Prefrontal glutamatergic emotion regulation is disturbed in cluster B and C personality disorders - A combined 1H/31P-MR spectroscopic study.
Prefrontal glutamatergic emotion regulation is disturbed in cluster B and C personality disorders - A combined 1H/31P-MR spectroscopic study.
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B 类和 C 类人格障碍中前额谷氨酸能情绪调节受到干扰 - 一项联合 1H/31P-MR 光谱研究
DOI：
10.1016/j.jad.2017.10.044
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发表时间：
2018
影响因子：
6.6
通讯作者：
Reichenbach JR
中科院分区：
文献类型：
--
作者：
Smesny S;Große J;Gussew A;Langbein K;Schönfeld N;Wagner G;Valente M;Reichenbach JR
人格障碍是一种最常见、最严重的精神障碍，主要表现为社会功能障碍、工作能力障碍、共病和自杀风险。PDS还对抑郁症或药物滥用等具有高自杀风险的精神障碍的发生率、临床病程和治疗反应产生至关重要的影响。方法采用1H/31P化学位移成像(CSI)技术，对22例B组(CB组)和21例C组(CC组)PD患者和60例健康对照(HC)的谷氨酸功能(NAA，Glu)和局部能量代谢(PCR，ATP)进行神经化学指标的检测。采用非参数统计检验和相关分析，评估疾病对代谢物的影响及其与症状的关系。结果包括Bonferroni校正在内的总体比较显示，所有组在背外侧前额叶皮质(DLPFC)的Glu存在显著差异。结果显示：(1)CB患者双侧DLPFC Glu升高，CC患者双侧DLPFC Glu降低，左侧DLPFC Pcr升高。(2)CC患者背内侧前额叶皮质(DmPFC)NAA和Glu显著降低，并伴有PCR值升高。(3)CB患者右侧前扣带回(ACC)NAA降低，CC患者左侧ACC NAA降低，双侧PCR值升高。结论DLPFC的观察结果可能反映了CB和CC-PD患者认知控制功能障碍的神经生化相关性。CB患者的改变提示基础活动增加，而CC患者的观察模式可能反映活动减少或抑制。ACa和dmPFC中NAA和Glu水平的变化间接支持了CB和CC PD中参与社会认知和心理形成能力的区域神经元功能受损的假设。进一步的研究应包括对神经元抑制代谢物(GABA)的研究和治疗效果的检查。
BackgroundPersonality disorders (PD) belong to the most common and most serious mental disorders as regards social dysfunction, inability to work, occurrence of comorbidity and suicidal risk. PDs also crucially influence the incidence, clinical course and treatment response of mental disorders with high suicidal risk, such as depression or substance abuse. One key issue of PD concerns the regulation of emotions.MethodsBoth1H-/31P-Chemical Shift Imaging (CSI) was applied in a single session to assess neurochemical markers of glutamate function (NAA, Glu) and local energy metabolism (PCr, ATP) in two patient cohorts encompassing 22 cluster B (CB) and 21 cluster C (CC) PD patients, whereby 10 patients of each group were on low-dose antidepressants, and in 60 healthy controls (HC). Non-parametric statistical tests and correlation analyses were performed to assess disease effects on the metabolites and their relation to symptomatology as assessed by SCL-90R self-ratings.ResultsOverall comparison including Bonferroni correction revealed significant differences of Glu across all groups in the dorsolateral prefrontal cortex (DLPFC). The following uncorrected results of pairwise tests were obtained: (i) Glu was bilaterally increased in the DLPFC in CB patients, whereas it was – together with NAA – bilaterally decreased in the DLPFC in CC patients and accompanied by increased PCr in the left DLPFC. (ii) NAA and Glu, accompanied by increased PCr, were significantly decreased in the dorsomedial prefrontal cortex (DMPFC) in CC patients. (iii) NAA was decreased in the right anterior cingulate cortex (ACC) in CB patients, and in the left ACC in CC patients with PCr being increased bilaterally. (iv) No associations were observed between metabolites and psychopathology measures.ConclusionThe observations in the DLPFC may reflect a neurobiochemical correlate of disturbed cognitive control function in CB and CC PD. While the alterations in CB patients suggest increased basal activity, the observed patterns in CC patients likely reflect decreased or inhibited activity. The alterations of NAA and Glu levels in the ACC and DMPFC indirectly support the assumption of disturbed neuronal function in regions involved in social cognition and mentalizing abilities in both CB and CC PD. Further studies should include the investigation of metabolites of neuronal inhibition (GABA) and the examination of treatment effects.
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影响因子：
3.7
作者：
Ferrari, Chiara;Lega, Carlotta;Cattaneo, Zaira
通讯作者：
Cattaneo, Zaira
影响因子：
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作者：
van Elst, LT;Valerius, G;Olbrich, HM
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Olbrich, HM
影响因子：
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作者：
Bernstein, DP;Stein, JA;Zule, W
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Zule, W
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作者：
A. Ruiz;E. Costanzo;D. de Achával;S. Guinjoan
通讯作者：
S. Guinjoan
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作者：
Banks, Sarah J.;Eddy, Kamryn T.;Phan, K. Luan
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Phan, K. Luan