A voxel-based diffusion tensor imaging study in unipolar and bipolar depression

作者：Repple Jonathan; Meinert Susanne; Grotegerd Dominik; Kugel Harald; Redlich Ronny; Dohm Katharina; Zaremba Dario; Opel Nils; Buerger Christian; Foerster Katharina; Nick Theresa; Arolt Volker; Heindel Walter; Deppe Michael; Dannlowski Udo

来源：Bipolar Disorders, 2017, 19(1): 23-31.

DOI：10.1111/bdi.12465

<jats:sec><jats:title>Objective</jats:title><jats:p>The absence of neurobiological diagnostic markers of bipolar disorder (<jats:styled-content style="fixed-case">BD</jats:styled-content>) leads to its frequent misdiagnosis as unipolar depression (<jats:styled-content style="fixed-case">UD</jats:styled-content>). We investigated if changes in fractional anisotropy (<jats:styled-content style="fixed-case">FA</jats:styled-content>) could help to differentiate <jats:styled-content style="fixed-case">BD</jats:styled-content> from <jats:styled-content style="fixed-case">UD</jats:styled-content> in the state of depression.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Using diffusion tensor imaging (<jats:styled-content style="fixed-case">DTI</jats:styled-content>) we employed a voxel‐based analysis approach to examine fractional anisotropy (<jats:styled-content style="fixed-case">FA</jats:styled-content>) in 86 patients experiencing an acute major depressive episode according to <jats:styled-content style="fixed-case">DSM</jats:styled-content>‐<jats:styled-content style="fixed-case">IV</jats:styled-content> (N=39 <jats:styled-content style="fixed-case">BD</jats:styled-content>, mean age 39.2 years; N=43 <jats:styled-content style="fixed-case">UD</jats:styled-content>, mean age 39.0 years), and 42 healthy controls (<jats:styled-content style="fixed-case">HC</jats:styled-content>, mean age 36.1 years). The groups did not differ in sex, age or total education time. <jats:styled-content style="fixed-case">FA</jats:styled-content> was investigated in white matter (<jats:styled-content style="fixed-case">FA</jats:styled-content> &gt;.2) and hypothesis‐driven anatomically defined tracts (region‐of‐interest [<jats:styled-content style="fixed-case">ROI</jats:styled-content>] analysis). Additionally, an exploratory gray matter <jats:styled-content style="fixed-case">FA</jats:styled-content> analysis was performed.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>White matter analysis showed decreased <jats:styled-content style="fixed-case">FA</jats:styled-content> in the right corticospinal tract in <jats:styled-content style="fixed-case">UD</jats:styled-content> vs <jats:styled-content style="fixed-case">HC</jats:styled-content> and in the right corticospinal tract/superior longitudinal fascicle in <jats:styled-content style="fixed-case">BD</jats:styled-content> vs <jats:styled-content style="fixed-case">HC</jats:styled-content> and also in <jats:styled-content style="fixed-case">BD</jats:styled-content> vs <jats:styled-content style="fixed-case">UD</jats:styled-content>. ROI analysis revealed decreased <jats:styled-content style="fixed-case">FA</jats:styled-content> in <jats:styled-content style="fixed-case">BD</jats:styled-content> vs <jats:styled-content style="fixed-case">UD</jats:styled-content> in the corpus callosum and in the cingulum. Gray matter exploratory analysis revealed decreased <jats:styled-content style="fixed-case">FA</jats:styled-content> in the left middle frontal gyrus and in the right inferior frontal gyrus in <jats:styled-content style="fixed-case">UD</jats:styled-content> vs <jats:styled-content style="fixed-case">HC</jats:styled-content>, and in the left superior medial gyrus in <jats:styled-content style="fixed-case">BD</jats:styled-content> vs <jats:styled-content style="fixed-case">HC</jats:styled-content>.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>This is one of very few studies directly showing differences in <jats:styled-content style="fixed-case">FA</jats:styled-content> between <jats:styled-content style="fixed-case">BD</jats:styled-content> and <jats:styled-content style="fixed-case">UD</jats:styled-content>. Gray matter <jats:styled-content style="fixed-case">FA</jats:styled-content> changes in prefrontal areas might be precursors for future prefrontal gray matter abnormalities in these disorders.</jats:p></jats:sec>

• 出版日期2017-2