Fronto-limbic dysfunction in mania pre-treatment and persistent amygdala over-activity post-treatment in pediatric bipolar disorder.
Fronto-limbic dysfunction in mania pre-treatment and persistent amygdala over-activity post-treatment in pediatric bipolar disorder.
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DOI：
10.1007/s00213-011-2243-2
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发表时间：
2011-08
影响因子：
3.4
通讯作者：
Pavuluri, Mani N.
中科院分区：
文献类型：
--
作者：
Passarotti, Alessandra M.;Sweeney, John A.;Pavuluri, Mani N.
关键词：
在儿童双相情感障碍(PBD)的药物治疗中，情感和认知交界处的神经缺陷可能会得到改善。我们检测了拉莫三嗪治疗对工作记忆神经界面的影响以及对多发性骨髓病的影响。未服药、急性疾病、躁狂和轻躁狂症患者(n=17)和健康对照组(HC；n=13；平均年龄=13.36±2.55)在治疗前和治疗后8周和6周单次拉莫三嗪治疗后，分别对愤怒面孔和中性面孔(即愤怒面孔)或快乐面孔和中性面孔(即快乐面孔)进行情感双背功能磁共振成像检查。在基线状态下，与HC相比，愤怒面孔状态下，PBD在左侧前额叶腹外侧皮质(VLPFC)和右侧尾状核的激活程度降低；对于快乐面孔状态，PBD在双侧PFC、右侧杏仁核和颞中回的激活程度增加。治疗后，在两种情况下，与HC相比，PBD在右侧杏仁核表现出更大的激活。与HC相比，愤怒面孔患者右侧VLPFC和杏仁核、左侧膝下前扣带回和左侧尾状回的变化更大，而高兴面孔患者的右侧颞中回的变化更大。药物治疗可改善患者的症状，并使与HC相关的高级皮质情绪和认知区域正常化，提示PBD患者的VLPFC功能障碍可能是状态特异性的。杏仁核在PBD中相对于HC过度活跃，与躁狂症状的缓解无关，可能是PBD的一个特征标记。
Neural deficits at the interface of affect and cognition may improve with pharmacotherapy in pediatric bipolar disorder (PBD). We examined lamotrigine treatment impact on the neural interface of working memory and affect in PBD. Un-medicated, acutely ill, patients with mania and hypomania (n=17), and healthy controls (HC; n=13; mean age=13.36±2.55) performed an affective two-back functional magnetic resonance imaging task with blocks of angry vs neutral faces (i.e., angry face condition) or happy vs neutral faces (i.e., happy face condition) before treatment and at follow-up, after 8-week treatment with second-generation antipsychotics followed by 6 weeks of lamotrigine monotherapy. At baseline, for the angry face condition, PBD, relative to HC, showed reduced activation in the left ventrolateral prefrontal cortex (VLPFC) and right caudate; for the happy face condition, PBD showed increased activation in bilateral PFC and right amygdala and middle temporal gyrus. Post-treatment, PBD showed greater activation in right amygdala relative to HC for both conditions. Patients, relative to HC, exhibited greater changes over time in the right VLPFC and amygdala, left subgenual anterior cingulate cortex and left caudate for the angry face condition, and in right middle temporal gyrus for the happy face condition. Pharmacotherapy resulted in symptom improvement and normalization of higher cortical emotional and cognitive regions in patients relative to HC, suggesting that the VLPFC dysfunction may be state-specific in PBD. Amygdala was overactive in PBD, relative to HC, regardless of reduction in manic symptoms, and may be a trait marker of PBD.
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影响因子：
5.7
作者：
Hart, Sarah J.;Green, Steven R.;Casp, Michael;Belger, Aysenil
通讯作者：
Belger, Aysenil
影响因子：
10.6
作者：
Frangou, S;Haldane, M;Kumari, V
通讯作者：
Kumari, V
影响因子：
4.8
作者：
Gruber, Oliver;Tost, Heike;Rietschel, Marcella
通讯作者：
Rietschel, Marcella
影响因子：
5.7
作者：
CASEY, BJ;COHEN, JD;RAPOPORT, JL
通讯作者：
RAPOPORT, JL
DOI：
10.1176/appi.ajp.2009.09010043
发表时间：
2010-01
期刊：
The American journal of psychiatry
影响因子：
--
作者：
Brotman MA;Rich BA;Guyer AE;Lunsford JR;Horsey SE;Reising MM;Thomas LA;Fromm SJ;Towbin K;Pine DS;Leibenluft E
通讯作者：
Leibenluft E