使用多模态 MRI 研究双相 I 障碍中与性别相关的大脑结构和功能差异。
Investigating sex-related differences in brain structure and function in bipolar I disorder using multimodal MRI.
机构信息
Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Department of Occupational Therapy, College of Medical Science and Technology, Chung Shan Medical University, Taichung, Taiwan.
出版信息
BMC Psychiatry. 2024 Nov 27;24(1):855. doi: 10.1186/s12888-024-06228-7.
BACKGROUND
Past research has highlighted that bipolar I disorder is associated with significant changes in brain structure and function. Notably, the manifestation and progression of bipolar I disorder have been known to differ between males and females. However, the relationship between sex-related differences and bipolar I disorder diagnosis affecting these changes was not fully understood. This study aimed to investigate the sex-by-diagnosis interactions concerning the structural and functional features of the brain in individuals with bipolar I disorder.
METHODS
Both structural and functional MRI data were obtained from 105 individuals with bipolar I disorder (36 males and 69 females) and 210 healthy controls (72 males and 138 females). Voxel-wise analyses of gray matter volume and functional connectivity were conducted using a general linear regression model. This model included age, sex, diagnosis, and a sex-by-diagnosis interaction as predictors to explore potential sex-related differences in the brain features of participants with bipolar I disorder.
RESULTS
The gray matter volume analysis revealed significant sex-by-diagnosis interactions in six brain regions: the left caudate (p < 0.001), left thalamus (p < 0.001), right caudate (p = 0.003), right thalamus (p < 0.001), left anterior cingulate gyrus (p = 0.022), and left middle/posterior cingulate gyrus (p = 0.015). Using these regions as seeds, we detected a significant sex-by-diagnosis interaction in the functional connectivity alteration between the left thalamus and right angular gyrus (p = 0.019).
CONCLUSIONS
Our findings revealed a noteworthy sex-by-diagnosis interaction, with male individuals with bipolar I disorder displaying larger gray matter volume and altered functional connectivity in the limbic system compared to female individuals with bipolar I disorder and healthy participants. These results hint at potential sex-related differences in the pathophysiology of the limbic system in bipolar I disorder, which may have significant implications for understanding the underlying mechanisms in bipolar I disorder. Our findings could contribute to developing more personalized treatment approaches for individuals with bipolar I disorder.
背景
过去的研究强调，双相 I 型障碍与大脑结构和功能的显著变化有关。值得注意的是，男性和女性的双相 I 型障碍表现和进展有所不同。然而，性别差异与影响这些变化的双相 I 型障碍诊断之间的关系尚未完全理解。本研究旨在探讨双相 I 型障碍患者大脑结构和功能特征的性别与诊断之间的相互作用。
方法
从 105 名双相 I 型障碍患者（36 名男性和 69 名女性）和 210 名健康对照者（72 名男性和 138 名女性）中获得结构和功能 MRI 数据。使用一般线性回归模型对灰质体积和功能连接进行体素分析。该模型包括年龄、性别、诊断和性别与诊断的交互作用作为预测因子，以探讨双相 I 型障碍患者大脑特征中潜在的性别差异。
结果
灰质体积分析显示，6 个脑区存在显著的性别与诊断的交互作用：左侧尾状核（p<0.001）、左侧丘脑（p<0.001）、右侧尾状核（p=0.003）、右侧丘脑（p<0.001）、左侧前扣带回（p=0.022）和左侧中/后扣带回（p=0.015）。使用这些区域作为种子，我们在左侧丘脑和右侧角回之间的功能连接改变中检测到显著的性别与诊断的交互作用（p=0.019）。
结论
我们的发现揭示了一个显著的性别与诊断的相互作用，即男性双相 I 型障碍患者的边缘系统的灰质体积较大，功能连接改变，而女性双相 I 型障碍患者和健康参与者则没有这种情况。这些结果表明，双相 I 型障碍的边缘系统的病理生理学可能存在潜在的性别差异，这可能对理解双相 I 型障碍的潜在机制具有重要意义。我们的研究结果可以为开发更个性化的双相 I 型障碍治疗方法做出贡献。
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