A preliminary fMRI study of sustained attention in euthymic, unmedicated bipolar disorder
A preliminary fMRI study of sustained attention in euthymic, unmedicated bipolar disorder
复制标题
DOI：
10.1038/sj.npp.1300492
复制
发表时间：
2004-09-01
影响因子：
7.6
通讯作者：
DelBello, MP
中科院分区：
文献类型：
--
作者：
Strakowski, SM;Adler, CM;DelBello, MP
双相情感障碍的症状提示调节情绪行为的前边缘网络功能障碍，并且前边缘网络与背侧注意系统相互作用。双相情感障碍患者即使在心境正常时，症状也很轻微，但仍易受情绪发作的影响。因此，我们预测，与健康受试者相比，双相情感障碍患者会表现出异常激活的区域的前边缘网络与相应的异常激活的其他皮质区参与注意力处理。在所有，10个未用药的正常胸腺双相情感障碍患者和10组匹配的健康受试者进行了研究，同时进行连续性能任务相同对版本（CPT-IP）的功能磁共振成像。使用回波平面成像（EPI）脉冲序列在3.0 T Bruker系统上获得fMRI扫描，同时受试者进行CPT-IP和对照条件，以对比区域脑激活的组间差异。心境正常的双相情感障碍受试者和健康受试者在CPT-IP上的表现相似，但表现出显着不同的大脑激活模式。具体来说，双相情感障碍患者表现出边缘系统、边缘系统和腹外侧前额叶区以及视觉联想皮层的激活增加。健康受试者的梭状回和内侧前额叶皮层的激活相对增加。总之，这些差异表明，双相情感障碍患者表现出过度激活的前边缘区与相应的异常激活的视觉联想皮层区，允许成功的性能的注意力任务。由于这些差异发生在正常心境中，它们可能代表了双相情感障碍患者大脑功能的特质而非状态异常。
The symptoms of bipolar disorder suggest dysfunction of anterior limbic networks that modulate emotional behavior and that reciprocally interact with dorsal attentional systems. Bipolar patients maintain a constant vulnerability to mood episodes even during euthymia, when symptoms are minimal. Consequently, we predicted that, compared with healthy subjects, bipolar patients would exhibit abnormal activation of regions of the anterior limbic network with corresponding abnormal activation of other cortical areas involved in attentional processing. In all, 10 unmedicated euthymic bipolar patients and 10 group-matched healthy subjects were studied with fMRI while performing the Continuous Performance Task-Identical Pairs version (CPT-IP). fMRI scans were obtained on a 3.0 T Bruker system using an echo planar imaging (EPI) pulse sequence, while subjects performed the CPT-IP and a control condition to contrast group differences in regional brain activation. The euthymic bipolar and healthy subjects performed similarly on the CPT-IP, yet showed significantly different patterns of brain activation. Specifically, bipolar patients exhibited increased activation of limbic, paralimbic, and ventrolateral prefrontal areas, as well as visual associational cortices. Healthy subjects exhibited relatively increased activation in fusiform gyrus and medial prefrontal cortex. In conclusion, these differences suggest that bipolar patients exhibit overactivation of anterior limbic areas with corresponding abnormal activation in visual associational cortical areas, permitting successful performance of an attentional task. Since the differences occurred in euthymia, they may represent trait, rather than state, abnormalities of brain function in bipolar disorder.