双相障碍患者的多巴胺转运受体基因多态性和静息态功能磁共振成像与脑奖赏环路的相关性研究

发布时间：2018-05-22 07:12

本文选题：双相情感障碍 + 受体　；参考：《中国全科医学》2017年12期

【摘要】：背景随着当代医疗技术水平的大幅提高,静息态功能磁共振成像(rs-fMRI)技术已经广泛应用于双相障碍(BD)的临床研究。目的探讨BD患者血清多巴胺转运受体(DAT)基因40 bp VNTR位点多态性和rs-fMRI与脑奖赏环路的相关性。方法收集2014年7月-2015年7月在浙江大学医学院附属邵逸夫医院住院,年龄在20~50岁之间、性别不限、右利手、符合纳入、排除标准并签署知情同意书的BD患者90例,根据患者疾病分期分为BD躁狂相组(A组)32例、BD抑郁相组(B组)31例、BD缓解期组(C组)27例,另选取同期本院体检健康者30例为健康对照组(D组)。3组患者行功能磁共振成像(fMRI),然后使用NIH开发的脑功能数据处理平台分析rs-fMRI,针对不同的神经特征探讨局部一致性(ReHo)增强和减弱的区域;应用聚合酶链式反应-限制性片段长度多态性(PCR-RFLP)技术测定4组外周血DAT基因40 bp VNTR位点的多态性,分析该位点的多态性和rs-fMRI与脑奖赏环路的相关性。结果 A组患者rs-fMRI的ReHo显著增强的区域主要在腹侧纹状体、右侧前扣带回等,ReHc显著减弱的区域包括双侧楔前叶等;B组患者的ReHo显著增强的区域在右侧岛叶皮质、左额中回、左楔前叶等,而ReHo显著减弱的区域在小脑右前叶、右中央前回等;C组患者ReHo显著增强的区域主要在腹侧纹状体、右侧前扣带回、双侧海马,ReHo明显减弱的区域是脑桥、左中央后回、左额下回和右扣带回。4组受试者DAT基因40 bp VNTR位点的基因型频率总体分布比较,差异无统计学意义(P0.10);4组的杂合度分布比较,差异无统计学意义(P0.10)。结论 BD与脑奖赏环路相关脑区的相关作用异常有关,但是二者的分子机制有待进一步的研究和探索。
[Abstract]:Background with the development of modern medical technology, resting functional magnetic resonance imaging (fMRI) has been widely used in the clinical study of bipolar disorder (BDD). Objective to investigate the relationship between the 40 BP VNTR polymorphism of dopamine transporter receptor (DATR) gene and the brain reward loop in BD patients. Methods from July 2014 to July 2015, 90 BD patients, aged between 20 and 50 years, who were hospitalized in the affiliated run Shaw Hospital of Zhejiang University Medical College, with unlimited sex, right-handedness, inclusion, exclusion criteria and informed consent, were collected. According to the stage of the disease, the patients were divided into two groups: group A (n = 32), group B (n = 31), group C (n = 27), and group C (n = 27). Another 30 healthy subjects were selected as the control group. Group D and group D were treated with functional magnetic resonance imaging (fMRI). Then the rs-fMRIs were analyzed by using the brain function data processing platform developed by NIH, and the local consistency was discussed according to different neural characteristics. The area of ReHo-enhanced and weakened; Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique was used to detect the polymorphism of the 40bp VNTR locus of DAT gene in peripheral blood of four groups. The relationship between the polymorphism of the locus and the brain reward loop was analyzed. Results in group A, the area of significantly enhanced ReHo of rs-fMRI was mainly in ventral striatum, and the area of significant decrease of ReHo in right anterior cingulate gyrus and isometric ReHc in group B was significantly increased in right insular cortex and left middle frontal gyrus. In the right anterior lobe of cerebellum and right precentral gyrus in group C, the areas of ReHo enhancement were mainly in ventral striatum, right anterior cingulate gyrus, bilateral hippocampal lamina, and pons. The genotype frequencies of 40 BP VNTR locus of DAT gene in the 4 groups of left posterior frontal gyrus, left inferior frontal gyrus and right cingulate gyrus were compared. There was no significant difference in heterozygosity distribution among the 4 groups (P 0.10, P 0.10). Conclusion BD is related to the abnormal function of brain reward loop, but the molecular mechanism of BD and BD need to be further studied and explored.
【作者单位】：浙江省衢州市人民医院放射科;浙江大学医学院附属邵逸夫医院精神卫生科;
【基金】：国家自然科学基金资助项目(81371490)
【分类号】：R749.4

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