Insula and amygdala resting-state functional connectivity differentiate bipolar from unipolar depression.
Insula and amygdala resting-state functional connectivity differentiate bipolar from unipolar depression.
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DOI：
10.1111/acps.12724
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发表时间：
2017-07
影响因子：
6.7
通讯作者：
Salas R
中科院分区：
文献类型：
--
作者：
Ambrosi E;Arciniegas DB;Madan A;Curtis KN;Patriquin MA;Jorge RE;Spalletta G;Fowler JC;Frueh BC;Salas R
区分抑郁发作由于双相情感障碍（BD）或重度抑郁症（MDD）仅在临床上的理由是具有挑战性的。我们的目的是比较静息状态功能连接（rsFC）的区域subserving类似抑郁症BD和MDD的情绪调节。我们招募了76名住院患者（BD，n=36; MDD，n=40）和健康对照组（HC，n=40）。使用基于种子的方法来鉴定与杏仁核和杏仁核显示不同rsFC的区域。然后进行岛状和杏仁核包裹术，沿着主要发现的诊断准确性。与MDD和HC相比，BD患者左额前叶和左中背外侧前额叶皮质之间以及双侧额前叶和右额极前额叶皮质（FPPFC）之间的rsFC较低。这些结果是由背侧前和后肌（PI）驱动的。与BD和HC相比，在MDD中观察到右杏仁核和左前海马之间的rsFC较低。这些结果是由中央内侧和外侧基底杏仁核驱动的。左PI/右FPPC rsFC显示区分BD和MDD的准确性为78%。杏仁核和岛叶rsFC区分抑郁性BD和MDD。观察到的差异表明，在双相和单相抑郁症的情绪功能障碍的病理生理机制的差异的可能性。
Distinguishing depressive episodes due to bipolar disorder (BD) or major depressive disorder (MDD) solely on clinical grounds is challenging. We aimed at comparing resting-state functional connectivity (rsFC) of regions subserving emotional regulation in similarly depressed BD and MDD. We enrolled 76 inpatients (BD, n=36; MDD, n=40), and healthy controls (HC, n=40). A seed-based approach was used to identify regions showing different rsFC with the insula and the amygdala. Insular and amygdalar parcellations were then performed along with diagnostic accuracy of the main findings. Lower rsFC between the left insula and the left mid-dorsolateral prefrontal cortex and between bilateral insula and right frontopolar prefrontal cortex (FPPFC) were observed in BD compared to MDD and HC. These results were driven by the dorsal anterior and posterior insula (PI). Lower rsFC between the right amygdala and the left anterior hippocampus was observed in MDD compared to BD and HC. These results were driven by the centromedial and laterobasal amygdala. Left PI/right FPPC rsFC showed 78% accuracy differentiating BD and MDD. Amygdalar and insular rsFC distinguished between depressed BD and MDD. The observed differences suggest the possibility of differential pathophysiological mechanisms of emotional dysfunction in bipolar and unipolar depression.