A Study On Cognitive Function And Brain Networks In Patients With Bipolar Depression And Mixed Features

Objective:1.Exploring the cognitive impairment and changes in resting brain network Degree centrality(DC)values in patients with bipolar depression with mixed features(BPD-MF)and bipolar depression without mixed features(BPD-NOS),And analyze whether there is a correlation between cognitive impairment and changes in DC values in complex brain networks.Further use Support Vector Machine(SVM)for classification.Methods:1.This study included 21 patients in the BPD MF group who met the DSM-5diagnostic criteria for bipolar disorder,depressive episodes,and mixed features;22patients in the BPD NOS group;and 43 healthy controls who matched their education level with the patient group.2.The clinical symptoms of the BPD MF and BPD NOS groups were evaluated using the Hamilton Depression Rating Scale(HAMD,24 question version),Hamilton Anxiety Rating Scale(HAMA,14 question version),and Young Mania Rating Scale(YMRS).The cognitive function of the BPD MF group,BPD NOS group,and HC group was evaluated using the MATRICS Consensus Cognitive Battery(MCCB)Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery.3.Perform resting state brain network DC analysis on three groups of participants.DC is an indicator reflecting local features in graph theory analysis methods,indicating the strength of brain network connections between a certain voxel and all voxels in the whole brain,indicating the importance of this voxel as a network node.The higher the DC value,the more important this node is in the brain network,increasing its connectivity with surrounding nodes.The lower the DC value,the less connectivity it has with surrounding nodes.Simultaneously analyze the correlation between DC values and the MCCB scale.4.Use SVM method to extract differential brain regions.Results:1.The analysis of clinical data showed that there were significant differences(P<0.05)among the three groups in terms of education years(11.38 ± 2.50,10.86 ±3.09,12.19 ± 1.74)and the total YMRS score(12.29 ± 2.15,6.81 ± 3.46)between the two groups.There was no statistically significant difference(P>0.05)in terms of gender,age,HAMA-14 total score,and HAMD-24 total score.2.Compared with the healthy control group,the BPD-MF group performed worse in the fields of cognitive functions such as information processing speed(BACS),word learning(HVLTR),working memory(WMS-III),reasoning and problem solving(NAB),and visual learning(BVMT),and the difference was statistically significant;The BPD-NOS group performed poorly in cognitive functional areas such as information processing speed(BACS),word learning(HVLTR),inference and problem solving(NAB),and visual learning(BVMT).This study did not find any statistically significant differences in cognitive function between the BPD-MF group and the BPD-NOS group.Further exploratory analysis found that,compared with the healthy control group,all patients with bipolar depression(BPD)performed worse in the fields of cognitive functions such as information processing speed(BACS,Fluency),attentiveness(CPTIP),working memory(WMS-III),word learning(HVLTR),reasoning and problem solving(NAB),visual learning(BVMT),and the difference was statistically significant(p<0.05).3.Analysis of variance did not observe any differences in brain regions among the three groups.Further exploratory analysis found that compared with the healthy control group,the BPD group had an increase in DC values in the right anterior cingulate gyrus,while the DC values in the left cerebellar region 6,right cerebellar region 6,left putamen,and right putamen decreased(P<0.05).4.Correlation analysis did not find a correlation between cognitive impairment in the BPD group and DC values in different brain regions.(P>0.05)。5.SVM distinguished BPD and found a decrease in DC in the left cerebellar region 6,with the highest diagnostic accuracy of 77.907%;Reduced DC in right cerebellar region 6,with a diagnostic accuracy of 75.5814%;The right putamen DC decreased,with a diagnostic accuracy of 66.2791%;Decreased DC in the left putamen nucleus;The diagnostic accuracy was 61.6279%;The right anterior cingulate gyrus DC increased,with a diagnostic accuracy of 75.5814%(P<0.01).Conclusion:1.Patients with bipolar depression and mixed features,as well as those without mixed features,have extensive cognitive impairment and exhibit similar cognitive patterns.2.The decrease in DC value in the left cerebellar region 6 can distinguish patients with bipolar depression from healthy controls and serve as a potential neuroimaging biomarker.