bekhterevОбозрение психиатрии и медицинской психологии имени В.М.БехтереваV.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY2313-70532713-055XV. M. BEKHTEREV NATIONAL RESEARCH MEDICAL CENTER FOR PSYCHIATRY AND NEUROLOGY OF THE RUSSIAN FEDERATION MINISTRY OF HEALTH10.31363/2313-7053-2023-800bekhterev-846Research ArticleНАУЧНЫЕ ОБЗОРЫSCIENTIFIC REVIEWФункциональная магнитно-резонансная томография покоя при биполярном аффективном расстройстве. Систематизированный обзорResting-state functional magnetic resonance imaging in bipolar affective disorder. A systematized umbrella reviewhttps://orcid.org/0000-0002-6242-1279МаркинК. В.MarkinK. V.

Маркин Кирилл Валерьевич - слушатель ординатуры кафедры психиатрии

194044, г. Санкт-Петербург, ул. Академика Лебедева 6

Kirill V. Markin 

Saint Petersburg

vmeda.work@ya.ruВоенно-медицинская академия им. С.М. КироваРоссияS.M. Kirov Military Medical AcademyRussian Federation2023190720235731529Copyright © Маркин К.В., 20232023Маркин К.В.Markin K.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.bekhterevreview.com/jour/article/view/846

Сложности диагностики биполярного аффективного расстройства (БАР) обуславливают необходимость поиска его возможных маркеров. Функциональная магнитно-резонансная томография покоя (фМРТп) представляет собой перспективный неинвазивный метод, позволяющий уточнить патофизиологические характеристики психических и неврологических заболеваний in vivo. Объем накопленных в мировом научном сообществе данных об изменениях спонтанной активности и функциональной коннективности (ФК) областей головного мозга при БАР требует качественного синтеза для определения спектра нарушений. Проведен систематизированный обзор обзоров с целью обобщения изменений, характерных для пациентов с БАР по данным фМРТп. Качественный синтез результатов 9 систематических обзоров и 6 мета-анализов позволил определить изменения спонтанной активности и ФК наиболее характерные для БАР, подтверждая единство функциональных нарушений у пациентов с данным расстройством. При этом, маниакальное состояние чаще всего ассоциировано с повышением активности миндалевидного тела и снижением его ФК с лобным отделом, снижением активности поясной коры и повышением её ФК с полосатым телом. Для депрессивной фазы наиболее характерны нарушения ФК внутри сети пассивного режима работы мозга, преимущественно связанные с задней поясной корой. Функциональные изменения при эутимии могут отражать остаточные проявления одной из экзацербационных фаз или могут быть связаны с наличием в анамнезе психотического эпизода. Кроме того, впервые в России проведен сравнительный анализ возможных методов количественного синтеза данных фМРТп.

Bipolar affective disorder (BD) is a complex mental illness that presents diagnostic challenges due to its heterogeneous nature. As a result, identifying potential markers for the disorder is crucial for effective diagnosis and treatment. Resting-state functional magnetic resonance imaging (rs-fMRI) is a promising non-invasive technique that provides a window into the pathophysiological characteristics of psychiatric and neurological diseases in vivo. The amount of data accumulated in the scientific community regarding changes in spontaneous activity and functional connectivity of brain regions in BD necessitates a comprehensive synthesis to determine the spectrum of disorders. Accordingly, a systematic review of reviews was conducted to summarize the changes characteristic of patients with BD as measured by fMRI. Qualitative synthesis of results of nine systematic reviews and six meta-analyses has allowed the definition of changes in spontaneous activity and functional connectivity most characteristic for BD, confirming the unity of functional disturbances of this nosological unit. The findings of the review indicate that the manic state in BD is often associated with increased activity of the amygdala and decreased functional connectivity between the amygdala and frontal regions. Conversely, the depressive phase is characterized by abnormalities of functional connectivity within the default mode network, particularly in relation to the posterior cingulate cortex. Changes in functional connectivity during periods of euthymia may reflect residual manifestations of one of the exacerbation phases or may be associated with a history of a psychotic episode. Furthermore, a comparative analysis of possible methods of quantitative fMRI data synthesis has been conducted for the first time in Russia, which is a valuable contribution to the field.

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The authors declare that there are no conflicts of interest present.