双相障碍（Bipolar Disorder, BD）发病机制不明。现有证据提示BD存在多巴胺（Dopamine, DA）功能的周期性失调，DA传递的差异对奖赏脑区起调控作用。不同临床相的BD存在奖赏环路（主要是边缘叶通路和额叶皮层）功能、结构异常，但研究结果并不一致，可能与样本是否同质、横断面还是纵向跟踪、功能磁共振（function MRI, fMRI）方法不同有关。为阐明奖赏环路在BD发病中的作用，我们拟采用任务与静息态fMRI、外周血DA浓度/基因相结合的方法，以抑郁相、躁狂相和缓解状态BD为对象，并与健康人群比较，观察（1）各组间奖赏环路及DA的差异；（2）对患者进行纵向观察，对在跟踪过程中临床相变化的患者再检测，比较同一个患者不同临床相的奖赏环路以及DA的差异；（3）分析转相与不转相的缓解期患者结果的差异性。研究对阐明BD的发病机制，为临床治愈的评估提供生物学指标有重要。

Pathology of bipolar disorder (BD) has not been clear. There are robust evidence to suggest that dysfunction of dopamine (DA) circulation has effects on BD onset, which also contributes to regulate activity of brain reward circus. BD patients with different emotional status have structural and functional abnormality in reward circus, especially in limbic system and frontal lobe; however, the findings were not consistent and sensitive. The main reasons includes: heterogeneity of sample, different experimental design (cross sectional or longitudinal) and different functional magnetic resonance imaging (fMRI) data analysis. The present study is longitudinal. In attempting to understand role of reward circus in BD, we will examine BD patients with different emotional status (depressive, manic, euthymic) and health control by event-related and resting fMRI combined with DA concentration in peripheral blood and gene testing. There are three main purposes in this study: to observe different activity pattern of reward circus and DA concentration among four groups; to investigate change of brain activity and DA concentration when emotion transaction occurs; to compare data between recovery BD patients and euthymic BD patients. Thus, the present is important to understand BD pathology and clarify different pattern of brain activity and biomarker specifically related to BD.