Neural changes in youth at high risk for bipolar disorder undergoing family-focused therapy or psychoeducation.
Neural changes in youth at high risk for bipolar disorder undergoing family-focused therapy or psychoeducation.
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接受以家庭为中心的治疗或心理教育的双相情感障碍高风险青年的神经变化。
DOI：
10.1111/bdi.13045
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发表时间：
2021-09
影响因子：
5.4
通讯作者：
Miklowitz DJ
中科院分区：
文献类型：
--
作者：
Garrett AS;Chang KD;Singh MK;Armstrong CC;Walshaw PD;Miklowitz DJ
情绪障碍患者可能通过情绪处理相关脑网络的变化从心理社会干预中获益。在这项研究中，我们使用功能性磁共振成像（fMRI）来研究双相情感障碍（BD）家族高危青少年情绪处理网络中与治疗相关的变化。
9 - 17岁的青少年被随机分配接受针对高危青少年的以家庭为中心的治疗（FFT - HR）或一种积极的对照治疗，即强化护理（EC）。在这4个月的治疗前后，参与者在观看快乐、恐惧和平静的面部表情时接受fMRI检查。FFT - HR组的20名青少年和EC组的20名青少年被纳入全脑激活治疗前后变化的分析。对显著的脑区簇进行评估，以确定其与情绪症状改善的相关性。
在背外侧前额叶皮层（DLPFC），FFT - HR组从治疗前到治疗后激活增加，而EC组则减少。FFT - HR组的脑岛激活减少，EC组则没有变化。在两种治疗中，海马体和杏仁核激活的降低与轻躁狂从治疗前到治疗后的改善相关，而DLPFC激活的增加与抑郁症从治疗前到治疗后的改善相关。
心理社会治疗解决了双相情感障碍高危青少年情绪调节网络的异常。前额叶皮层激活增加表明FFT - HR治疗从治疗前到治疗后情绪调节增强。家庭互动的改善可能促进前额叶资源的发展，从而为预防未来的情绪发作提供保护。
Patients with mood disorders may benefit from psychosocial interventions through changes in brain networks underlying emotion processing. In this study, we used functional magnetic resonance imaging (fMRI) to investigate treatment-related changes in emotion processing networks in youth at familial high risk for bipolar disorder (BD). Youth, ages 9–17, were randomly assigned to family-focused therapy for high-risk youth (FFT-HR) or an active comparison treatment, Enhanced Care (EC). Before and after these 4-month treatments, participants underwent fMRI while viewing happy, fearful, and calm facial expressions. Twenty youth in FFT-HR and 20 in EC were included in analyses of pre- to post-treatment changes in activation across the whole brain. Significant clusters were assessed for correlation with mood symptom improvement. In the dorsolateral prefrontal cortex (DLPFC), activation increased from pre- to post-treatment in the FFT-HR group and decreased in the EC group. Insula activation decreased in the FFT-HR group and did not change in the EC group. Across both treatments, decreasing activation in the hippocampus and amygdala was correlated with pre- to post-treatment improvement in hypomania, while increasing activation in the DLPFC was correlated with pre- to post-treatment improvement in depression. Psychosocial treatment addresses abnormalities in emotion regulation networks in youth at high risk for BD. Increased prefrontal cortex activation suggests enhanced emotion regulation from pre- to post-treatment with FFT-HR. Improvements in family interactions may facilitate the development of prefrontal resources that provide protection against future mood episodes.
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影响因子：
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作者：
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通讯作者：
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DOI：
10.1111/j.1469-7610.2010.02210.x
发表时间：
2010-04-01
影响因子：
7.6
作者：
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通讯作者：
Navsaria, Neha