Altered brain regional homogeneity, depressive symptoms, and cognitive impairments in medication-free female patients with current depressive episodes in bipolar disorder and major depressive disorder

Abstract Background Although symptoms of depressive episodes in patients with bipolar depressive episodes (BDE) and major depressive disorder (MDD) are similar, the treatment strategies for these disorders are completely different, suggesting that BDE and MDD have different neurobiological backgroun...

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Main Authors: Sulin Ni, Ting Peng, Shuzhan Gao, Chenxi Ling, Fan Wu, Jing Jiang, Jing Sun, Chaoyong Xiao, Xijia Xu
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Psychiatry
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Online Access:https://doi.org/10.1186/s12888-024-06352-4
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author Sulin Ni
Ting Peng
Shuzhan Gao
Chenxi Ling
Fan Wu
Jing Jiang
Jing Sun
Chaoyong Xiao
Xijia Xu
author_facet Sulin Ni
Ting Peng
Shuzhan Gao
Chenxi Ling
Fan Wu
Jing Jiang
Jing Sun
Chaoyong Xiao
Xijia Xu
author_sort Sulin Ni
collection DOAJ
description Abstract Background Although symptoms of depressive episodes in patients with bipolar depressive episodes (BDE) and major depressive disorder (MDD) are similar, the treatment strategies for these disorders are completely different, suggesting that BDE and MDD have different neurobiological backgrounds. In this study, we examined the relationship between brain function and clinical symptoms, particularly cognitive function, in female individuals with bipolar disorder and MDD experiencing depressive episodes. Methods Regional homogeneity (ReHo) was analyzed in 51 medication-free female patients with BDE, 63 medication-free female patients with MDD, and 45 female healthy controls (HCs). Depressive symptom severity was assessed using the 24-item Hamilton Depression Rating Scale (HAMD-24), and multidimensional cognitive function was evaluated using the MATRICS Consensus Cognition Battery. Partial correlation analysis was used to explore the links between the brain regions and clinical characteristics. A support vector machine (SVM) was used to assess the classification accuracy. Results Compared with HCs, patients with BDE and MDD had decreased ReHo in the left lobule VI of the cerebellum and increased ReHo in the left precuneus. Patients with BDE also had reduced ReHo in the left lobules IV–V of the cerebellum and increased ReHo in the right putamen, unlike patients with MDD who had no significant differences in these regions. Patients with BDE exhibited more severe cognitive deficits in processing speed, attention, word learning, and overall cognitive function than those with MDD. In patients with BDE, a significant negative correlation was found between the right putamen and HAMD-24 scores. However, no significant association was observed between abnormal ReHo levels and cognitive function. The SVM effectively differentiated between patients with BDE, MDD, and HCs. Conclusion Cognitive impairment was more severe in female patients with BDE than in those with MDD. Changes in the ReHo values of the right putamen and left lobules IV–V may serve as unique neuroimaging markers for BDE. Alterations in the ReHo values of the left precuneus and left lobule VI could serve as common pathophysiological mechanisms for BDE and MDD in women and indicate depressive states.
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spelling doaj-art-45ff695cc8ae481995ef7ec64140ddc32025-08-20T02:20:38ZengBMCBMC Psychiatry1471-244X2024-12-0124111410.1186/s12888-024-06352-4Altered brain regional homogeneity, depressive symptoms, and cognitive impairments in medication-free female patients with current depressive episodes in bipolar disorder and major depressive disorderSulin Ni0Ting Peng1Shuzhan Gao2Chenxi Ling3Fan Wu4Jing Jiang5Jing Sun6Chaoyong Xiao7Xijia Xu8Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain HospitalDepartment of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain HospitalDepartment of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain HospitalDepartment of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain HospitalDepartment of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain HospitalDepartment of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain HospitalDepartment of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain HospitalDepartment of Radiology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain HospitalDepartment of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain HospitalAbstract Background Although symptoms of depressive episodes in patients with bipolar depressive episodes (BDE) and major depressive disorder (MDD) are similar, the treatment strategies for these disorders are completely different, suggesting that BDE and MDD have different neurobiological backgrounds. In this study, we examined the relationship between brain function and clinical symptoms, particularly cognitive function, in female individuals with bipolar disorder and MDD experiencing depressive episodes. Methods Regional homogeneity (ReHo) was analyzed in 51 medication-free female patients with BDE, 63 medication-free female patients with MDD, and 45 female healthy controls (HCs). Depressive symptom severity was assessed using the 24-item Hamilton Depression Rating Scale (HAMD-24), and multidimensional cognitive function was evaluated using the MATRICS Consensus Cognition Battery. Partial correlation analysis was used to explore the links between the brain regions and clinical characteristics. A support vector machine (SVM) was used to assess the classification accuracy. Results Compared with HCs, patients with BDE and MDD had decreased ReHo in the left lobule VI of the cerebellum and increased ReHo in the left precuneus. Patients with BDE also had reduced ReHo in the left lobules IV–V of the cerebellum and increased ReHo in the right putamen, unlike patients with MDD who had no significant differences in these regions. Patients with BDE exhibited more severe cognitive deficits in processing speed, attention, word learning, and overall cognitive function than those with MDD. In patients with BDE, a significant negative correlation was found between the right putamen and HAMD-24 scores. However, no significant association was observed between abnormal ReHo levels and cognitive function. The SVM effectively differentiated between patients with BDE, MDD, and HCs. Conclusion Cognitive impairment was more severe in female patients with BDE than in those with MDD. Changes in the ReHo values of the right putamen and left lobules IV–V may serve as unique neuroimaging markers for BDE. Alterations in the ReHo values of the left precuneus and left lobule VI could serve as common pathophysiological mechanisms for BDE and MDD in women and indicate depressive states.https://doi.org/10.1186/s12888-024-06352-4Bipolar disorderMajor depressive disorderDepressive episodesCognitive dysfunctionRegional homogeneitySupport vector machine
spellingShingle Sulin Ni
Ting Peng
Shuzhan Gao
Chenxi Ling
Fan Wu
Jing Jiang
Jing Sun
Chaoyong Xiao
Xijia Xu
Altered brain regional homogeneity, depressive symptoms, and cognitive impairments in medication-free female patients with current depressive episodes in bipolar disorder and major depressive disorder
BMC Psychiatry
Bipolar disorder
Major depressive disorder
Depressive episodes
Cognitive dysfunction
Regional homogeneity
Support vector machine
title Altered brain regional homogeneity, depressive symptoms, and cognitive impairments in medication-free female patients with current depressive episodes in bipolar disorder and major depressive disorder
title_full Altered brain regional homogeneity, depressive symptoms, and cognitive impairments in medication-free female patients with current depressive episodes in bipolar disorder and major depressive disorder
title_fullStr Altered brain regional homogeneity, depressive symptoms, and cognitive impairments in medication-free female patients with current depressive episodes in bipolar disorder and major depressive disorder
title_full_unstemmed Altered brain regional homogeneity, depressive symptoms, and cognitive impairments in medication-free female patients with current depressive episodes in bipolar disorder and major depressive disorder
title_short Altered brain regional homogeneity, depressive symptoms, and cognitive impairments in medication-free female patients with current depressive episodes in bipolar disorder and major depressive disorder
title_sort altered brain regional homogeneity depressive symptoms and cognitive impairments in medication free female patients with current depressive episodes in bipolar disorder and major depressive disorder
topic Bipolar disorder
Major depressive disorder
Depressive episodes
Cognitive dysfunction
Regional homogeneity
Support vector machine
url https://doi.org/10.1186/s12888-024-06352-4
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