Huai-Hsuan Tseng, Cheng Ying Wu, Hui Hua Chang, Tsung-Hua Lu, Wei Hung Chang, Chia-Fen Hsu, Ren-Yi Lin, Ding-Ruey Yeh, Fu-Zen Shaw, Yen Kuang Yang, Po See Chen
{"title":"躁郁症患者后扣带回和内侧前额叶的兴奋-抑制平衡。","authors":"Huai-Hsuan Tseng, Cheng Ying Wu, Hui Hua Chang, Tsung-Hua Lu, Wei Hung Chang, Chia-Fen Hsu, Ren-Yi Lin, Ding-Ruey Yeh, Fu-Zen Shaw, Yen Kuang Yang, Po See Chen","doi":"10.1017/S0033291724001326","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Persistent cognitive deficits and functional impairments are associated with bipolar disorder (BD), even during the euthymic phase. The dysfunction of default mode network (DMN) is critical for self-referential and emotional mental processes and is implicated in BD. The current study aims to explore the balance of excitatory and inhibitory neurotransmitters, i.e. glutamate and <i>γ</i>-aminobutyric acid (GABA), in hubs of the DMN during the euthymic patients with BD (euBD).</p><p><strong>Method: </strong>Thirty-four euBD and 55 healthy controls (HC) were recruited to the study. Using proton magnetic resonance spectroscopy (<sup>1</sup>H-MRS), glutamate (with PRESS sequence) and GABA levels (with MEGAPRESS sequence) were measured in the medial prefrontal cortex/anterior cingulate cortex (mPFC/ACC) and the posterior cingulate gyrus (PCC). Measured concentrations of excitatory glutamate/glutamine (Glx) and inhibitory GABA were used to calculate the excitatory/inhibitory (<i>E</i>/<i>I</i>) ratio. Executive and attentional functions were respectively assessed using the Wisconsin card-sorting test and continuous performance test.</p><p><strong>Results: </strong>euBD performed worse on attentional function than controls (<i>p</i> = 0.001). Compared to controls, euBD had higher <i>E</i>/<i>I</i> ratios in the PCC (<i>p</i> = 0.023), mainly driven by a higher Glx level in the PCC of euBD (<i>p</i> = 0.002). Only in the BD group, a marginally significant negative association between the mPFC <i>E</i>/<i>I</i> ratio (Glx/GABA) and executive function was observed (<i>p</i> = 0.068).</p><p><strong>Conclusions: </strong>Disturbed E/I balance, particularly elevated Glx/GABA ratio in PCC is observed in euBD. The <i>E</i>/<i>I</i> balance in hubs of DMN may serve as potential biomarkers for euBD, which may also contribute to their poorer executive function.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":null,"pages":null},"PeriodicalIF":5.9000,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Posterior cingulate and medial prefrontal excitation-inhibition balance in euthymic bipolar disorder.\",\"authors\":\"Huai-Hsuan Tseng, Cheng Ying Wu, Hui Hua Chang, Tsung-Hua Lu, Wei Hung Chang, Chia-Fen Hsu, Ren-Yi Lin, Ding-Ruey Yeh, Fu-Zen Shaw, Yen Kuang Yang, Po See Chen\",\"doi\":\"10.1017/S0033291724001326\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Persistent cognitive deficits and functional impairments are associated with bipolar disorder (BD), even during the euthymic phase. The dysfunction of default mode network (DMN) is critical for self-referential and emotional mental processes and is implicated in BD. The current study aims to explore the balance of excitatory and inhibitory neurotransmitters, i.e. glutamate and <i>γ</i>-aminobutyric acid (GABA), in hubs of the DMN during the euthymic patients with BD (euBD).</p><p><strong>Method: </strong>Thirty-four euBD and 55 healthy controls (HC) were recruited to the study. Using proton magnetic resonance spectroscopy (<sup>1</sup>H-MRS), glutamate (with PRESS sequence) and GABA levels (with MEGAPRESS sequence) were measured in the medial prefrontal cortex/anterior cingulate cortex (mPFC/ACC) and the posterior cingulate gyrus (PCC). Measured concentrations of excitatory glutamate/glutamine (Glx) and inhibitory GABA were used to calculate the excitatory/inhibitory (<i>E</i>/<i>I</i>) ratio. Executive and attentional functions were respectively assessed using the Wisconsin card-sorting test and continuous performance test.</p><p><strong>Results: </strong>euBD performed worse on attentional function than controls (<i>p</i> = 0.001). Compared to controls, euBD had higher <i>E</i>/<i>I</i> ratios in the PCC (<i>p</i> = 0.023), mainly driven by a higher Glx level in the PCC of euBD (<i>p</i> = 0.002). Only in the BD group, a marginally significant negative association between the mPFC <i>E</i>/<i>I</i> ratio (Glx/GABA) and executive function was observed (<i>p</i> = 0.068).</p><p><strong>Conclusions: </strong>Disturbed E/I balance, particularly elevated Glx/GABA ratio in PCC is observed in euBD. The <i>E</i>/<i>I</i> balance in hubs of DMN may serve as potential biomarkers for euBD, which may also contribute to their poorer executive function.</p>\",\"PeriodicalId\":20891,\"journal\":{\"name\":\"Psychological Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":5.9000,\"publicationDate\":\"2024-06-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Psychological Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1017/S0033291724001326\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Psychological Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1017/S0033291724001326","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
Posterior cingulate and medial prefrontal excitation-inhibition balance in euthymic bipolar disorder.
Background: Persistent cognitive deficits and functional impairments are associated with bipolar disorder (BD), even during the euthymic phase. The dysfunction of default mode network (DMN) is critical for self-referential and emotional mental processes and is implicated in BD. The current study aims to explore the balance of excitatory and inhibitory neurotransmitters, i.e. glutamate and γ-aminobutyric acid (GABA), in hubs of the DMN during the euthymic patients with BD (euBD).
Method: Thirty-four euBD and 55 healthy controls (HC) were recruited to the study. Using proton magnetic resonance spectroscopy (1H-MRS), glutamate (with PRESS sequence) and GABA levels (with MEGAPRESS sequence) were measured in the medial prefrontal cortex/anterior cingulate cortex (mPFC/ACC) and the posterior cingulate gyrus (PCC). Measured concentrations of excitatory glutamate/glutamine (Glx) and inhibitory GABA were used to calculate the excitatory/inhibitory (E/I) ratio. Executive and attentional functions were respectively assessed using the Wisconsin card-sorting test and continuous performance test.
Results: euBD performed worse on attentional function than controls (p = 0.001). Compared to controls, euBD had higher E/I ratios in the PCC (p = 0.023), mainly driven by a higher Glx level in the PCC of euBD (p = 0.002). Only in the BD group, a marginally significant negative association between the mPFC E/I ratio (Glx/GABA) and executive function was observed (p = 0.068).
Conclusions: Disturbed E/I balance, particularly elevated Glx/GABA ratio in PCC is observed in euBD. The E/I balance in hubs of DMN may serve as potential biomarkers for euBD, which may also contribute to their poorer executive function.
期刊介绍:
Now in its fifth decade of publication, Psychological Medicine is a leading international journal in the fields of psychiatry, related aspects of psychology and basic sciences. From 2014, there are 16 issues a year, each featuring original articles reporting key research being undertaken worldwide, together with shorter editorials by distinguished scholars and an important book review section. The journal''s success is clearly demonstrated by a consistently high impact factor.