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双相障碍患者白质微结构特征与认知功能的关系

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目的:使用弥散张量成像(DTI)探索双相障碍(BD)患者白质结构特征及其与认知功能的关系。方法:纳入符合美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)诊断标准的BDⅠ型患者15例,BD Ⅱ型患者26例,正常对照37例。使用连线测验(TMT)、重复性成套神经心理状态测验(RBANS)评估认知功能,基于白质骨架的纤维束空间统计方法(TBSS)探索3组白质各向异性(FA)、平均扩散系数(MD)差异并与认知功能行相关分析。结果:BDⅠ及BD Ⅱ组的RBANS量表"注意力(P<0。001)、延迟记忆(P<0。01)"得分及总分(P<0。001)低于正常对照组,胼胝体及右侧上辐射冠FA值低于正常对照组(P<0。05);BDⅠ组的胼胝体膝部FA值与视觉广度得分呈正相关(r=0。74,P<0。05),BD Ⅱ组在该区域FA值与言语功能得分呈正相关(r=0。55,P<0。05)。结论:双相障碍患者的胼胝体、右侧上辐射冠区域白质完整性可能受损,并可能与认知损害存在关联。
Relationship between white matter microstructural features and cognitive function in patients with bipolar disorder
Objective:To explore the white matter structural characteristics in patients with bipolar disorder(BD)using diffusion tensor imaging(DTI)and investigate their relationship with cognitive function.Methods:A total of 15 patients with BD type Ⅰ and 26 patients with BD type Ⅱ who met the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition(DSM-Ⅳ)diagnostic criteria and 37 normal controls were included.Cognitive function was assessed with the Trail Making Test(TMT)and Repeatable Battery for the Assessment of Neuropsy-chological Status(RBANS).The tract-based spatial statistics(TBSS)method was used to explore the differences in fractional anisotropy(FA)and mean diffusivity(MD)among the three groups and perform correlation analyses with cognitive function.Results:Patients with BD Ⅰ and BD Ⅱ had lower scores in attention(P<0.001),delayed memory(P<0.01),and total scores(P<0.001)on the RBANS compared to the normal control group.They also exhibited lower FA values in the corpus callosum and right superior corona radiata compared to the normal control group(P<0.05).In the BD Ⅰ group,there was a positive correlation between FA values in the genu of corpus cal-losum and visuospatial/constructional scores(r=0.74,P<0.05),while in the BD Ⅱ group,a positive correlation was found between FA values in the same region and language function scores(r=0.55,P<0.05).Conclusion:It suggests that patients with bipolar disorder may have impaired white matter integrity in the corpus callosum and right superior corona radiata,which may be associated with cognitive impairment.

bipolar disorderdiffusion tensor imagingwhite mattercognitive function

梁峻钒、刘华、郭芯吟、李雪华、袁继香、喻明兰、王婷婷、何容芳、向波、刘可智、梁雪梅

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西南医科大学附属医院精神科,四川泸州 646000

精神疾病基础与临床泸州市重点实验室,四川泸州 646000

川北医学院精神卫生学院,四川南充 637000

西南医科大学附属医院医学实验中心,四川泸州 646000

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双相障碍 弥散张量成像 白质 认知功能

四川科技厅重点研发项目四川科技厅重点研发项目泸州市-西南医科大学联合项目

2023NSFSC01242022YFS06152021LZXNYD-D04

2024

中国心理卫生杂志
中国心理卫生协会

中国心理卫生杂志

CSTPCDCHSSCD北大核心
影响因子:2.088
ISSN:1000-6729
年,卷(期):2024.38(10)