ABSTRACT
BACKGROUND: Bipolar disorder (BD) is a serious mental illness. Several studies have shown that brain structure and function changes and the development of BD are associated with age and sex differences. Therefore, we hypothesized that the functional and structural neural circuitry of BD patients would differ according to age. The amygdala and prefrontal cortex (PFC) are play a key role in the emotional and cognitive processing of patients with BD. In this study, we used magnetic resonance imaging (MRI) to examine the structural and functional connectivity within amygdala-PFC neural circuitry in women with BD at different ages. METHODS: Forty-nine female patients with BD who were aged 13-25 years and 60 age-matched healthy control (HC) individuals, as well as 43 female patients with BD who were aged 26-45 years and 60 age-matched HC individuals underwent resting-state functional MRI (rs-fMRI) and diffusion tensor imaging to examine the structural and functional connectivity within the amygdala-PFC neural circuitry. RESULTS: We found abnormalities in the amygdala-PFC functional connectivity in patients aged 13-25 years and significantly different fractional anisotropy (FA) values in patients aged 26-45 compared with the age-matched HCs. The significance of these findings was indicated by corrected p values of less than 0.05 (uncorrected p values less than 0.001). CONCLUSIONS: The findings in this cross-sectional study suggested that abnormalities in the functional connectivity of the amygdala-PFC neural circuitry are related to the pathophysiology of BD in women aged 13-25 years, while changes in the structural integrity of this neural circuitry are associated with the pathophysiology of BD in women aged 26-45 years. Therefore, functional and structural brain alterations may occur at different ages in female patients with BD.
Subject(s)
Amygdala , Bipolar Disorder , Connectome/methods , Prefrontal Cortex , Adolescent , Adult , Amygdala/diagnostic imaging , Amygdala/physiopathology , Bipolar Disorder/pathology , Bipolar Disorder/physiopathology , Bipolar Disorder/psychology , Case-Control Studies , Cross-Sectional Studies , Diffusion Tensor Imaging/methods , Female , Humans , Magnetic Resonance Imaging/methods , Middle Aged , Prefrontal Cortex/diagnostic imaging , Prefrontal Cortex/physiopathologyABSTRACT
BACKGROUND: Post partum depression (PPD) is relatively common in China but its clinical characteristics and risk factors have not been studied. We set out to investigate whether known risk factors for PPD could be found in Chinese women. METHODS: A case control design was used to determine the impact of known risk factors for PPD in a cohort of 1970 Chinese women with recurrent DSM-IV major depressive disorder (MDD). In a within-case design we examined the risk factors for PPD in patients with recurrent MDD. We compared the clinical features of MDD in cases with PPD to those without MDD. Odds ratios were calculated using logistic and ordinal regression. RESULTS: Lower occupational and educational statuses increased the risk of PPD, as did a history of pre-menstrual symptoms, stressful life events and elevated levels of the personality trait of neuroticism. Patients with PPD and MDD were more likely to experience a comorbid anxiety disorder, had a younger age of onset of MDD, have higher levels of neuroticism and dysthymia. LIMITATIONS: Results obtained in this clinical sample may not be applicable to PPD within the community. Data were obtained retrospectively and we do not know whether the correlations we observe have the same causes as those operating in other populations. CONCLUSIONS: Our results are consistent with the hypothesis that the despite cultural differences between Chinese and Western women, the phenomenology and risk factors for PPD are very similar.
