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研究生： 安娜
Anastazija Popesku
論文名稱： 第一型與第二型雙相情緒障礙症患者在愛荷華賭局作業中的腦部活動差異及其與行為表現、生物指標之關係
DIFFERENCES IN NEURAL ACTIVITY BETWEEN BIPOLAR I AND II PATIENTS DURING IOWA GAMBLING TASK AND THEIR RELATIONSHIP TO TASK PERFORMANCE AND BIOMARKERS
指導教授： 陳德祐
Chen, Der-Yow
學位類別： 碩士
Master
系所名稱： 社會科學院 - 心理學系
Department of Psychology
論文出版年： 2022
畢業學年度： 110
語文別： 英文
論文頁數： 105
外文關鍵詞： bipolar I disorder, bipolar II disorder, fMRI, inflammation, leptin, reward circuit
相關次數： 點閱：122  下載：0 
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    • Literature on differences at the neural as well as behavioral levels between individuals with bipolar I disorder (BDI) and bipolar II disorder (BDII) remains scarce. Aberrant functioning of the reward circuitry in BD, including the effects of inflammation and other metabolic biomarkers on the reward circuitry in general, has been previously reported. The current study aimed to investigate the differences between BDI and BDII patients under different conditions via the employment of the Iowa Gambling Task (IGT), as well as the differential relationship between inflammation, metabolic biomarkers, and task performance on one hand and neural activity on the other hand. The data from 75 participants were analyzed (BDI: n = 15; BDII: n = 28; healthy controls, HC: n = 32). We found no differences in task performance or learning pace across the groups. Functional MRI results indicated a significant cluster in the left anterior cingulate cortex (ACC) that showed heightened activation during gain vs. loss trials, and a significant cluster with increased activity in the right superior frontal gyrus (SFG)/medial frontal gyrus (MedFG) during risky vs. safe trials in BDI compared to BDII. When participants gained vs. lost, in BDI compared to BDII, levels of C-reactive protein (CRP) were negatively correlated with activity in the regions that are part of the reward circuit, default mode network (DMN), and salience network (SN); leptin levels were negatively correlated with the activity in the regions associated with the DMN; HOMA-IR levels were negatively correlated with activity in a small cluster in the bilateral middle frontal gyrus (MFG)/SFG; and NS, for the most part, was negatively correlated with neural activity in the regions associated with the reward circuit, executive network, emotion processing, and SN. When participants played risky vs. safe, BDI compared to BDII, levels of CRP were mostly positively correlated with neural activity in the regions associated with the reward circuit, left ventrolateral prefrontal cortex (vlPFC), dorsolateral prefrontal cortex (dlPFC), and parts of the cerebellum; leptin levels exhibited a negative correlation with the activity in the more temporal and posterior regions; and NS mostly displayed a more negative correlation with neural activity in portions of the executive control network, reward circuit, SN, DMN, and so forth. Our findings suggest BDI patients may be more sensitive to inflammation, metabolic dysregulation, and risk-seeking/risk-aversion (via NS) compared to BDII patients, in terms of how they relate to the reward circuit and risk-taking conditions.

