The Structure And Function Of Brain And Clinical Characteristics In Patients With Bipolar Depression And Unipolar Depression

Objective:The brain structure and function and clinical characteristics of unipolar depression and bipolar depression disorders were studied with multimodal magnetic resonance imaging,The pathological mechanisms of unipolar depression and bipolar depression disorders were explored from the aspects of brain structure and function,providing a basis on the differences of the clinical characteristics between unipolar depression and bipolar depression disorders.Methods:1.Subjects in the bipolar depression group,the unipolar depression group and the healthy control group were scaned by 3.0T resting state functional magnetic resonance imaging and diffusion tensor imaging.2.The fALFF values of the whole brain were calculated in the three groups.Statistical analysis of variance was performed on 3 groups of subjects,and double samples t-test statistics were performed on the basis of different brain regions.The correlation between fALFF values and HAMA scores,HAMD scores,factor scores of HAMD,family history,incidence times,onset age and course of disease in the bipolar depression group and the unipolar depression group was analyzed by Pearson statistical method.3.To calculated the fractional anisotropy(FA),mean diffusivity(MD),axial diffusivity(AD)and radial diffusivity(RD).Tract based Spatial Statistics(TBSS)analysis the FA value,MD value,AD value and RD value in three groups.Double sample t-test analysis were performed between each other group.The correlation between FA values and HAMA scores,HAMD scores,factor scores of HAMD,family history,incidence times,onset age and course of disease in the bipolar depression group and the unipolar depression group was analyzed by Pearson statistical method.Results:1.Compared with the unipolar depression group,the brain areas with decreased fALFF value in the bipolar depression group were right temporal middle gyrus,left occipital middle gyrus,right middle frontal gyrus,left middle frontal gyrus,left superior frontal gyrus and left medial frontal gyrus,the brain areas with increased fALFF value in the bipolar depression group were left superior temporal gyrus and inferior parietal lobule.There was no significant correlation between fALFF value of these brain areas and HAMD score,family history,incidence times,onset age and course of disease(P>0.05).The fALFF value of the right middle temporal gyrus in the bipolar depression group was negatively correlated with HAMA score(P<0.05).The fALFF values of left occipital middle gyrus,right middle frontal gyrus,left middle frontal gyrus,left superior frontal gyrus,left medial frontal gyrus,left superior temporal gyrus and inferior parietal lobule in the bipolar depression group had no correlation with HAMA score(P>0.05).The fALFF values of inferior parietal lobule were positively correlated with the anxiety/somatization factor scores of HAMD(P<0.05).There was no significant correlation between the fALFF values of inferior parietal lobule and the factor scores of HAMD inclued weight,cognitive impairment,day and night change,block,sleep disorder and despair(P>0.05).There was no significant correlation between the fALFF value of right temporal middle gyrus,left occipital middle gyrus,right middle frontal gyrus,middle left frontal gyrus,left superior frontal gyrus,left medial frontal gyrus and left superior temporal gyrus and the factor scores of HAMD anxiety/somalization,weight,cognitive impairment,day and night changes,block,sleep disorder and despair(P>0.05).2.Compared with the unipolar depression group,the white matter areas with significantly lower FA values in the bipolar depression group were left superior frontal gyrus,right superior frontal gyrus,left middle frontal gyrus,left angular gyrus,right cuneus,right superior temporal gyrus,right precuneus(P<0.05).There was no significant correlation between the FA values of these brain areas and HAMA score,HAMD score,family history,frequency of onset,age of onset,and course of disease(P>0.05).The FA values of left angular gyrus were positively correlated with the cognitive impairment factor scores of HAMD(P<0.05).There was no significant correlation between the FA value of left angular gyrus and the factor scores of HAMD include anxiety/somalization,weight,,day and night change,block,sleep disorder and despair(P>0.05).There was no significant correlation between the FA value of left superior frontal gyrus,right superior frontal gyrus,left middle frontal gyrus,right cuneus,right superior temporal gyrus,right precuneus and the factor scores of HAMD anxiety/somalization,weight,cognitive impairment,day and night changes,block,sleep disorder and despair(P>0.05).There was no significant difference of MD value,AD value and RD value between bipolar depression group and unipolar depression group(P>0.05).Conclusion:Brain function activation of right middle temporal gyrus,left middle occipital gyrus,right middle frontal gyrus,left middle frontal gyrus,left superior frontal gyrus,left medial frontal gyrus,left superior temporal gyrus and inferior parietal lobule were different in patients with bipolar depression compared with those with unipolar depression.Right middle temporal gyrus was associated with anxiety symptoms in patients with bipolar depression,and inferior parietal lobule was associated with anxiety somatization symptoms in patients with bipolar depression.Patients with bipolar depression had more damage to the white matter area in left superior frontal gyrus,right superior frontal gyrus,left middle frontal gyrus,left angular gyrus,right cuneus,right superior temporal gyrus and right precuneus than those with unipolar depression.The damage of white matter in the left angular gyrus was associated with cognitive impairment of bipolar depression.This provides the research foundation for exploring the pathological mechanism of patients with bipolar depression and unipolar depression.