Résumé
Objective To investigate the prefrontal lobe function in patients with bipolar disorder with impulsive aggressive behavior using magnetic resonance spectroscopy (MRS),so as to explore the possible relationship between impulsive aggressive behavior and prefrontal brain function in patients with bipolar disorder from the perspective in brain function.Methods A total of 24 patients with bipolar disorder (10 cases with impulsive aggressive behavior,and 14 with non-impulsive aggressive behavior) were enrolled in the study.The modified overt aggression behavior scale (MOAS) and the Barratt Impulsiveness Scale 11 (BIS-11) were used to evaluate the included subjects.Magnetic resonance spectroscopy (MRI) scans were performed on the subjects using 3.0T magnetic resonance imaging equipment to analyze quantitatively N-Acetyl-L-aspartic acid/Cr (NAA/Cr),choline/Cr (Cho/Cr),and glutamine and/or glutamic acid/Cr (Glx/ Cr) ratios.Results The left prefrontal NAA/Cr value in patients with bipolar disorder was significantly lower in impulsive aggressive behavior group than that in non-impulsive aggressive behavior group,and the difference was statistically significant (P ＜ 0.05);however,there was no obvious statistical difference in the comparison of the right prefrontal NAA/Cr value,as well as left and right prefrontal values of Cho/Cr and GlX/Cr between impulsive aggressive behavior group and non-impulsive aggressive behavior group.Conclusions The NAA/Cr value is significantly abnormal in the left prefrontal cortex of bipolar disorder patients with impulsive aggressive behavior (P ＜ 0.05),suggesting that there may exist decreased density of neurons in the left side of prefrontal lobe or dysfunction of neurons in bipolar disorder patients with impulsive aggressive behavior.