A Regional Homogeneity Study Of Patients With Depressive Phase Of Pediatric Bipolar Disorder Based On Rs-fMRI

Objectives:Using the Regional Homogeneity(ReHo)method in resting-state functional magnetic resonance imaging(rs-fMRI),we aim to investigate the characteristics of local spontaneous brain activity changes in individuals experiencing the depressive phase of Pediatric Bipolar Disorder(PBD).This approach aims to enhance our understanding of the underlying pathophysiological mechanisms involved in the central nervous system of patients with this disorder,and further elucidate the specific neurobiological features associated with the depressive phase of PBD.Methods:The experimental group(depressive phase of PBD group)consisted of 36 children and adolescents with bipolar disorder who were diagnosed for the first time and judged to be in a state of depression by the scale evaluation during scanning.The average age of the patient group was 15.28 ± 2.11 years old,and none of the patient groups had received any drug treatment.At the same time,27 healthy volunteers with matching age,gender,handicap,and educational level were recruited from the community as the Healthy Controls group(HC group).The average age of the control group was 14.74±2.25 years old.All subjects were scanned with 3.0T conventional and resting functional magnetic resonance imaging scanning,and evaluated with clinical scales.The HAMD and the YMRS were used to assess the patient’s disease status.The software package of DPABI was used to preprocess the rs-fMRI datas and calculate the ReHo values of each brain region of each person.Two-sample t test was used to compare the differences in ReHo values of all brain regions of the two groups of subjects,and then the ReHo values in the different brain regions were extracted to analyze their correlation with clinical scales.Results:(1)Compared with the healthy control,the ReHo values of the right posterior cerebellar lobe,the right anterior cingulate and paracingulate gyrus,and the left medial superior frontal gyrus in depressive phase of PBD group decreased significantly,and the ReHo values of the bilateral posterior central gyrus,the left middle occipital gyrus,and the right superior temporal gyrus increased significantly on the contrary.(2)In the depressive phase of PBD group,we found the ReHo values of the left medial superior frontal gyrus was negatively correlated with the HAMD score,while other brain regions were not significantly correlated with the HAMD score,the number of depressive episodes or the duration of the disease.Conclusions:(1)Based on the ReHo method,it was found that depressive phase of PBD patients have functional abnormalities in multiple brain regions,which are distributed in various brain lobes,including the cerebellum,suggesting that depressive phase of PBD patients may have extensive central nervous system dysfunction and reorganization.(2)The ReHo value of the left medial superior frontal gyrus is related to the severity of the disease,suggesting that the left medial superior frontal gyrus plays a more important role in the pathogenesis of depressive phase of PBD compared to other brain regions.