뇌의 연결성 및 구조 변화가 양극성장애 환자의 특질 공감에 미치는 영향에 대한 다면적 연구 Altered brain connectivity and structures in bipolar disorders and their effect on trait empathy원문보기
공감은 사회적 존재로 진화해온 인간이 인간 사회에서 살아가기 위한 핵심적인 능력이다. 여러 정신장애들은 그 병태생리적에 따른 뇌의 구조적, 기능적 변화를 통해 공감능력의 변화를가져온다. 양극성 장애는 주요 우울삽화 병력을 공유하면서 조증삽화를 수반하는 양극성장애 I 유형과 경조증삽화를 수반하는 양극성장애 II유형으로 구분된다. 특질 공감의 전 영역이 저하되는 것으로 알려진 조현병과는 달리, 양극성 장애가 공감 기제에미치는 영향은 아직 소수의 연구만이 존재한다. 이들 연구는 ...
공감은 사회적 존재로 진화해온 인간이 인간 사회에서 살아가기 위한 핵심적인 능력이다. 여러 정신장애들은 그 병태생리적에 따른 뇌의 구조적, 기능적 변화를 통해 공감능력의 변화를가져온다. 양극성 장애는 주요 우울삽화 병력을 공유하면서 조증삽화를 수반하는 양극성장애 I 유형과 경조증삽화를 수반하는 양극성장애 II유형으로 구분된다. 특질 공감의 전 영역이 저하되는 것으로 알려진 조현병과는 달리, 양극성 장애가 공감 기제에미치는 영향은 아직 소수의 연구만이 존재한다. 이들 연구는 인지적 공감의 저하와 동시에 역설적인 정서적 공감의 증가가 관찰됨을 보고하고 있다. 본 연구는 양극성 장애의 고유한 공감 양상 변화에 기저하는 뇌 기전을 확인하기 위해 가장 널리 쓰이는 특질 공감의 측정 도구인 대인관계 반응척도 점수(IRI)와, 다양한 방법으로 측정된 뇌의 구조적지표들 및 기능적 연결성 지표들 간의 관계를 분석하였다. 본 연구에서는 공감의 지각-운동 모델을 이론적 준거로 삼아, 거울 뉴런 네트워크, 섬엽과 대상피질, 변연계 구조물들, 전전두엽을 포함하는 ROI를 설정하고, 회색질 피질 두께, 백질의 연결성을 반영하는 확산 텐서 지표, 피질하 구조물의 형태, 각 영역의 휴지상태 기능적 연결성을 측정하였다. 양극성 장애 I유형과 II유형은 대조군과의 비교 및, 특질공감과의 상호작용에 있어 서로 다른패턴을 나타내었으며, 특별히 양극성 장애 I 유형에서 거울뉴런-섬엽-변연계 네트워크를 구성하는 구조물들에서 특질공감척도의 관점수용(PT) 및 주관적 고통경험(PD) 과 유의미한 상호작용이 확인된 영역이 양극성장애 I 유형에서 고유하게 발견됨으로써, 특질공감에서 나타난 양극성장애의 독특한 변화 양상이 그 생물학적 기저에 근거함을 확인하였으며, II유형과 구분되는 I유형의 특성임을 발견하였다.
공감은 사회적 존재로 진화해온 인간이 인간 사회에서 살아가기 위한 핵심적인 능력이다. 여러 정신장애들은 그 병태생리적에 따른 뇌의 구조적, 기능적 변화를 통해 공감능력의 변화를가져온다. 양극성 장애는 주요 우울삽화 병력을 공유하면서 조증삽화를 수반하는 양극성장애 I 유형과 경조증삽화를 수반하는 양극성장애 II유형으로 구분된다. 특질 공감의 전 영역이 저하되는 것으로 알려진 조현병과는 달리, 양극성 장애가 공감 기제에미치는 영향은 아직 소수의 연구만이 존재한다. 이들 연구는 인지적 공감의 저하와 동시에 역설적인 정서적 공감의 증가가 관찰됨을 보고하고 있다. 본 연구는 양극성 장애의 고유한 공감 양상 변화에 기저하는 뇌 기전을 확인하기 위해 가장 널리 쓰이는 특질 공감의 측정 도구인 대인관계 반응척도 점수(IRI)와, 다양한 방법으로 측정된 뇌의 구조적지표들 및 기능적 연결성 지표들 간의 관계를 분석하였다. 본 연구에서는 공감의 지각-운동 모델을 이론적 준거로 삼아, 거울 뉴런 네트워크, 섬엽과 대상피질, 변연계 구조물들, 전전두엽을 포함하는 ROI를 설정하고, 회색질 피질 두께, 백질의 연결성을 반영하는 확산 텐서 지표, 피질하 구조물의 형태, 각 영역의 휴지상태 기능적 연결성을 측정하였다. 양극성 장애 I유형과 II유형은 대조군과의 비교 및, 특질공감과의 상호작용에 있어 서로 다른패턴을 나타내었으며, 특별히 양극성 장애 I 유형에서 거울뉴런-섬엽-변연계 네트워크를 구성하는 구조물들에서 특질공감척도의 관점수용(PT) 및 주관적 고통경험(PD) 과 유의미한 상호작용이 확인된 영역이 양극성장애 I 유형에서 고유하게 발견됨으로써, 특질공감에서 나타난 양극성장애의 독특한 변화 양상이 그 생물학적 기저에 근거함을 확인하였으며, II유형과 구분되는 I유형의 특성임을 발견하였다.
