A preliminary functional magnetic resonance imaging study of prefrontal-amygdalar activation changes in adolescents with bipolar depression treated with lamotrigine
A preliminary functional magnetic resonance imaging study of prefrontal-amygdalar activation changes in adolescents with bipolar depression treated with lamotrigine
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DOI：
10.1111/j.1399-5618.2007.00576.x
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发表时间：
2008-05-01
影响因子：
5.4
通讯作者：
Reiss, Allan
中科院分区：
文献类型：
--
作者：
Chang, Kiki D.;Wagner, Christopher;Reiss, Allan
目的：关于双相情感障碍（BD）情绪失调的假设集中在情绪发作期间边缘系统过度活跃而前额叶相对活动不足。因此，我们假设用拉莫三嗪成功治疗的双相抑郁青少年会表现出杏仁核激活的减少和前额叶激活的增加。方法：八名双相情感障碍青少年在基线和拉莫三嗪治疗八周后接受了功能磁共振成像（fMRI）。在扫描过程中呈现出一些消极和中性的情感图片，受试者被要求评价每张图片给他们带来的感受。双侧杏仁核和背外侧前额叶皮质 (DLPFC) 对负负中性图片的激活与儿童抑郁评定量表 (CDRS) 评分相关。结果：平均 (SD) CDRS 评分显着下降，从基线时的 53.0 (10.6) 降至第 8 周的 26.3 (5.3)。这种临床改善与右杏仁核激活减少相关 (r = 0.91, p = 0.002）。在第 8 周，而非基线时，CDRS 评分与双侧杏仁核激活呈正相关（r = 0.85，p = 0.007）。 DLPFC 激活与 CDRS 评分的变化不相关。结论：这些初步结果表明，随着抑郁症状的改善，接受拉莫三嗪治疗的 BD 青少年在观看负面刺激时杏仁核激活较少。需要更大规模的对照研究来证实这些发现。
Objectives: Hypotheses regarding mood dysregulation in bipolar disorder (BD) have centered on limbic overactivity with relative prefrontal underactivity during mood episodes. Therefore, we hypothesized that adolescents with bipolar depression successfully treated with lamotrigine would show decreases in amygdalar activation, and increases in prefrontal activation.Methods: Eight adolescents with BD underwent functional magnetic resonance imaging (fMRI) at baseline and after eight weeks of lamotrigine treatment. Blocks of negatively and neutrally valenced emotional pictures were presented during scanning, and subjects were asked to rate how each picture made them feel. Activation in bilateral amygdalae and dorsolateral prefrontal cortices (DLPFC) for negative minus neutral pictures was correlated with Children's Depression Rating Scale (CDRS) scores.Results: Mean (SD) CDRS scores decreased significantly, from 53.0 (10.6) at baseline to 26.3 (5.3) at Week 8. This clinical improvement was correlated with decreased right amygdalar activation (r = 0.91, p = 0.002). At Week 8, but not baseline, CDRS score was positively correlated with bilateral amygdalar activation (r = 0.85, p = 0.007). DLPFC activation was not correlated with change in CDRS score.Conclusions: These preliminary results indicate that adolescents with BD treated with lamotrigine demonstrated less amygdalar activation when viewing negative stimuli as depressive symptoms improved. Larger controlled studies are needed to confirm these findings.