伴焦虑症状的双相障碍患者脑影像学研究进展

Research progress of brain imaging in patients with bipolar disorder with anxiety symptom

双相障碍(BD)是一种复杂的精神疾病,其特征是情绪不稳、易激惹和功能障碍。伴焦虑症状的BD患者往往存在更严重的临床症状、更差的社会功能以及更高的自杀风险。目前,对伴焦虑症状的BD的研究主要集中于临床特征、发病率和治疗等方面,神经生物遗传学机制方面的研究较少且结果不一致。磁共振成像(MRI)具有无创、分辨率高等优点,被广泛应用于对疾病发病机制的研究。因此,本文通过对伴焦虑症状的BD患者的脑影像学研究进展进行综述,探索其大脑结构与功能的一致性变化,以期加深对BD神经生物学机制的理解,为临床诊断及治疗提供参考。本研究共纳入14篇文献,并对伴焦虑症状的BD患者的大脑结构及功能进行分析,结果显示,伴焦虑症状的BD患者大脑功能活动改变主要涉及前额叶、后扣带皮层、颞叶以及角回,大脑结构改变主要涉及左侧海马及额中回,但研究结果的一致性有待提高。该领域的研究较少,后续需要同质性更高的临床样本以及开展更大规模的纵向研究对以上结果进行验证和补充。

Bipolar disorder(BD)is a complex mental illness characterized by mood fluctuations,excitability and impaired functioning.Anxiety in BD patients frequently leads to increased clinical symptoms,worse social functioning,and a higher risk of suicide.Current research on BD with anxiety symptom primarily examined clinical characteristics,prevalence and treatment,with limited focus and inconsistent findings on its neuro-biogenetic mechanisms.The findings in this area were also inconsistent.Magnetic resonance imaging(MRI),known for its non-invasive nature and high resolution,is extensively utilized in investigating disease mechanisms.Consequently,this paper gave a comprehensive review on the progress in brain imaging on BD patients with anxiety symptom,seeking to discern stable changes in brain structure and function,thereby enrich our understanding of the neurobiological etiology of this condition and offer valuable insights for clinical diagnosis and treatment strategies making.This paper covered 14 original studies and synthesized their findings on brain structure and function.Conclusively,the changes of brain functional activities in BD patients with anxiety symptom mainly involve the prefrontal lobe,posterior cingulate cortex,temporal lobe and angular gyrus,while the changes of brain structure mainly involve the left hippocampus and middle frontal gyrus,but the consistency of the research results needs to be enhanced.The research in this field is not sufficient,and more homogeneous clinical samples and larger longitudinal studies are needed to verify and supplement the above results.