Distinguishing bipolar and major depressive disorders by brain structural morphometry: a pilot study.
Distinguishing bipolar and major depressive disorders by brain structural morphometry: a pilot study.
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通过大脑结构形态计量学区分双极性和主要抑郁症：一项试点研究。
DOI：
10.1186/s12888-015-0685-5
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发表时间：
2015-11-21
期刊：
影响因子：
4.4
通讯作者：
Chan RC
中科院分区：
文献类型：
--
作者：
Fung G;Deng Y;Zhao Q;Li Z;Qu M;Li K;Zeng YW;Jin Z;Ma YT;Yu X;Wang ZR;Shum DH;Chan RC
双相情感障碍（BD）和重度抑郁症（MDD）抑郁发作期间常见症状的临床表现对准确诊断提出了挑战。疾病特异性神经解剖学特征可能有助于这两种临床状况之间的可靠区分。对于我们的样本16 BD患者，19 MDD患者和29名健康志愿者，我们采用了基于顶点的大脑皮层成像技术来检查皮质厚度和表面积，这两个组成部分的皮质体积具有不同的遗传决定因素。基于神经解剖特征的具体特点，我们然后使用支持向量机（SVM）算法来区分BD和MDD患者。与MDD患者相比，BD患者左侧颞叶、楔前叶、中央前叶、顶下叶、上级顶叶和右侧颞中回的皮质面积明显增大。此外，在BD患者中发现了更大体积的皮质下区域。在SVM判别分析中，总体准确性为74.3%，灵敏度为62.5%，特异性为84.2%（p = 0.028）。与对照组相比，BD患者的颞顶区表面积更大，而MDD患者的额颞区皮质更薄，尤其是内侧眶额区。这些发现表明，BD和MDD患者的皮质厚度和表面积存在明显的空间分布变化，表明这两种疾病可能存在不同的病因学和神经病理学过程。对疾病特异性生物学特征的多模态分类的应用为开发可能有助于诊断决策的潜在分类工具提供了线索。
The clinical presentation of common symptoms during depressive episodes in bipolar disorder (BD) and major depressive disorder (MDD) poses challenges for accurate diagnosis. Disorder-specific neuroanatomical features may aid the development of reliable discrimination between these two clinical conditions. For our sample of 16 BD patients, 19 MDD patients and 29 healthy volunteers, we adopted vertex-wise cortical based brain imaging techniques to examine cortical thickness and surface area, two components of cortical volume with distinct genetic determinants. Based on specific characteristics of neuroanatomical features, we then used support vector machine (SVM) algorithm to discriminate between patients with BD and MDD. Compared to MDD patients, BD patients showed significantly larger cortical surface area in the left bankssts, precuneus, precentral, inferior parietal, superior parietal and the right middle temporal gyri. In addition, larger volumes of subcortical regions were found in BD patients. In SVM discriminative analyses, the overall accuracy was 74.3 %, with a sensitivity of 62.5 % and a specificity of 84.2 % (p = 0.028). Compared to controls, larger surface area in the temporo-parietal regions were observed in BD patients, and thinner cortices in fronto-temporal regions were observed in MDD patients, especially in the medial orbito-frontal area. These findings have demonstrated distinct spatially distributed variations in cortical thickness and surface area in patients with BD and MDD, suggesting potentially varying etiological and neuropathological processes in these two conditions. The employment of multimodal classification on disorder-specific biological features has shed light to the development of potential classification tools that could aid diagnostic decisions.