Aberrant Neural Activity in Patients With Bipolar Depressive Disorder Distinguishing to the Unipolar Depressive Disorder: A Resting-State Functional Magnetic Resonance Imaging Study.

Meihui Qiu,Yueqi Huang,Jianye Zhang,Jun Shi,Huifeng Zhang,Daihui Peng,David Mellor,Ting Shen,Chuangxin Wu

doi:10.3389/fpsyt.2018.00238

Abstract

This study aims to explore the intrinsic patterns of spontaneous activity of bipolar depression (BD) patients by analyzing the fractional amplitude of low frequency fluctuation (fALFF) that help differentiate BD from unipolar depressive disorder(UD). Twenty eight patients with BD, 47 patients with UD and 29 healthy controls were enrolled to receive the resting-state functional magnetic resonance imaging (rs-fMRI) scans. The group differences of fALFF values were calculated among three groups. In addition, the correlations between the clinical variables and mfALFF values were estimated. The brain regions with activation discrepancies among three groups are located in precuneus, the left middle temporal gyrus (MTG) and left inferior parietal lobe (IPL) and lingual gyrus. Compared with HC group, BD group shows decreased fALFF in precuneus, the left IPL and increased fALFF in lingual gyrus remarkably; UD group shows significantly decreased fALFF in precuneus, the left MTG and the left IPL. On the contrast of patients with UD, patients with BD have significantly increased fALFF value in the left precuneus, the left MGT and lingual gyrus. Furthermore, a negative correlation is found between the mfALFF values in precuneus and the scores of cognitive impairment factor in the UD group. The similar pattern of intrinsic activity in PCC suggests depressive state-dependent change. The aberrant patterns of intrinsic activity in precuneus, the IPL and lingual gyrus might be provide quantitative nodes that help to conduct further study for better distinguishing between BD and UD.

Highlights

Bipolar disorder, characterized by abnormal mood, cognitive dysfunctions, changes of behaviors, and disturbed circadian rhythms, ranks the twelfth burdens of all diseases in terms of disability-adjusted of Life Years [1]
The brain regions with significant differences were located in precuneus, the left middle temporal gyrus (MTG), the left inferior parietal lobe (IPL), and lingual gyrus
We examined the fractional amplitude of low frequency fluctuation (fALFF) changes in patients with bipolar depression (BD) and UD compared with healthy controls by using resting-state fMRI

Summary

Introduction

Bipolar disorder, characterized by abnormal mood, cognitive dysfunctions, changes of behaviors, and disturbed circadian rhythms, ranks the twelfth burdens of all diseases in terms of disability-adjusted of Life Years [1]. The precise diagnosis and efficient treatment have generally been limited by the fact that the dynamic process of bipolar disorder is dominated by depression or elevated mood (mania or hypomania). Most individuals with bipolar disorder (58–71%) have depressive onset polarity, which usually show some overlapping clinical manifestations with the UD, such as depressed mood, retardation of thinking, and cognitive impairment. The misdiagnosis of bipolar disorder would result in the delay of treatment, exerting a heavy economic burden on patients’ families and the society [4, 5]. It is imperative to find appropriate methods to distinguish bipolar disorder patients from individuals with UD, which could help to minimize the impact of mixed diagnoses in early therapeutic intervention

Objectives

Methods

Results

Discussion

Conclusion