Empathic abilities are impaired in many mental disorders. Unlike other mental disorder shows consistent impairment like schizophrenia, bipolar disorder shows characteristic pattern of altered trait empathy-increased emotional empathy and decreased cognitive empathy. Although the pathology of bipolar...
Empathic abilities are impaired in many mental disorders. Unlike other mental disorder shows consistent impairment like schizophrenia, bipolar disorder shows characteristic pattern of altered trait empathy-increased emotional empathy and decreased cognitive empathy. Although the pathology of bipolar disorder thought to involve disrupted white matter integrity, decreased cortical thickness, altered subcortical structure shapes, and abnormal functional connectivity, the relationship between empathic disabilities and altered structure of brain remains unclear. The present study tested associations between empathic disabilities and structural change of the brain in order to investigate the neural basis of impaired empathy in bipolar disorder. Particularly compared propensity-matched samples of bipolar disorder I and bipolar disorder II, since they have significantly different symptoms and neural phenotypes. Empathic abilities were assessed using the Interpersonal Reactivity Index (IRI). Using multimethod neuroimaging approach including cortical thickness analysis, quantitative probabilistic tractography using TRACULA pipeline, SPHARM based shape analysis, and the resting-state functional connectivity, the associations between empathic abilities and various indices of brain structure and functional connectivity. According to the perception-action model of empathy, brain structures consist the network across human mirror neuron system, insula, and limbic system were selected as regions-of-interest (ROIs). Planned pair-wise comparisons between pairs were conducted, and false-discovery rate was controlled before hypothesis testing. The interaction between the indices shown significant difference between the groups and IRI scores were also discussed. The The self-report measurement of trait empathy partially support previous reports. As expected, bipolar disorder I group shown significantly higher IRI-PD score compare to control. However, the difference was not significant between controls and bipolar disorder II group. Only bipolar disorder II group revealed significantly lower score in perspective taking compare to controls.
For cortical thickness, the significantly thinner cortical thickness was observed in bipolar disorder I group, in comparison with controls. The thinner areas were left pSTS and right IFG, the cortex consists human mirror neuron system. The comparison between bipolar disorder II group and bipolar disorder I group revealed consistent thinner graymatter cortex in mirror neuron system, and areas involved in cognitive facets of empathy (VMPFC), and pre-supplementary motor cortex. The results of interaction between IRI score and thickness supports thinner cortices are related to lower trait empathic abilities. Structural connectivity revealed lower FA in several major tracts, especially left inferior longitudinal fasciculus. Also, the interaction revealed, the correlation between axial diffusivity and IRI-PT score in bipolar disorder I group. Shape analysis revealed deformation in bipolar caudate, right putamen, and right thalamus in bipolar disorder I group. Bipolar disorder II group also shown small deformation in right thalamus. Interestingly, the deformation of right nucleus accumbens correlate with IRI-PD score in bipolar disorder I group, and the negative correlation with deformation and IRI-PD score was found in left globus pallidus. There were the trends of difference in functional connectivity between bipolar disorder I and control group, but only when one-side testing is applied. Compare to bipolar disorder II group, control group shown significantly stronger functional connectivity between left insular and both mirror neuron system components and cognitive empathy components. It indicates the inflated function of the network connecting mirror neuron system-insular-and frontal areas in bipolar II patients. Among the pair of control group and both patient groups, the significant negative interaction was observed. Bipolar disorder I group shown negative correlation between IRI-PD score and functional connectivity between left insular and ipsilateral STS, DMPFC. The result indicates possible role of inflated functional connections mediated by left insular, on over-activated personal distress of individuals with bipolar disorder I. In conclusion, these results suggest that, decreased cortical thickness and disrupted connectivity of both functional and structural networks consist the mirror neuron system-insular-limbic or prefrontal system, constitutes a pathology underpinning specific components of empathic disabilities in bipolar disorders, highlighting that different aspects of empathic impairments between two subtypes of bipolar disorders would have distinct neuropathological bases.
