Objective To discuss the differences in local spontaneous brain activity among patients with depressive disorder, major depressive episode with mixed feature (MMF), bipolar disorder with mixed feature (BMF) and bipolar disorder (BD) by amplitude of low-frequency fluctuation. Methods From June to December 2021，resting state functional magnetic resonance imaging data and general information were collected from 20 patients with depression, 15 patients with MMF, 20 patients with BMF, and 25 patients with bipolar disorder who met DSM-5 diagnostic criteria and attended the outpatient clinic of Beijing Anding Hospital, Capital Medical University. 40 healthy people matched with each group in terms of gender and age were recruited as healthy controls during the same period. After image data preprocessing, individual ALFF maps were calculated, and differences in local spontaneous brain activity were explored using one-way ANOVA and post hoc tests. Results of one-way ANOVA show that patients with depressive disorder, MMF, BMF, and BD exhibited significant difference of ALFF in the left inferior temporal gyrus [cluster size k=372, P<0.001，Family Wise Error (FWE) corrected]，left raphe nuclei (k=271，P<0.001，FWE corrected), right anterior cingulum (k=193，P < 0.001，FWE corrected), right middle temporal gyrus (k=149, P<0.001 FWE corrected), right superior media frontal gyrus (k=117，P<0.001，FWE corrected), right cerebellum crux (k=68, P=0.009, FWE corrected), right inferior temporal gyrus (k=63，P=0.014, FWE corrected), and left middle temporal (k=49, P=0.048，FWE corrected). The post hoc test results show that the ALFF Values of the left inferior temporal gyrus in patients with bipolar disorder and BMF were higher than those in patients with depression, while the ALFF values of the right cerebellum in patients with MMF, bipolar disorder and BMF were lower than those in patients with depression, and the differences were statistically significant (P<0.01) The left raphe nuclei ALFF value of BMF patients was lower than that of MMF and depression patients (P < 0.05). Conclusions In patients with affective disorder spectrum , local spontaneous brain activity in frontal lobe temporal lobe, cerebellum, raphe nuclei and other brain regions is abnormal, but in BMF patients, compared with MMF patients, local spontaneous brain activity in raphe nuclei is weak.

目的 基于低频振荡振幅(ALFF)分析方法,探讨抑郁症、伴混合特征的抑郁症(MMF)、伴混合特征的双相障碍(BMF)和双相障碍患者之间局部自发脑活动的差异.方法 收集2021年6-12月就诊于首都医科大学附属北京安定医院门诊符合DSM-5诊断标准的20例抑郁症、15例MMF、20例BMF、25例双相障碍患者,以及40名性别和年龄与各组患者匹配的健康对照者的静息态功能磁共振数据和一般资料.影像数据预处理后,计算个体ALFF图,采用单因素方差分析和事后检验比较5组受试者局部自发脑活动的差异.结果 单因素方差分析结果显示,5组受试者的左侧颞下回(k=372,P＜0.001)、左侧中缝核(k=271,P＜0.001)、右侧前扣带和旁扣带回(k=193,P＜0.001)、右侧颞中回(k=149,P＜0.001)、右内侧额上回(k=117,P＜0.001)、右侧小脑crus 2区(k=68,P=0.009)、右侧颞下回(k=63,P=0.014)和左侧颞中回(k=49,P=0.048)的ALFF值比较,差异有统计学意义(P均簇水平FWE校正).事后检验结果显示,双相障碍和BMF组患者左侧颞下回的ALFF值高于抑郁症组患者,MMF、双相障碍和BMF组患者右侧小脑的ALFF值低于抑郁症组患者,差异均有统计学意义(均P＜0.01).BMF患者左侧中缝核ALFF值低于MMF和抑郁症组患者,差异有统计学意义(P＜0.05).结论 情感障碍谱系患者额叶、颞叶、小脑、中缝核等多个脑区局部自发脑活动异常,但BMF患者相对于MMF患者,中缝核局部自发脑活动较弱.

基金项目:国家自然科学基金(81901368, U19B2032);北京市属医院科研培育计划(PX2020072, PX2020074);首都卫生发展科研专项(首发2020-4-2125)