Abstract
ObjectiveStudies on alterations in the regional neural activity in the brain of patients with bipolar disorder (BD) have provided conflicting results because of different medications used and study designs. A low bone mineral density (BMD) is also observed in patients with BD. This study aimed to further explore regional neural activities in unmedicated patients with BD and their association with BMD.MethodsIn this study, 40 patients with BD and 42 healthy controls were scanned through resting-state functional magnetic resonance imaging (fMRI). Imaging data were analyzed with regional homogeneity (ReHo) and pattern classification. Pearson’s correlation analyses were performed to explore the correlations between abnormal ReHo and BMD.ResultsA significant increase in ReHo values in the left inferior frontal gyrus (IFG)/temporal pole, left cerebellum vermis I/vermis II/parahippocampal gyrus/brainstem, and right superior temporal gyrus (STG) and a decrease in ReHo in the occipital gyrus (OG; left middle OG/superior OG/bilateral cuneus) were found in the patients with BD (p < 0.05) compared with those in the healthy controls. No significant correlation was observed between the abnormal ReHo values in any of the brain regions of the patients with BMD.Support vector machine (SVM) analyses revealed that the ReHo values in the right STG for distinguishing patients from healthy controls showed an accuracy of 91.89%, a sensitivity of 75.68%, and a specificity of 83.78%. The ReHo values in the left cerebellum vermis I/vermis II/parahippocampal gyrus/brainstem indicated an accuracy of 78.38%, a sensitivity of 75.68%, and a specificity of 81.08%.ConclusionThis study further confirms the abnormal brain activities in extensive regions, and these brain regions are primarily located in the fronto–temporal–occipital circuit and the cerebellum vermis of patients with BD. The regional neural activity in the right STG and the left cerebellum vermis I/vermis II/parahippocampal gyrus/brainstem may serve as potential imaging markers to distinguish patients with BD from healthy controls.
Highlights
Bipolar disorder (BD) is a chronic, debilitating mood disorder associated with a high suicide risk [1, 2]
The significance level was set at p < 0.05 for multiple comparisons corrected with Gaussian random field (GRF) theory
The Regional homogeneity (ReHo) values in the left middle occipital gyrus (OG)/superior OG/bilateral cuneus were negatively correlated with the verbal function total score of RBANS (r = −0.335, p = 0.046), whereas the ReHo values in the left cerebellum vermis I/vermis II/parahippocampal gyrus/ brainstem were negatively correlated with the figure memory of RBANS (r = −0.380, p = 0.026) (Figure 2)
Summary
Bipolar disorder (BD) is a chronic, debilitating mood disorder associated with a high suicide risk [1, 2]. Patients with BD can be misdiagnosed as having unipolar depression if they only experience depressive episodes with no history of mania. Such patients are at a risk of inadequate treatment and poor clinical outcomes [4, 5]. Three studies have revealed the increased functional connections of the amygdala, medial prefrontal cortex, and ventrolateral prefrontal cortex and a decreased connectivity between the medial prefrontal and cingulate cortices [6,7,8]. The analytical techniques used in these neuroimaging studies are FC analysis and independent component analysis (ICA) that are efficient in exploring the function of brain networks but not local brain activities
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