缓解期双相障碍Ⅰ型患者脑半球间静息态功能连接的探讨

摘要

Objective:Abnormalities in structural and functional brain connectivity have been increasingly reported in patientswith bipolar disorder (BD) by recent neuroimaging studies.However,BD-related alterations in interhemispheric functional interaction are still largely unclear.Resting-state functional magnetic resonance imaging (rs-fMRI) approaches,which reveal patterns of coherent spontaneous fluctuations in the fMRI signal,provide a means to quantitatively detect interhemispheric functional interaction pattern.We examined interhemispheric resting-state functional connectivity (RSFC) and its relationships with clinical characteristics in bipolar Ⅰ euthymia using a recently validated approach,voxel-mirrored homotopic connectivity (VMHC).Materials and Methods:Euthymic subjects with bipolar Ⅰ disorder (n=27) and matched healthy subjects (n=27) underwent resting-state functional magnetic resonance imaging scans.Rs-fMRI data were co-registered to the high-resolution T1 symmetric anatomical template,and the homotopic resting state functional connectivity was computed for each subject.Results:Group comparisons revealed that patients exhibited lower VMHC than healthy subjects in inferior frontal gyrus (opercular part),Rolandic operculum,insula,putamen (P＜0.05,GRF corrected).Negative correlation was found between the duration of BD and VMHC in the inferior frontal gyrus and Rolandic operculum (r=-0.402,P=0.037;r=0.402,P=0.038).Conclusions:These findings suggest substantial impairment of functional coordination between homotopic brain regions in bipolar Ⅰ euthymia.Inferior frontal gyrus and Rolandic operculum may have a role in the chronicity of BD.%目的 神经影像学研究提示双相障碍(bipolar disorder,BD)患者脑结构及功能连接异常,而BD相关大脑半球间功能交互作用变化仍不清,静息态功能磁共振成像(resting-state functional magnetie resonance imaging,rs-fMRI)方法,反映fMRI信号内神经元自发活动特征,为定量研究双侧大脑半球交互作用提供了有利的手段.该研究采用有效的评价方法,即基于体素镜像同伦功能连接(voxel-mirrored homotopic connectivity,VMHC),探讨缓解期BD Ⅰ型患者双侧大脑半球同步活动模式及其与临床特征的相关性.材料与方法 对27例缓解期BD Ⅰ型患者及27例健康匹配对照进行磁共振扫描,将rs-fMRI数据配准到高清T1对称解剖模板后,计算两侧半球镜像同伦体素间功能连接(即VMHC),进行进一步的统计分析.结果 岛盖部额下回、罗兰迪克岛盖、岛叶、壳核功能同伦连接减低(P＜0.05,GRF团块校正);岛盖部额下回及罗兰迪克岛盖VMHC值与病程呈负相关(r=-0.402,P=0.037;r=-0.402,P=0.038).结论 缓解期BD Ⅰ型患者多个半球间镜像脑区存在功能协同性的损害,特别是岛盖部额下回及罗兰迪克岛盖脑区可能在疾病慢性化过程中起重要作用.