A Resting-state FMRI Study Of Bipolar Disorder With Onset Of Major Depressive Episode

Objective Using regional homogeneity(ReHo)and low frequency amplitude(ALFF)as the data processing method,exploring the brain function differences of depression and bipolar disorder,looking forward to provide a new basis for bipolar disorder early identification.Method(1)Follow-up: tracking patients with mood disorder which collected information during the first depressive episode between January 2006 and December 2006,according to the follow-up diagnosis results dividing into unipolar depression and bipolar depression group.(2)Data processing: extraction data and related materials of two groups from database,using ReHo and ALFF as image data processing method.Using independent two sample t test to compare groups of brain function(Alphasim correction,P < 0.01),and then use the ROC analysis to verify the heterogeneous degrees of differences brain areas.For the bipolar depression group,doing the correlation between ReHo,ALFF and clinical features of whole brain voxel.Results(1)compared with health control,unipolar depression group:ReHo value rised area: right middle frontal gyrus,left superior frontal gyrus,right cuneus,left middle occipital gyrus,left supramarginal gyrus.ReHo value declined area: left middle frontal gyrus orbital part,right frontal Operculum.ALFF value rised areas: right middle frontal gyrus,left superior frontal gyrus,left inferior frontal gyrus orbital part,right insula,right cuneus,left superior occipital gyrus,left superior parietal gyrus.ALFF value declined area: left superior frontal gyrus medial orbital.(2)compared with health control,bipolar depression group:ReHo value rised area: right middle frontal gyrus,left superior frontal gyrus,left inferior frontal gyrus orbital part,right fusiform gyrus.ReHo value declined area: left superior temporal gyrus,right middle occipital gyrus.ALFF value rised areas: right postcentral gyrus,left inferior frontal gyrus triangular part,right fusiform gyrus.ALFF value declined area: right superior temporal gyrus,left parahippocampal gyrus.(3)Compared with unipolar depression group,bipolar depression group:ReHo value declined area: right rolandic operculum,left fusiform gyrus.Left fusiform gyrus identifying the sensitivity of the bipolar depressive disorder was0.619,specific degree is 0.905,the area under the curve is 0.780;right rolandic operculum identifying the sensitivity of the bipolar depressive disorder was 0.667,specific degree is 0.810,the area under the curve is 0.769.ALFF value rised area: left superior temporal gyrus.ALFF values to identify the sensitivity of the bipolar depressive disorder was 0.714,specific degree is 0.952,the area under the curve is 0.862.(4)The correlation of brain function and clinical scale in bipolar depression:Hamilton anxiety scale:Positive correlation: ReHo value of left middle frontal gyrus,left lingual gyrus,left cuneus.Negative correlation: ReHo value of left superior frontal gyrus;ALFF value of right superior frontal gyrus,left supplementary motor area.Hamilton depression rating scale :Positive correlation: ReHo value of left inferior temporal gyrus,left middle occipital gyrus;ALFF value of right middle frontal gyrus.Negative correlation: ReHo value of left postcentral gyrus;ALFF value of right postcentral gyrus.(5)The correlation of brain function and neuropsychological in bipolar depression:Positive correlation: ReHo value of left middle frontal gyrus,right superior frontal gyrus,right inferior frontal gyrus triangular part,right inferior frontal gyrus;ALFF value of right anterior cingulate paracingulate gyri,right insula.Negative correlation: ReHo value of right paracentral lobule,right precuneus.Conclusion(1)Compared with health control,the difference of ReHo and ALFF in middle frontal gyrus,superior frontal gyrus and middle occipital gyrus were all found in both unipolar depression and bipolar depression which may share the same pathological mechanism.(2)The unipolar depression and bipolar depression have differences in right rolandic operculum,left fusiform gyrus,left superior temporal gyrus.And through the ROC analysis,different brain regions have good specificity,possibly as bipolar early recognition of brain function.(3)Frontal local activities characteristics is closely related to clinical symptoms and cognitive function in bipolar depressive disorder.