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双相Ⅱ型障碍重性抑郁发作患者自杀行为相关的脑自发神经活动改变
Altered brain spontaneous neuronal activity associated with suicidality in bipolar Ⅱ disorder patients with a current major depressive episode
【摘要】 目的:探讨伴自杀未遂行为的双相Ⅱ型障碍(BD-Ⅱ)重性抑郁发作患者大脑自发神经活动改变及其与目前自杀风险的关联。方法:入组116例BD-Ⅱ重性抑郁发作患者(伴自杀未遂组50例,不伴自杀未遂组66例)及62名人口资料匹配的健康对照者。所有受试者完成临床资料采集及静息态功能磁共振扫描。基于全脑体素水平比较受试者脑区低频振幅(ALFF)值,分别检测伴自杀未遂患者的自杀风险、抑郁症状和焦虑症状严重程度与显著差异的脑区ALFF值的相关性。结果:与不伴自杀未遂组相比,伴自杀未遂组左侧前扣带回(ACC)ALFF值显著增高,且与自杀风险呈正相关(P<0.05),而与患者目前抑郁症状及焦虑症状的严重程度无关联(P>0.05)。结论:ACC功能异常可能是BD-Ⅱ重性抑郁发作患者自杀行为特征性生物风险标记,是潜在的自杀防治生物靶点。
【Abstract】 Objective: To explore altered brain spontaneous neuronal activity in bipolar Ⅱ disorder(BD-Ⅱ) depression patients with suicide attempts and its correlation with the level of suicide risk. Method:A total of 116 BD-Ⅱ patients with a current major depressive episode and 62 demographically matched healthy controls(HC group) were enrolled.The BD-Ⅱ patients were divided into patients with suicide attempt(SA group,n=50) and patients with no prior history of suicide attempts(NSA group,n=66).All participants completed clinical assessments and underwent a resting-state functional magnetic resonance imaging scan.Whole brain amplitude of low-frequency fluctuation(ALFF) values were compared among the three groups.The correlation between abnormal ALFF and the level of suicide risk,severity of depression symptoms,and anxiety symptoms were explored respectively in the SA group. Results:Compared to NSA patients,SA patients showed elevated brain activity in the left anterior cingulate cortex(ACC).Additionally,ALFF of the left ACC was positively correlated with the level of risk in the SA group(P<0.05),but not the severity of depressive or anxiety symptoms(P>0.05). Conclusion:Dysfunction of ACC might be a critical objective feature of suicidality in the BD-Ⅱ depression patients and a potential biological target for suicide prevention.
【Key words】 bipolar Ⅱ disorder; suicide attempt; anterior cingulate cortex; resting-state functional magnetic resonance imaging; amplitude of low-frequency fluctuation;
- 【文献出处】 临床精神医学杂志 ,Journal of Clinical Psychiatry , 编辑部邮箱 ,2020年05期
- 【分类号】R749.4
- 【被引频次】1
- 【下载频次】125