Reduced amygdalar gray matter volume in familial pediatric bipolar disorder
Reduced amygdalar gray matter volume in familial pediatric bipolar disorder
复制标题
DOI：
10.1097/01.chi.0000159948.75136.0d
复制
发表时间：
2005-06-01
影响因子：
13.3
通讯作者：
Reiss, A
中科院分区：
文献类型：
--
作者：
Chang, K;Karchemskiy, A;Reiss, A
目的：皮质下边缘结构被认为参与成人和儿童双相情感障碍（BD）的病理生理学。我们试图研究与健康对照组相比，这些结构的形态特征在儿科受试者与家族性BD。方法：20名BD I儿童和青少年（平均年龄= 14.6岁，4名女性）和20名健康年龄，性别和10名匹配的对照组接受了3 T的高分辨率磁共振成像。患者大多情绪正常，大多数正在服用药物。杏仁核、海马、丘脑和尾状核的体积由对诊断不知情的研究人员手工描记确定。进行协方差分析，总脑体积，年龄和性别作为协变量。结果：BD患者海马、尾状核和丘脑的体积与对照组无差异。BD患者的左右杏仁核体积较小，这是由灰质体积减少引起的。探索性分析显示，既往暴露于锂或丙戊酸盐的BD受试者的杏仁核灰质体积往往大于未暴露于锂或丙戊酸盐的BD受试者。结论：早发性BD儿童和青少年可能有杏仁核体积减少，与该人群的其他研究一致。长期药物暴露于锂或丙戊酸盐可能是BD成人患者杏仁核体积相对于对照组增加的原因。
Objective: Subcortical limbic structures have been proposed to be involved in the pathophysiology of adult and pediatric bipolar disorder (BD). We sought to study morphometric characteristics of these structures in pediatric subjects with familial BD compared with healthy controls. Method: Twenty children and adolescents with BD I (mean age = 14.6 years, four females) and 20 healthy age, gender, and 10-matched controls underwent high-resolution magnetic resonance imaging at 3 T. Patients were mostly euthymic and most were taking medications. Amygdala, hippocampus, thalamus, and caudate volumes were determined by manual tracings from researchers blinded to diagnosis. Analyses of covariance were performed, with total brain volume, age, and gender as covariates. Results: No differences were found in the volumes of hippocampus, caudate, and thalamus between subjects with BD and controls. Subjects with BD had smaller volumes in the left and right amygdala, driven by reductions in gray matter volume. Exploratory analyses revealed that subjects with BD with past lithium or valproate exposure tended to have greater amygdalar gray matter volume than subjects with BD without such exposure. Conclusions: Children and adolescents with early-onset BD may have reduced amygdalar volumes, consistent with other studies in this population. Prolonged medication exposure to lithium or valproate may account for findings in adults with BD of increased amygdalar volume relative to controls.