Empathic abilities are impaired in many mental disorders. Unlike other mental disorder shows consistent impairment like schizophrenia, bipolar disorder shows characteristic pattern of altered trait empathy-increased emotional empathy and decreased cognitive empathy. Although the pathology of bipolar disorder thought to involve disrupted white matter integrity, decreased cortical thickness, altered subcortical structure shapes, and abnormal functional connectivity, the relationship between empathic disabilities and altered structure of brain remains unclear. The present study tested associations between empathic disabilities and structural change of the brain in order to investigate the neural basis of impaired empathy in bipolar disorder. Particularly compared propensity-matched samples of bipolar disorder I and bipolar disorder II, since they have significantly different symptoms and neural phenotypes. Empathic abilities were assessed using the Interpersonal Reactivity Index (IRI). Using multimethod neuroimaging approach including cortical thickness analysis, quantitative probabilistic tractography using TRACULA pipeline, SPHARM based shape analysis, and the resting-state functional connectivity, the associations between empathic abilities and various indices of brain structure and functional connectivity. According to the perception-action model of empathy, brain structures consist the network across human mirror neuron system, insula, and limbic system were selected as regions-of-interest (ROIs). Planned pair-wise comparisons between pairs were conducted, and false-discovery rate was controlled before hypothesis testing. The interaction between the indices shown significant difference between the groups and IRI scores were also discussed. The The self-report measurement of trait empathy partially support previous reports. As expected, bipolar disorder I group shown significantly higher IRI-PD score compare to control. However, the difference was not significant between controls and bipolar disorder II group. Only bipolar disorder II group revealed significantly lower score in perspective taking compare to controls.
For cortical thickness, the significantly thinner cortical thickness was observed in bipolar disorder I group, in comparison with controls. The thinner areas were left pSTS and right IFG, the cortex consists human mirror neuron system. The comparison between bipolar disorder II group and bipolar disorder I group revealed consistent thinner graymatter cortex in mirror neuron system, and areas involved in cognitive facets of empathy (VMPFC), and pre-supplementary motor cortex. The results of interaction between IRI score and thickness supports thinner cortices are related to lower trait empathic abilities. Structural connectivity revealed lower FA in several major tracts, especially left inferior longitudinal fasciculus. Also, the interaction revealed, the correlation between axial diffusivity and IRI-PT score in bipolar disorder I group. Shape analysis revealed deformation in bipolar caudate, right putamen, and right thalamus in bipolar disorder I group. Bipolar disorder II group also shown small deformation in right thalamus. Interestingly, the deformation of right nucleus accumbens correlate with IRI-PD score in bipolar disorder I group, and the negative correlation with deformation and IRI-PD score was found in left globus pallidus. There were the trends of difference in functional connectivity between bipolar disorder I and control group, but only when one-side testing is applied. Compare to bipolar disorder II group, control group shown significantly stronger functional connectivity between left insular and both mirror neuron system components and cognitive empathy components. It indicates the inflated function of the network connecting mirror neuron system-insular-and frontal areas in bipolar II patients. Among the pair of control group and both patient groups, the significant negative interaction was observed. Bipolar disorder I group shown negative correlation between IRI-PD score and functional connectivity between left insular and ipsilateral STS, DMPFC. The result indicates possible role of inflated functional connections mediated by left insular, on over-activated personal distress of individuals with bipolar disorder I. In conclusion, these results suggest that, decreased cortical thickness and disrupted connectivity of both functional and structural networks consist the mirror neuron system-insular-limbic or prefrontal system, constitutes a pathology underpinning specific components of empathic disabilities in bipolar disorders, highlighting that different aspects of empathic impairments between two subtypes of bipolar disorders would have distinct neuropathological bases.
주제어
#Multimethod Neuroimaging Perception-Action Model Empathy Bipolar Disorder
학위논문 정보
저자
June Kang
학위수여기관
고려대학교 대학원
학위구분
국내박사
학과
의과학과 의생명과학전공
지도교수
함병주,Christian Wallraven
발행연도
2018
총페이지
128 p.
키워드
Multimethod Neuroimaging Perception-Action Model Empathy Bipolar Disorder
※ AI-Helper는 부적절한 답변을 할 수 있습니다.