A study of bipolar disorder using magnetization transfer imaging and voxel-based morphometry
A study of bipolar disorder using magnetization transfer imaging and voxel-based morphometry
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DOI：
10.1093/brain/awh274
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发表时间：
2004-11-01
期刊：
影响因子：
14.5
通讯作者：
Ron, MA
中科院分区：
文献类型：
--
作者：
Bruno, SD;Barker, GJ;Ron, MA
双相情感障碍 (BP) 传统上被认为是一种复发性疾病，每次发作之间可完全恢复，并且通常认为不存在神经病理学异常。近年来，人们认识到，许多 BP 的预后较差，认知缺陷往往是持续存在的，并且现代成像技术可以检测到结构性脑异常，这促使人们寻找其神经病理学基础。尸检研究的缺点使得使用对神经病理变化敏感的成像技术引人注目。我们在这里报告了第一项联合使用两种此类技术的 BP 患者研究：磁化转移成像 (MTI) 和基于体素的形态测量 (VBM)。对 39 名 BP 患者（13 名男性和 26 名女性；28 名 BPI 患者和 11 名 BPII 患者）和 35 名健康对照者进行了调查。所有受试者均获得高分辨率体积 T1 加权图像和 MT 图像。使用统计参数映射 2 (SPM2) 中的逐体素分析处理图像。与对照组相比，双相情感障碍患者右膝下前扣带回和邻近白质的磁化传递比 MTR（指示大分子密度损失的指标）降低。 VBM 没有显示 BP 患者和对照组之间灰质和白质的显着体积差异，但包含额纹状体连接的前额叶区域双侧白质密度显着降低。我们的研究结果表明，在没有明显体积变化的情况下，BP 患者的前扣带回和回下白质存在细微的异常。这些发现与之前报道的神经病理学研究一致，并说明了与我们之前使用相同方法对精神分裂症患者进行的研究的重要相似之处（前扣带回的参与）和差异（血压中缺乏广泛的皮质异常）。
Bipolar disorder (BP) traditionally has been considered as a recurrent illness with full recovery between episodes, and the absence of neuropathological abnormalities has usually been taken for granted. In recent times, the realization that, for many BP carries a poor prognosis, that cognitive deficits are often persistent and that structural brain abnormalities are detectable with modern imaging techniques has spurred the search for its neuropathological substrate. The shortcomings of post-mortem studies make the use of imaging techniques sensitive to neuropathological changes compelling. We report here the first study of BP patients using two such techniques in conjunction: magnetization transfer imaging (MTI) and voxel-based morphometry (VBM). Thirty-nine patients with BP (13 males and 26 females; 28 with BPI and 11 with BPII) and 35 healthy controls were investigated. Both high-resolution volumetric T1-weighted images and MT images were acquired from all subjects. Images were processed using a voxel-by-voxel analysis in statistical parametric mapping 2 (SPM2). The magnetization transfer ratio MTR, an index indicative of loss of macromolecular density, was reduced in the right subgenual anterior cingulate and adjacent white matter in bipolar patients compared with controls. VBM did not reveal significant volumetric differences between BP patients and controls in grey and white matter, but white matter density was significantly reduced bilaterally in prefrontal areas encompassing fronto-striatal connections. Our findings suggest that subtle abnormalities are present in the anterior cingulate and subgyral white matter in patients with BP in the absence of significant volumetric changes. These findings are in keeping with those of previously reported neuropathological studies and illustrate important similarities (involvement of the anterior cingulate) and differences (lack of widespread cortical abnormalities in BP) with our previous studies in schizophrenic patients using the same methodology.