The Rs-fMRI Differences Among Depression,Bipolar Disorder,Schizophrenia,and The Relation To Cognitive Function,Clinical Characteristics

Objective:Studies have shown that mental disorder has related changes in brain imaging or genetics.Major depressive disorder(MDD),Bipolar disorder(BD),and schizophrenia(SZ)are common psychiatric diseases in psychiatry,but clinical diagnosis is often delayed,which have an impact on disease diagnosis and treatment.Unfortunately,the current clinical is no available marker used to distinguish the three diseases.This study used a cross-sectional studies of patients with MDD,BD,SZ to explore brain imaging differences among the three disease,and attempt to find the correlation with cognitive function,clinical characteristics.Methods:A total of 96 hospitalized patients diagnosed with bipolar-disorder,depression,and schizophrenia who met the DSM-5 diagnostic criteria.Upon enrollment,the Hamilton Depression Rating Scale(HAMD-17),Hamilton Rating Scale for Anxiety(HAMA),Young Mania Rating Scale(YMRS),Positive and Negative Symptom Scale(PANSS),Repeatable Battery for the Assessment of Neuropsychological Status(RBANS)were all completed,Perfecting the 3.0T magnetic resonance imaging(MRI).All the obtained resting-state functional MRI(rs-fMRI)data were preprocessed by Data Processing&Analysis for Brain Imaging(DPABI)toolbox.Get the Regional homogeneity(ReHo)and fractional amplitude of low irequency fluctuation(fALFF),Voxel-mirrored Homotopic Connectivity(VMHC)brain map.Analysis of Covariance(ANCOVA)was used to compare the differences in brain maps among the three groups of patients.Correlation analysis was used to analyze the correlation between the brain maps and cognitive function,clinical characteristics.Results:1.A total of 96 patients were enrolled and image data were collected(86 cases were finally available).Independent samples non-parametric test or chi-square test among the three groups of diseases showed no significant differences in gender,age,educational years and ethnicity among the three disease groups(P>0.05).There was a statistically significant difference in duration of disease(P<0.05).Cognitive function among the three groups:immediate memory,visual spatial structure,delayed memory,and total scores of RBANS were statistically significant(P<0-05).Statistical differences between language and attention were not significant(P>0.05).2.Analysis of Covarianee:there were no significant differences in fALFF,ReHo and VMHC brain images among the MDD,BD and SZ.Post hoc analysis showed that MDD and SZ were different in the fALFF of right superior temporal gyrus temporal pole,inferior frontal gyrus,and the left superior occipital gyrus,inferior parietal lobule;the VMHC of bilateral putamen,hippocampus and parahippocampal gyrus.There was no significant difference in fALFF and VMHC between MDD and BD,BD and SZ.Post hoc analysis showed no difference in pairwise comparison of ReHo among the three groups(GRF corrected,voxel level P<0.01,cluster level P<0.05,two tailed).There were differences in brain regions related to cognitive function among the three diseases.The fALFF,ReHo of the occipital lobe were significantly correlated with cognitive function in MDD and SZ.3.Correlation analysis:The RBANS total score was positively correlated with the fALFF in the left middle occipital gyrus of MDD,and negatively correlated with left posterior cingulate;positively correlated with the ReHo in the left occipital lobe of MDD;positively correlated with the fALFF in the right supramarginal gyrus of SZ,and negatively correlated with the left parietal lobe;positively correlated with the VMHC in the Putamen of SZ.Immediate memory was positively correlated with the fALFF in the left middle occipital gyrus of MDD,and negatively correlated with the precuneus lobes.Visual spatial structure was positively correlated with the fALFF in the right caudate and anterior cingulate gyrus of MDD.Language was positively correlated with the fALFF in left middle occipital gyrus of MDD,negatively correlated with the right hippocampus and parahippocampal gyrus;positively correlated with the fALFF in the right cerebellum anterior lobe of SZ.Attention was positively correlated with the fALFF in the right temporal loble of SZ,negatively correlated with the left calcarine gyrus,lingual gyrus,right cerebellum anterior lobe,middle temporal gyrus;negatively correlated with the ReHo in left occipital lobe of SZ.Delayed memory was positively correlated with the fALFF in the right occipital gyrus,cuneus of SZ;positively correlated with bilateral cerebellar anterior lobes,putamen,posterior cingulate gyrus,middle frontal gyrus and precuneus(GRF corrected,voxel level P<0.005,cluster level P<0.05,two tailed).4.The analysis of clinical characteristics:the duration of disease of MDD was positively correlated with the fALFF of the cerebellum posterior lobe and right lingual gyrus,the ReHo of the left cerebellum posterior lobe and central gyrus,and the VMHC of the bilateral cerebellum posterior lobe,central posterior gyrus and inferior parietal lobule.The duration of disease of BD was positively correlated with the fALFF of the left cerebellum anterior lobe,the right thalamus and lingual gyrus.fALFF,ReHo and VMHC analysis showed that there was no correlation between MDD brain map and HAMD score,BD brain map and YMRS score,and SZ brain map and PANSS score(GRF corrected,voxel level P<0.005,cluster level P<0.05,two tailed).Conclusion:1.After GRF adjustment,there was no statistically significant difference in resting-state brain function fMRI among MDD,BD and SZ,but the difference of fALFF and VMHC between MDD and SZ was statistically significant.2.The occipital lobe plays an important role in the cognitive function of MDD and 5Z.3.The duration of MDD and BD is related to the resting-state brain function,suggesting that the resting brain function of the two diseases may be aggravated with the prolongation of the duration of the disease;4.The three diseases may have different resting-state brain functional mechanisms.