Comparative Study Of Male Patients With Major Depressive Disorder And Bipolar Disorder: A Resting State FMri Study

Objective: Major Depressive Disorder(MDD)and Bipolar Disorder(BD)are two kinds of diseases whose pathological mechanism is not clear and which are difficult to be differentiated,the male population of these two diseases has many similar clinical features but has their own specificity,a growing body of research suggests that the similarities and differences between male MDD and male BD are closely related to abnormal activity in brain regions.Exploring the relationship between brain activity and disease in these two groups of people may help us to find the difference between male MDD patients and male BD patients,Therefore,this study intends to use the method of Amplitude of LowFrequency Fluctuations(ALFF)to compare the brain activity of male MDD with that of male BD in order to find the differences and similarities of brain activity,and to provide relevant evidence for clinical diagnosis and treatment.Methods: In this study,59 male MDD subjects,54 male BD subjects and 79 Healthy Control subjects(HC)were scanned by resting-state functional magnetic resonance imaging(r-f MRI).With diagnosis as the main factor and age and years of education as covariates,the difference of brain regions between the three groups was obtained by covariance analysis.The GRF was used to correct the difference(p < 0.01),the ALFF value of the difference brain region was extracted after the correction,and then the difference brain region was analyzed by two-to-two comparison after the correction.The result was corrected by Bonferroni after the correction(p < 0.05),the specific differences of brain activity between male MDD,male BD and male HC were obtained.Results:(1)there were no significant differences in age and education among the three groups(P > 0.05),and there were significant differences in Hamd-17 scores and YMRS scores among the three groups(p < 0.05);There was no significant difference between male MDD group and male BD Group in course of disease(p = 0.104)and YMRS score(p = 0.190).(2)the results of covariance analysis showed that ALFF was significantly different in four regions(p < 0.01,corrected by GRF):(CLUSTER1,CL1)left parahippocampal gyrus,left fusiform gyrus,left amygdala,left hippocampus;(CLUSTER2,CL2)left middle frontal gyrus,left inferior frontal gyrus,left superior frontal gyrus,;(CLUSTER3,CL3)left inferior frontal gyrus of island cap,left insula,left inferior frontal gyrus,left temporal pole: superior temporal gyrus,left lenticular nucleus;(CLUSTER4,CL4)left inferior frontal gyrus of trigonum,left inferior frontal gyrus of orbit.(3)the results of post-mortem examination showed that compared with male HC Group,in male MDD and BD groups,ALFF values in CL1(left parahippocampal gyrus,left fusiform gyrus,left amygdala,left hippocampus),CL3(left inferior frontal gyrus,left insula,left inferior triangular gyrus,left temporal pole: superior temporal gyrus,left lenticular putamen)and CL4(left inferior triangular gyrus,left inferior orbital gyrus)were increased,and there was statistical significance(p < 0.05,Bonferroni correction).Compared with male HC Group and male MDD Group,ALFF in CL2 region(left medial orbitofrontal gyrus,left inferior orbitofrontal gyrus,left superior orbitofrontal gyrus)in male BD group was significantly higher(p < 0.05,Bonferroni correction).(4)In male MDD patients and male BD patients,there was no significant difference in the Alff value of brain regions between the drug group and the non drug group(P > 0.05).(5)There was no significant difference in Alff between stable male BD patients and depressive male BD patients(P > 0.05)Conclusions:(1)both male MDD patients and male BD patients have abnormal left hemisphere spontaneous activity,which plays an important role in the occurrence and evolution of clinical symptoms in male MDD patients and male BD patients,it may be that the two groups share many neuroimaging factors with similar clinical manifestations.(2)the abnormal function of left orbitofrontal cortex may be a potential marker of neuroimaging difference between BD and MDD patients.