摘要
目的:探讨外周血犬尿氨酸通路(KP)代谢和眶额皮层(OFC)微观结构改变的相关性,及其与双相障碍(BD)患者自杀行为(SB)的关系。方法:纳入门诊招募的66名伴SB的BD患者和29名不伴SB的BD患者,以及社区招募的30名健康对照(HC),检测外周血KP代谢物水平,并提取OFC浅层白质微观结构指标(包括各向异性分数、平均扩散率、轴向扩散率、细胞内体积分数、方向分散度和各向同性体积分数),分析两者与自杀严重程度的关联。结果:伴SB的BD患者的外周血犬尿喹啉酸、吡啶甲酸和犬尿喹啉酸/犬尿氨酸均显著低于不伴SB的BD患者和HC,右外侧OFC浅层白质方向分散度显著低于不伴SB的BD患者(P<0.05)。在BD患者组中,外周血KP代谢与右外侧OFC浅层白质方向分散度改变存在显著相关,且两者均与自杀严重程度呈显著负相关(P<0.05)。结论:伴SB的BD患者外周血KP代谢失调,且右外侧OFC浅层白质存在微观结构异常;外周血KP代谢与右外侧OFC浅层白质微观结构改变有关,两者可能参与了BD患者自杀行为的发生。
Objective:To investigate the associations among peripheral blood kynurenine pathway(KP)me-tabolism,orbitofrontal cortex(OFC)microstructure,and suicidal behavior(SB)in patients with bipo-lar disorder(BD).Methods:A total of 66 patients with BD and SB,29 patients with BD and without SB from the outpatient clinic,and 30 healthy controls(HC)from the community were recruited.The levels of peripheral blood of KP metabolites were measured,and superficial white matter microstruc-tural indicators of the OFC(including fractional anisotropy,mean diffusivity,axial diffusivity,intra-cellular volume fraction,orientation dispersion,and isotropic volume fraction)were extracted.The associations between these factors and the severity of suicidal behavior were analyzed.Results:Pe-ripheral blood levels of kynurenic acid,picolinic acid,and kynurenic acid/kynurenine in patients with BD and SB were significantly lower than those in patients with BD and without SB and HC.The ori-entation dispersion of the superficial white matter in the right lateral OFC was significantly lower in pa-tients with BD and SB compared to those without SB(P<0.05).Within the patient with BD group,significant correlations were observed between peripheral blood KP metabolism and the orientation dis-persion of the superficial white matter in the right lateral OFC.Both showed significant negative corre-lations with the severity of suicidal behavior(P<0.05).Conclusion:Patients with BD and SB exhib-ited dysregulation in peripheral blood KP metabolism and microstructural abnormalities in the superfi-cial white matter of the right lateral OFC.Peripheral blood KP metabolism was associated with micro-structural changes in the superficial white matter of the right lateral OFC,and both might contribute to the occurrence of suicidal behavior in patients with BD.
作者
孙晨寅
张慧凤
赵冬梅
刘虹烨
殷铭
吴百川
陈嘉烨
彭代辉
SUN Chenyin;ZHANG Huifeng;ZHAO Dongmei;LIU Hongye;YIN Ming;WU Baichuan;CHEN Jiaye;PENG Daihui(Division of Mood Disorders,Shanghai Jiao Tong University School of Medicine Affiliated Mental Health Center,Shanghai 200030,China;Clinical DivisionⅡ,Affiliated Mental Health Center of East China Normal University,Shanghai 200335,China;Psychiatric Center,Tongji University Affiliated Tongji Hospital,Shanghai 200065,China;Division of Psychiatry,Suzhou Guangji Hospital,Suzhou 215137,Jiangsu,China)
出处
《武汉大学学报(医学版)》
2026年第1期58-64,共7页
Medical Journal of Wuhan University
基金
科技创新2030-“脑科学与类脑研究”重大项目(编号:2021ZD0200600)
上海市科学技术委员会(编号:YDZX20213100001003)
上海市青年科技启明星计划(扬帆专项)(编号:22YF1439100)。
关键词
双相障碍
自杀行为
犬尿氨酸通路
弥散张量成像
神经突起
眶额皮层
Bipolar Disorder
Suicidal Behavior
Kynurenine Pathway
Diffusion Tensor Imaging
Neurite
Orbitofrontal Cortex
