Clinical utility of a short resting-state MRI scan in differentiating bipolar from unipolar depression
Clinical utility of a short resting-state MRI scan in differentiating bipolar from unipolar depression
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短静息态 MRI 扫描在区分双相和单相抑郁症中的临床应用
DOI：
10.1111/acps.12752
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发表时间：
2017-09-01
影响因子：
6.7
通讯作者：
Li, T.
中科院分区：
文献类型：
--
作者：
Li, M.;Das, T.;Li, T.
目的：双相情感障碍中的抑郁症（BipD）需要一种治疗方法，该方法来自于治疗单相重度抑郁症（UniD），但迄今为止，没有可靠的方法可以将这两种疾病分开。本研究的目的是建立一个非侵入性的功能性MRI为基础的方法来分类从UniD.Method的临床有效性和实用性的BipD：每个小单位（体素）与其他单位的大脑的连接程度（程度中心性或DC）估计在22例BipD和22个年龄，性别和抑郁症严重程度匹配的患者与UniD和22名健康对照。模式分类分析进行了使用支持向量机（SVM）的approach.Results：度中心性模式从8分钟休息功能磁共振区分从UniD的准确性为86%，诊断优势比为9.6。与UniD相比，BipD中左侧楔前叶的DC减少，双侧楔前叶的DC增加。在这个具有高度不确定性（50%先验概率）的样本中，DC测试的阳性预测值为79%。结论：程度中心性图是区分双相抑郁症和单相抑郁症的潜在候选指标。这里报告的测试性能需要在常规临床实践中进行进一步的务实评价。
Objective: Depression in bipolar disorder (BipD) requires a therapeutic approach that is from treating unipolar major depressive disorder (UniD), but to date, no reliable methods could separate these two disorders. The aim of this study was to establish the clinical validity and utility of a non-invasive functional MRI-based method to classify BipD from UniD.Method: The degree of connectivity (degree centrality or DC) of every small unit (voxel) with every other unit of the brain was estimated in 22 patients with BipD and 22 age, gender, and depressive severity-matched patients with UniD and 22 healthy controls. Pattern classification analysis was carried out using a support-vector machine (SVM) approach.Results: Degree centrality pattern from 8-min resting fMRI discriminated BipD from UniD with an accuracy of 86% and diagnostic odds ratio of 9.6. DC was reduced in the left insula and increased in bilateral precuneus in BipD when compared to UniD. In this sample with a high degree of uncertainty (50% prior probability), positive predictive value of the DC test was 79%.Conclusion: Degree centrality maps are potential candidate measures to separate bipolar depression from unipolar depression. Test performance reported here requires further pragmatic evaluation in regular clinical practice.