Frontotemporal alterations in pediatric bipolar disorder - Results of a voxel-based morphometry study
Frontotemporal alterations in pediatric bipolar disorder - Results of a voxel-based morphometry study
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DOI：
10.1001/archpsyc.62.7.734
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发表时间：
2005-07-01
影响因子：
--
通讯作者：
Leibenluft, E
中科院分区：
文献类型：
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作者：
Dickstein, DP;Milham, MP;Leibenluft, E
背景：虽然大量磁共振成像 (MRI) 研究评估了成人双相情感障碍 (BPD)，但很少检查 BPD 儿童的 MRI 变化。 目的：使用基于体素的形态测定法确定 BPD 儿童的体积变化，这是一种自动 MRI 分析方法，可降低对各种偏差的敏感性。先验感兴趣区域包括杏仁核、伏隔核、海马、背外侧前额皮质 (DLPFC) 和眶额皮质。设计：正在进行的儿科 BPD 病理生理学研究。设置：国家心理健康研究所校内；经机构审查委员会批准。 患者：患有 BPD 的儿科受试者 (n = 20)，至少有 1 次躁狂或轻躁狂发作，符合严格的 DSM-IV 标准（持续时间和升高、扩张的情绪）。对照组 (n = 20) 及其一级亲属没有精神疾病。各组的年龄和性别相匹配，并且智商没有差异。 主要结果指标：使用 1.5-T MRI 机器，我们收集了 1.2 毫米的轴向切片（每个受试者 124 个），并在稳态序列中采集了轴向 3 维破坏梯度回波。通过优化的基于体素的形态测量进行图像分析。结果：患有 BPD 的受试者左侧 DLPFC 的灰质体积减少。在不太保守的统计阈值下，在左侧伏隔核和左侧杏仁核中发现了额外的灰质减少。海马体或眶额皮质没有发现差异。结论：我们的结果与暗示前额皮质参与情绪调节的数据一致，情绪调节过程在 BPD 中受到干扰。杏仁核和伏核体积的减少与儿科 BPD 的神经心理学数据一致。需要进一步研究来确定 BPD 儿童和成人的这些发现之间的关系。
Context: While numerous magnetic resonance imaging (MRI) studies have evaluated adults with bipolar disorder (BPD), few have examined MRI changes in children with BPD.Objective: To determine volume alterations in children with BPD using voxel-based morphometry, an automated MRI analysis method with reduced susceptibility to various biases. A priori regions of interest included amygdala, accumbens, hippocampus, dorsolateral prefrontal cortex (DLPFC), and orbitofrontal cortex.Design: Ongoing study of the pathophysiology of pediatric BPD.Setting: Intramural National Institute of Mental Health; approved by the institutional review board.Patients: Pediatric subjects with BPD (n = 20) with at least I manic or hypomanic episode meeting strict DSM-IV criteria for duration and elevated, expansive mood. Controls (n = 20) and their first-degree relatives lacked psychiatric disorders. Groups were matched for age and sex and did not differ in IQ.Main Outcome Measures: With a 1.5-T MRI machine, we collected 1.2-mm axial sections (124 per subject) with an axial 3-dimensional spoiled gradient recalled echo in the steady state sequence. Image analysis was by optimized voxel-based morphometry.Results: Subjects with BPD had reduced gray matter volume in the left DLPFC. With a less conservative statistical threshold, additional gray matter reductions were found in the left accumbens and left amygdala. No difference was found in the hippocampus or orbitofrontal cortex.Conclusions: Our results are consistent with data implicating the prefrontal cortex in emotion regulation, a process that is perturbed in BPD. Reductions in amygdala and accumbens volumes are consistent with neuropsychological data on pediatric BPD. Further study is required to determine the relationship between these findings in children and adults with BPD.