摘要目的:探究双相抑郁发作(bipolar depression，BD)患者进行情绪识别时的脑功能连接和脑网络作用机制，并评估脑功能指标与临床症状的相关性。方法:2023年8月至2024年9月，招募34例BD患者和35例健康对照。采用17项汉密尔顿抑郁量表(17-item Hamilton depression scale，HAMD-17)和汉密尔顿焦虑量表(Hamilton anxiety scale，HAMA)分别评估患者的焦虑、抑郁症状。在所有被试进行情绪识别任务的同时，使用52通道功能近红外光谱技术(functional near-infrared spectroscopy，fNIRS)采集被试背外侧前额叶区(dorsolateral prefrontal cortex，DLPFC)、内侧前额叶(medial prefrontal cortex，mPFC)、颞叶(temporal lobe，TL)的氧合血红蛋白浓度变化数据。被试完成情绪识别任务后，根据fNIRS算法理论，计算各脑区功能连接值(brain functional connectivity，BFC)、脑功能网络(brain functional network，BFN)参数等脑功能指标。采用SPSS 26.0软件对数据进行 t检验、Wilcoxon秩和检验、 χ2检验、Pearson相关分析和多元线性回归分析。 结果:BD患者的情绪识别准确率[(69.40±18.32)%]低于健康对照组[(76.94±6.09)%]( t＝－2.13， P＝0.036)，平均思考时间[(4.00±1.78)s]高于健康对照[(2.69±1.27)s] ( t＝－2.81， P＝0.007)。BD患者右DLPFC-右mPFC、右DLPFC-左TL、右DLPFC-左mPFC、右TL-右mPFC、右TL-左TL、右TL-左mPFC、右mPFC-左DLPFC、右mPFC-左mPFC的BFC值均低于健康对照组(均 P<0.05)；BD患者的聚类系数、小世界系数均低于健康对照(均 P<0.05)。BD患者特征路径长度高于健康对照( t＝1.27， P<0.05)。BD患者的HAMD-17总分与聚类系数、小世界系数、右DLPFC-左mpFC和右mPFC-左DLPFC的BFC值呈负相关( r＝－0.45～－0.27，均 P<0.05)，HAMA总分与右DLPFC-左mPFC的BFC值呈正相关( r＝0.30， P<0.05)。多元线性回归分析结果表明，聚类系数( β＝－0.12， t＝－0.69， P＝0.009)、小世界系数( β＝－0.22， t＝－1.05， P＝0.013)和右DLPFC-左mPFC的BFC值( β＝－0.47， t＝－2.29， P＝0.030)和右mPFC-左DLPFC的BFC值( β＝－0.20， t＝－0.90， P＝0.010)均为BD患者抑郁症状的影响因素；右DLPFC-左mPFC的BFC值( β＝0.37， t＝2.36， P＝0.026)为BD患者焦虑症状的影响因素。 结论:BD患者情绪识别时，DLPFC、mPFC、TL 3个脑区的一些BFC值和BFN参数存在异常，且与BD患者的临床症状相关。这些异常可能与BD患者的情绪识别缺陷有关，该结果有助于为BD患者临床干预方案的制定提供理论指导。

abstractsObjective:To investigate the brain functional connectivity and network of patients with bipolar depression (BD) during emotion recognition, and to assess the correlation of brain functional indicators with clinical data.Methods:From August 2023 to September 2024, a total of 34 BD patients and 35 healthy controls were recruited for the study. The 17-item Hamilton depression scale(HAMD-17) and the Hamilton anxiety scale (HAMA) were used to assess the depression and anxiety symptoms of BD patients. While all the participants performed the emotion recognition task, a functional near-infrared spectroscopy (fNIRS) with 52 channels was utilized to collect their oxyhemoglobin concentrations in dorsolateral prefrontal cortex (DLPFC), medial prefrontal cortex (mPFC), and temporal lobe (TL). Brain functional indicators, including brain functional connectivity(BFC) and brain functional network (BFN) parameters, were extracted using fNIRS analysis algorithms. SPSS 26.0 software was used to perform t-test, Wilcoxon rank sum test, chi-square test, Pearson correlation and multiple linear regression analysis. Results:The emotion recognition accuracy of BD patients ((69.40±18.32) %) was lower than that of healthy controls ((76.94±6.09)%)( t=-2.13, P=0.036), and the average spending time ((4.00±1.78) s) of BD patients was longer than that of healthy controls ((2.69±1.27) s) ( t=-2.81, P=0.007). The BFC values of right DLPFC-right mPFC, right DLPFC-left TL, right DLPFC-left mPFC, right TL-right mPFC, right TL-left TL, right TL-left mPFC, right mPFC-left DLPFC, and right mPFC-left mPFC, the clustering coefficient, and small-world coefficient of BD patients were lower than those of healthy controls (all P<0.05).The characteristic path length of BD patients was higher than that of healthy controls ( t=1.27, P<0.05). For BD patients, the total score of HAMD-17 were significantly and negatively correlated with the clustering coefficient, small-world coefficients, and BFC values of right DLPFC-left mPFC and right mPFC-left DLPFC ( r=-0.45--0.27, all P<0.05).The total score of HAMA was significantly and positively correlated with the BFC value of right DLPFC-left mPFC ( r=0.30, P<0.05). The results of multiple linear regression analysis showed that the clustering coefficient ( β=-0.12, t=-0.69, P=0.009), small-world coefficients ( β=-0.22, t=-1.05, P=0.013), and BFC values of right DLPFC-left mPFC ( β=-0.47, t=-2.29, P=0.030) and right mPFC-left DLPFC( β=-0.20, t=-0.90, P=0.010) were influencing factors of depressive symptoms in BD patients. The BFC value of right DLPFC -left mPFC ( β=0.37, t=2.36, P=0.026) was influencing factor for anxiety symptoms in BD patients. Conclusions:There are abnormalities in some BFC values and BFN parameters in the DLPFC, mPFC, and TL brain regions during the emotional recognition task, which are related to the clinical symptoms. The abnormalities may be associated with the emotional recognition deficits in BD patients. These findings may provide theoretical guidance for the development of clinical intervention strategies for BD patients.