双相I型情感障碍岛叶参与的情感认知环路的脑成像研究

项目名称： 双相I型情感障碍岛叶参与的情感认知环路的脑成像研究

项目编号： No.81471389

项目类型： 面上项目

立项/批准年度： 2015

项目学科： 医药、卫生

项目作者： 刘春红

作者单位： 首都医科大学

项目金额： 70万元

中文摘要： 双相障碍（bipolar disorder, BD）是一种以躁狂或抑郁反复发作为临床特征的疾病，不同的临床期（抑郁期、躁狂期和稳定期）的脑影像研究尚未获得可靠稳定的神经影像标志。我们前期研究发现，BD抑郁期患者存在岛叶参与的情感-认知环路的异常，故提出岛叶不同亚区或不同亚区参与的脑网络可作为BD不同临床期的状态指标。本研究拟收集同一BD患者不同临床期、未患病同胞以及健康对照的多模态磁共振数据进行研究，即用结构磁共振成像观察皮质密度或厚度改变，用静息态功能磁共振成像观察血液氧合水平的动态变化，用弥散张量成像观察白质纤维束的完整性，在全脑分析的基础上，进一步进行岛叶各个亚区与全脑的功能连接分析；同时随访患者的治疗转归和未患病同胞的精神病转化。旨在探索BD不同临床期患者在岛叶参与的皮层-边缘环路中的状态指标以及早期预警的神经影像标志，从而为BD早期识别、早期诊断、进展检测和治疗评估提供参考依据。

中文关键词： 双相障碍；磁共振成像；早期诊断；岛叶；同胞

英文摘要： Bipolar disorder(BD) is a common psychiatric illness characterized by alternating depressive and manic phases intersparsed with a varing inter-episodic interval (the euthymia phase).The different phases(including depression, mania, and euthymia) had difficulties in obtaining robust neuroimaging markers for BD. In our previous studies, BD depression had abnormality in insula participated emotional cognition circuits. We hypothesized that the insular subregion or insular subregion related network may be a state marker for different episodes of BD. In the current study, we aimed to investigate each BD patient when he/her is at each clinical phase, unaffected sibling, and healthy subjects. We used structural magnetic resonance imaging(MRI) to observe gray matter density or volume changes; used functional MRI to observe fluctuations of resting-state blood oxygen level-dependent (BOLD) signals; used diffusion tensor imaging (DTI) to observe intact white matter fiber tracts. We then performed insular subregion functional connectivity analysis based on the whole brain results. At the same time, we observed the treatment outcomes for BD patients and mental illness transformation for unaffected siblings. The state marker within insular participated cortico-limbic circuits for different episode phases with BD and neuroimaging marker for early warning may provide reliable basis on discovering early identification, early diagnosis, progress monitoring, and treatment evaluation.

英文关键词： bipolar disorder;magnetic resonance imaging;early diagnosis;insula;sibling