Differentiating bipolar I disorder, bipolar II disorder and unipolar depression based on neurobiological alterations of Grays behavioral activation and inhibition system (BAS/BIS)

根据格雷行为激活和抑制系统 (BAS/BIS) 的神经生物学改变区分双相 I 型障碍、双相 II 型障碍和单相抑郁症

• 批准号: 268165132
• 负责人: Professorin Dr. Michèle Wessa, since 5/2017
• 金额: --
• 依托单位: Abteilung Klinische Psychologie und Psychotherapie
• 依托单位国家: 德国
• 项目类别: Research Grants
• 财政年份: 2014
• 资助国家: 德国
• 起止时间: 2013-12-31 至 2018-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/268165132?language=en
• 关键词: Differentiating; bipolar; disorder; II; unipolar

Bipolar disorder is a devastating mental disease characterized by recurrent episodes of depressed and elevated mood. As our knowledge concerning the etiology of bipolar spectrum disorders is rather limited, diagnosis is based on behavioral manifestations. This has the side effect that at onset bipolar spectrum disorders and in particular bipolar II disorder are often misdiagnosed as unipolar depression leading to detrimental effects on the course of the disease. Interestingly, both bipolar and unipolar affective disorders might be seen as disorders of aberrant motivation herein referring to the process of initiating, controlling and maintaining behavior with the goal of maximizing pleasurable outcomes. During depression a diminished interest in almost all activities is observed, whereas during mania patients display excessive involvement in pleasurable activities with a high probability of negative long-term consequences. It is assumed that reduced (depression) / increased (mania) approach motivation towards appetitive stimuli as well as increased (depression) / reduced (mania) processing of aversive stimuli, is related to alterations in the behavioral activation system (BAS). Further, alterations in the behavioral inhibition system (BIS) that regulates the BAS in case of approach-avoidance conflicts might also be of relevance in mood disorders. First evidence also suggests that rumination referring to repeated, often realistic thoughts concerning one topic mediates the association between increased BAS-sensitivity and manic symptoms. However, BAS, BIS and rumination as well as their neurobiological correlates have not been systematically studied in patients with affective disorders. The proposed study likes to investigate three patient groups: bipolar I disorder, bipolar II disorder and unipolar depression with regard to approach and avoidance behavior and rumination. Applying magnetic resonance imaging (MRI), we like to identify functional biomarkers that allow differentiation of these disorders with sufficient sensitivity and specificity. Participants would undergo extensive clinical diagnostics, neuropsychological testing, an approach-avoidance task and a rumination task during MRI. Data will be analyzed in the context of the general linear model and with machine learning algorithms.

双相情感障碍是一种毁灭性的精神疾病，其特征是抑郁和情绪升高的反复发作。由于我们对双相谱系障碍病因学的认识相当有限，诊断是基于行为表现。这具有的副作用是，在发作时双相谱系障碍，特别是双相II型障碍经常被误诊为单相抑郁症，导致对疾病进程的有害影响。有趣的是，双相和单极情感障碍都可以被视为异常动机的障碍，在本文中是指以最大化愉快结果为目标的启动、控制和维持行为的过程。在抑郁症期间，观察到对几乎所有活动的兴趣减少，而在躁狂症期间，患者表现出过度参与愉快的活动，很有可能产生负面的长期后果。据推测，减少（抑郁症）/增加（躁狂症）的做法对食欲刺激的动机，以及增加（抑郁症）/减少（躁狂症）的厌恶刺激的处理，是有关的行为激活系统（BAS）的改变。此外，行为抑制系统（BIS）的变化，调节BAS的情况下，接近-回避冲突也可能是相关的情绪障碍。第一个证据也表明，反刍指的是重复的，往往是现实的想法，关于一个主题介导的协会之间的巴斯敏感性增加和躁狂症状。然而，在情感性精神障碍患者中，BAS、BIS和反刍以及它们的神经生物学相关性尚未得到系统的研究。拟议的研究喜欢调查三个患者群体：双相I型障碍，双相II型障碍和单相抑郁症的接近和回避行为和反刍。应用磁共振成像（MRI），我们喜欢识别功能性生物标志物，以足够的灵敏度和特异性区分这些疾病。参与者将在MRI期间接受广泛的临床诊断，神经心理学测试，接近回避任务和反刍任务。数据将在一般线性模型的背景下进行分析，并使用机器学习算法。