Common and distinct patterns of intrinsic brain activity alterations in major depression and bipolar disorder: voxel-based meta-analysis.
Common and distinct patterns of intrinsic brain activity alterations in major depression and bipolar disorder: voxel-based meta-analysis.
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重度抑郁症和躁郁症患者内在大脑活动改变的常见和独特模式：基于体素的荟萃分析
DOI：
10.1038/s41398-020-01036-5
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发表时间：
2020-10-19
影响因子：
6.8
通讯作者：
Wang Y
中科院分区：
文献类型：
--
作者：
Gong J;Wang J;Qiu S;Chen P;Luo Z;Wang J;Huang L;Wang Y
确定重度抑郁症(MDD)和双相情感障碍(BD)之间的内在脑活动的差异和相似之处是必要的。然而，结果还没有产生一致的结论。对全脑静息状态功能磁共振成像(rS-fMRI)研究进行荟萃分析，探讨患者(包括MDD和BD)和健康对照组(HCS)之间低频波动(ALF)幅度的差异。系统的文献检索确定了50项研究，比较了1399名MDD患者和1332名肥胖症患者，15项研究比较了494名BD患者和593名肥胖症患者。与HCS相比，MDD患者右侧额上回(SFG)(包括内侧眶前叶皮质、内侧前额叶皮质[mPFC]、前扣带回[ACC])、双侧岛叶延伸至纹状体和左侧缘上回的ALF值升高，而双侧小脑、双侧楔前叶和左侧枕叶皮质的ALF值降低。BD表现为双侧额下回、双侧脑岛延伸至纹状体、右侧三叉神经节和右侧颞上回，双侧楔前叶、左侧小脑(延伸至枕叶皮质)、左侧ACC和左侧STG的Alff降低。此外，与BD患者相比，MDD患者左侧舌回、左侧ACC、双侧楔前/扣带后回、左侧STG的ALF值增加，右侧岛叶、右侧MPFC、右侧梭形回和双侧纹状体的ALF值降低。联合分析显示，两种疾病的双侧脑岛Alff、mPFC升高，左侧小脑Alff降低。我们的综合Meta分析表明，MDD和BD表现出共同的局部内在异常脑活动模式，主要包括岛叶、mPFC和小脑，而边缘系统和枕叶皮质可能与空间上不同的脑功能模式相关，这为了解情感性精神障碍脑功能障碍的潜在病理生理机制，开发更有针对性和有效的治疗和干预策略提供了有用的见解。
Identification of intrinsic brain activity differences and similarities between major depression (MDD) and bipolar disorder (BD) is necessary. However, results have not yet yielded consistent conclusions. A meta-analysis of whole-brain resting-state functional MRI (rs-fMRI) studies that explored differences in the amplitude of low-frequency fluctuation (ALFF) between patients (including MDD and BD) and healthy controls (HCs) was conducted using seed-baseddmapping software. Systematic literature search identified 50 studies comparing 1399 MDD patients and 1332 HCs, and 15 studies comparing 494 BD patients and 593 HCs. MDD patients displayed increased ALFF in the right superior frontal gyrus (SFG) (including the medial orbitofrontal cortex, medial prefrontal cortex [mPFC], anterior cingulate cortex [ACC]), bilateral insula extending into the striatum and left supramarginal gyrus and decreased ALFF in the bilateral cerebellum, bilateral precuneus, and left occipital cortex compared with HCs. BD showed increased ALFF in the bilateral inferior frontal gyrus, bilateral insula extending into the striatum, right SFG, and right superior temporal gyrus (STG) and decreased ALFF in the bilateral precuneus, left cerebellum (extending to the occipital cortex), left ACC, and left STG. In addition, MDD displayed increased ALFF in the left lingual gyrus, left ACC, bilateral precuneus/posterior cingulate gyrus, and left STG and decreased ALFF in the right insula, right mPFC, right fusiform gyrus, and bilateral striatum relative to BD patients. Conjunction analysis showed increased ALFF in the bilateral insula, mPFC, and decreased ALFF in the left cerebellum in both disorders. Our comprehensive meta-analysis suggests that MDD and BD show a common pattern of aberrant regional intrinsic brain activity which predominantly includes the insula, mPFC, and cerebellum, while the limbic system and occipital cortex may be associated with spatially distinct patterns of brain function, which provide useful insights for understanding the underlying pathophysiology of brain dysfunction in affective disorders, and developing more targeted and efficacious treatment and intervention strategies.
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