Reduced activation to implicit affect induction in euthymic bipolar patients: An fMRI study
Reduced activation to implicit affect induction in euthymic bipolar patients: An fMRI study
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DOI：
10.1016/j.jad.2006.06.005
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发表时间：
2007-01-01
影响因子：
6.6
通讯作者：
Sachdev, Perminder
中科院分区：
文献类型：
--
作者：
Malhi, Gin S.;Lagopoulos, Jim;Sachdev, Perminder
目的：研究双相情感障碍患者在内隐情绪诱发时是否与健康受试者有相似或不同的脑区。方法：采用事件相关功能磁共振成像(FMRI)技术，对10例双相情感障碍患者和10例年龄性别匹配的健康受试者进行了基于词的记忆任务的研究，这些受试者被试内隐地唤起消极、积极或无情感变化。激活范式包括使用特定的反应键提名目标词是否包含在先前呈现的词列表中。结果：与患者相比，健康受试者在前扣带回和后扣带回、额叶内侧前额叶皮质、额叶中部和右侧副海马回的消极和积极影响下，fMRI任务产生了显著更大的激活。只有负性情绪在中央后回、顶下小叶、丘脑和壳核有显著的激活作用，只有正性情绪在中央前回、颞上回、楔前回、楔状回、尾状回、桥脑、中脑和小脑有明显的激活作用。与健康受试者相比，患者没有大脑区域的反应更大。两组之间在速度和准确性方面没有统计学上的显著差异。结论：与健康受试者相比，心境双相患者的前额叶、扣带、边缘和皮质下神经活动减少，提示情绪妥协是独立于认知和执行功能的。这一发现具有重要的临床意义，并对双相情感障碍的诊断和治疗具有重要意义。未来的研究应该旨在复制这些发现，并检查双相情感障碍的发展，特别是调查药物的影响。(C)2006爱思唯尔B.V.保留所有权利。
Objective: To examine whether euthymic bipolar patients engage similar or contrasting brain regions as healthy subjects when responding to implicit affect induction.Methods: The study examined 10 euthymic patients with bipolar I disorder, and 10 age- and gender-matched healthy subjects using event-related functional magnetic resonance imaging (fMRI) while subjects engaged in a modified word-based memory task designed to implicitly evoke negative, positive or no affective change. The activation paradigm involved nominating whether a target word was contained within a previously presented word list using specified response keys.Results: The fMRI task produced significantly greater activation in healthy subjects as compared to patients in response to both negative and positive affect in the anterior and posterior cingulate, medial prefrontal cortex, middle frontal and right parahippocampal gyri. Only negative affect produced significantly greater activation in the postcentral gyrus, inferior parietal lobule, thalamus and putamen and only positive affect achieved the same in the precentral, superior temporal and lingual gyri, precuneus, cuneus, caudate, pons, midbrain and cerebellum. There were no brain regions in which responses were greater in patients as compared to healthy subjects. There were no statistically significant differences between the groups with respect to speed or accuracy.Conclusions: Diminished prefrontal, cingulate, limbic and subcortical neural activity in euthymic bipolar patients as compared to healthy subjects is suggestive of emotional compromise that is independent of cognitive and executive functioning. This finding is of clinical importance and has implications both for the diagnosis and treatment of bipolar disorder. Future studies should aim to replicate these findings and examine the development of bipolar disorder, investigating in particular the effects of medication. (c) 2006 Elsevier B.V. All rights reserved.