Hippocampal volumes in bipolar disorders: opposing effects of illness burden and lithium treatment
Hippocampal volumes in bipolar disorders: opposing effects of illness burden and lithium treatment
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DOI：
10.1111/j.1399-5618.2012.01013.x
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发表时间：
2012-05-01
影响因子：
5.4
通讯作者：
Alda, Martin
中科院分区：
文献类型：
--
作者：
Hajek, Tomas;Cullis, Jeffrey;Alda, Martin
Hajek T，Cullis J，Novak T，Kopecek M，Hoschl C，布拉格登R，ODonovan C，Bauer M，Young L T，MacQueen G，Alda M.双相情感障碍的海马体积：疾病负担和锂治疗的相反作用。?双相情感障碍2012：14：261270。(C)2012作者Journal compilation（C）2012 John Wiley & Sons A/S.目的：与疾病负担相关的海马体积减少是单相抑郁症最常见的表现之一。在大多数双相情感障碍（BD）患者的研究中，海马体积没有变化，这可能反映了锂（Li）的神经保护作用。研究方法：我们从专门的Li诊所招募了17名BD患者，至少有两年的定期监测Li治疗（Li组），并将他们与12名BD参与者进行比较，这些参与者在扫描前两年内终身Li暴露< 3个月且未接受Li治疗（非Li组）和11名健康对照。所有BD患者都有至少10年的疾病和5次发作。我们还招募了13名未接受过Li治疗的年轻BD参与者（15-30岁）和18名性别和年龄匹配的健康对照。我们比较了从1.5 T磁共振成像（MRI）扫描获得的海马体积，使用优化的基于体素的形态测量与小体积校正。结果如下：非Li组的左侧海马体积小于对照组（校正p < 0.05），具有体积小于Li组（校正p < 0.1）的趋势，与对照组没有差异。接近典型发病年龄的年轻、Li初治BD患者的海马体积与对照组相当。结论：然而，与对照组相比，有限的终身锂暴露患者的海马体积显着降低，具有可比的疾病负担，但超过两年的锂治疗，或年轻的锂初治BD患者，显示海马体积与对照组相当。这些结果提供了间接支持的神经保护作用的锂和疾病负担的负面影响，在双相情感障碍海马体积。
Hajek T, Cullis J, Novak T, Kopecek M, Hoschl C, Blagdon R, ODonovan C, Bauer M, Young L T, MacQueen G, Alda M. Hippocampal volumes in bipolar disorders: opposing effects of illness burden and lithium treatment. ?Bipolar Disord 2012: 14: 261270. (C) 2012 The Authors. Journal compilation (C) 2012 John Wiley & Sons A/S. Objective: Hippocampal volume decrease associated with illness burden is among the most replicated findings in unipolar depression. The absence of hippocampal volume changes in most studies of individuals with bipolar disorder (BD) may reflect neuroprotective effects of lithium (Li). Methods: We recruited 17 BD patients from specialized Li clinics, with at least two years of regularly monitored Li treatment (Li group), and compared them to 12 BD participants with < 3 months of lifetime Li exposure and no Li treatment within two years prior to the scanning (non-Li group) and 11 healthy controls. All BD patients had at least 10 years of illness and five episodes. We also recruited 13 Li-naive, young BD participants (15-30 years of age) and 18 sex- and age-matched healthy controls. We compared hippocampal volumes obtained from 1.5-T magnetic resonance imaging (MRI) scans using optimized voxel-based morphometry with small volume correction. Results: The non-Li group had smaller left hippocampal volumes than controls (corrected p < 0.05), with a trend for lower volumes than the Li group (corrected p < 0.1), which did not differ from controls. Young, Li-naive BD patients close to the typical age of onset had comparable hippocampal volumes to controls. Conclusions: Whereas patients with limited lifetime Li exposure had significantly lower hippocampal volumes than controls, patients with comparable illness burden, but with over two years of Li treatment, or young Li-naive BD patients, showed hippocampal volumes comparable to controls. These results provide indirect support for neuroprotective effects of Li and negative effects of illness burden on hippocampal volumes in bipolar disorders.