    ABSTRACT II ACKNOWLEDGMENTS IV 1 INTRODUCTION 1 1.1 Bipolar Disorder (BD) 1 1.2 Differences Between Bipolar I and II Disorder 2 1.3 Reward Circuitry in Bipolar Disorder 3 1.4 Inflammation & Reward Circuitry 4 1.5 Leptin & Insulin & Reward Circuitry 4 1.6 Reward Processing & Decision-Making 5 1.7 The Objective of the Present Study 6 2 MATERIALS & METHODS 8 2.1 Participants 8 2.1.1 Exclusion Criteria 9 2.1.2 Consent 9 2.2 Biomarkers Measurement 9 2.2.1 C-Reactive Protein (CRP) Measurement 9 2.2.2 Serum Leptin Measurement 9 2.2.3 Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) 10 2.3 Experimental Design 10 2.3.1 Iowa Gambling Task (IGT) 10 2.3.2 Experimental Paradigm 11 2.3.3 Experimental Conditions 12 2.4 Image Acquisition 13 2.5 Statistical Analyses 13 2.5.1 Demographic Data, Baseline Information, & Biomarker Between-Group Comparisons 13 2.5.2 Behavioral Analysis 14 2.5.2.1 Performance Analysis 14 2.5.2.2 Learning Curve 14 2.5.3 fMRI Analysis 14 2.5.3.1 Image Preprocessing 14 2.5.3.2 Multivariate Modeling 15 2.5.3.3 MVM Group-by-Condition Analysis: BDI – BDII 16 2.5.3.4 MVM Group-by-Condition Cluster-Based Region of Interest (ROI) Analysis 17 2.5.3.5 MVM Models With Covariates: BDI – BDII 17 2.5.3.6 MVM Models With Covariates Cluster-Based ROI Analysis 17 3 RESULTS 19 3.1 Demographic Data, Baseline Information, & Biomarker Between-Group Comparisons 19 3.2 Behavioral Results 24 3.2.1 Performance Analysis 24 3.2.2 Learning Curve 24 3.3 fMRI Results 25 3.3.1 MVM Group-by-Condition Analysis: BDI – BDII 25 3.3.1.1 Gain – Loss 26 3.3.1.2 Risky – Safe 26 3.3.2 MVM Group-by-Condition Cluster-Based ROI Analysis 29 3.3.2.1 Gain – Loss 29 3.3.2.2 Risky – Safe 29 3.3.3 MVM Models With Covariates: BDI – BDII 30 3.3.3.1 CRP: Gain – Loss 31 3.3.3.2 CRP: Risky – Safe 31 3.3.3.3 Leptin: Gain – Loss 38 3.3.3.4 Leptin: Risky – Safe 38 3.3.3.5 HOMA-IR: Gain – Loss 42 3.3.3.6 HOMA-IR: Risky – Safe 42 3.3.3.7 Net Score: Gain – Loss 44 3.3.3.8 Net Score: Risky – Safe 44 49 3.3.4 MVM Models With Covariates Cluster-Based ROI Analysis 50 3.3.4.1 CRP: Gain – Loss 50 3.3.4.2 CRP: Risky – Safe 51 3.3.4.3 Leptin: Gain – Loss 53 3.3.4.4 Leptin: Risky – Safe 54 3.3.4.5 HOMA-IR: Gain – Loss 55 3.3.4.6 Net Score: Gain – Loss 56 3.3.4.7 Net Score: Risky – Safe 58 4 DISCUSSION 61 4.1 Net Score & Learning Curve 61 4.2 MVM Group-by-Condition Analysis: BDI – BDII 61 4.3 MVM Models With Covariates – CRP: BDI – BDII 62 4.4 MVM Models With Covariates – Leptin: BDI – BDII 64 4.5 MVM Models With Covariates – HOMA-IR: BDI – BDII 64 4.6 MVM Models With Covariates – Net Score: BDI – BDII 65 4.7 Limitations 67 4.8 Conclusion 67 A DETAILS OF THE MVM MODELS 69 A1 MVM Group-by-Condition Analysis 70 A1.1 Main Effect of Group 70 A1.2 Main Effect of Condition 72 A1.3 Interaction Effect of Group X Condition 75 A2 MVM Models With Covariates 80 A2.1 Main Effect of CRP 80 A2.2 Interaction Effect of CRP X Group X Condition 82 A2.3 Main Effect of Leptin 85 A2.4 Interaction Effect of Leptin X Group X Condition 89 A2.5 Main Effect of HOMA-IR 93 A2.6 Interaction Effect of HOMA-IR X Group X Condition 95 A2.7 Main Effect of NS 100 A2.8 Interaction Effect of NS X Group X Condition 102 B DEALING WITH OUTLIERS 106 B1 Gain-Loss: Natural Logarithmic Transformation of CRP Levels 107 B2 Gain-Loss: Removing the CRP Outlier 108 LIST OF REFERENCES 109

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