized by periods of elevated mood and depression. Many individuals with BD are initially misdiagnosed and treated for unipolar depression (UD). In this study, we report direct comparisons between medication-free individuals with BD and those with UD in terms of the neurometabolites in the anterior cingulate cortex (ACC), medial prefrontal cortex (mPFC), parietal cortex (PC), and posterior cingulate cortex (PCC) of the brain.Methods: Participants included medication-free patients with BD or UD, and matched healthy controls. All patients were in the depressive state and had similar symptoms. All subjects were subjected to a multi-voxel proton magnetic resonance spectroscopy procedure with a 3.0 T GE Signa MR scanner. After post-processing, the absolute concentrations of glycerophosphocholine + phosphocholine (GPC + PC), phosphocreatine + creatine (PCr + Cr), Glx (glutamate + glutamine), myo-inositol (MI), and N-acetyl aspartate (NAA) from the above brain regions were compared across the three groups.Results: Patients with BD showed significantly higher levels of Glx in their ACC, lower GPC + PC, PCr + Cr, MI, and NAA in their PC, and lower NAA in their mPFC, compared to healthy controls; patients with UD presented significantly lower levels of GPC + PC, PCr + Cr, and NAA in their PCC, and lower Glx in their mPFC. All analyzed brain metabolites, except Glx, were significantly lower in the PC of patients with BD, whereas levels of GPC + PC, PCr + Cr, and NAA were significantly reduced in the PCC of patients with UD.Conclusions: These results add to the evidence of brain metabolite differences in brains of patients with UD and BD which may be of help in differentiating these two mood disorders.