Abnormalities of dorsolateral prefrontal function in women with premenstrual dysphoric disorder: a multimodal neuroimaging study.
Abnormalities of dorsolateral prefrontal function in women with premenstrual dysphoric disorder: a multimodal neuroimaging study.
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DOI：
10.1176/appi.ajp.2012.12030385
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发表时间：
2013-03
期刊：
影响因子：
--
通讯作者：
Berman KF
中科院分区：
文献类型：
--
作者：
Baller EB;Wei SM;Kohn PD;Rubinow DR;Alarcón G;Schmidt PJ;Berman KF
为了研究经前不安症（PMDD）的神经基质，作者在工作记忆期间使用[15O]H2O正电子发射断层扫描（PET）区域脑血流量（rCBF）和血氧水平依赖（BOLD）功能MRI （fMRI）信号测量，并结合6个月的激素操作方案。在三种激素条件下（促性腺激素释放激素激动剂醋酸leuprolide、leuprolide +雌二醇、leuprolide +黄体酮诱导卵巢抑制），完成n-back任务时，对前瞻性确诊PMDD的女性和无症状对照者进行PET和fMRI扫描。15名患者和15名匹配的对照组接受了PET成像。14名患者和14名对照组接受了功能磁共振成像检查。在每一种激素条件下，rCBF用[15O]H2O PET测量，BOLD信号用fMRI测量，两者都是在n-back工作记忆范式下进行的。在激素操作前获得每位患者的总体功能评估量表（GAF）评分和临床特征，并在治疗前和治疗过程中测量症状。在PET和fMRI研究中，诊断的主要影响被观察到，PMDD患者比对照组表现出更大的前额叶激活。在患者组中，背外侧前额叶皮层激活异常增加的程度与疾病的几个方面相关：GAF评分显示的残疾、症状出现时的年龄、经前不悦症持续时间以及经前不悦症前后症状的差异。经前抑郁症的异常工作记忆激活，特别是在背外侧前额叶皮层，与经前抑郁症的严重程度、症状、发病年龄和疾病负担有关。这些结果支持了研究结果的临床相关性，以及背外侧前额皮质功能障碍是经前不悦症风险的基础。功能磁共振成像和PET数据的一致性证明了结果的神经生物学有效性。
To investigate the neural substrate of premenstrual dysphoric disorder (PMDD), the authors used [15O]H2O positron emission tomography (PET) regional cerebral blood flow (rCBF) and blood-oxygen-level-dependent (BOLD) functional MRI (fMRI) signal measurements during working memory in conjunction with a 6-month hormone manipulation protocol. PET and fMRI scans were obtained from women with prospectively confirmed PMDD and asymptomatic comparison subjects while they completed the n-back task during three hormone conditions: ovarian suppression induced by the gonadotropin-releasing hormone agonist leuprolide acetate, leuprolide plus estradiol, and leuprolide plus progesterone. Fifteen patients and 15 matched comparison subjects underwent PET imaging. Fourteen patients and 14 comparison subjects underwent fMRI. For each hormone condition, rCBF was measured with [15O]H2O PET, and BOLD signal was measured with fMRI, both during an n-back working memory paradigm. Global Assessment of Functioning Scale (GAF) scores and clinical characteristics were obtained for each patient before hormone manipulation, and symptoms were measured before and during the protocol. In both the PET and fMRI studies, a main effect of diagnosis was observed, with PMDD patients showing greater prefrontal activation than comparison subjects. In the patient group, the degree to which dorsolateral prefrontal cortex activation was abnormally increased correlated with several dimensions of disease: disability as indicated by GAF scores, age at symptom onset, duration of PMDD, and differences in pre- and postmenses PMDD symptoms. Abnormal working memory activation in PMDD, specifically in the dorsolateral prefrontal cortex, is related to PMDD severity, symptoms, age at onset, and disease burden. These results support the clinical relevance of the findings and the proposal that dorsolateral prefrontal cortex dysfunction represents a substrate of risk for PMDD. The concordance of the fMRI and PET data attests to the neurobiological validity of the results.
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影响因子：
1.9
作者：
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通讯作者：
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