Clinical significance of brain white matter hyperintensities in young adults with psychiatric illness
Clinical significance of brain white matter hyperintensities in young adults with psychiatric illness
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DOI：
10.1080/713854500
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发表时间：
2003-09-01
影响因子：
3.8
通讯作者：
Renshaw, PF
中科院分区：
文献类型：
--
作者：
Breeze, JL;Hesdorffer, DC;Renshaw, PF
磁共振成像（MRI）提供了大脑解剖的详细图像，特别是灰色和白色物质结构的清晰定义。几项脑MRI研究表明，双相情感障碍（BD）的成年人比没有BD的成年人更可能有“白色高信号”（WMH）。在其他身体健康的患者中，这些病变的频率不成比例地更高，这表明疾病本身或用于控制疾病的治疗可能是白色物质变化发展的风险因素。同样，WMH可能是某些类型的BD的病因因素。除了回顾相关文献外，本研究还试图确定锂治疗是否与年轻精神病患者WMH患病率增加相关。为了验证这一假设，我们评估了来自马萨诸塞州贝尔蒙特姆克林医院住院患者的600多个脑部MRI扫描。我们控制了可能的混杂变量，如年龄、血管疾病、药物滥用和疾病严重程度的标志物，我们发现BD患者并不比其他精神病患者更容易患WMH。锂的使用与WMH的存在无显著相关性。一个多变量回归模型的存在WMH显示，心脏病，女性性别，和多个精神病入院WMH.This研究不支持以前的研究结果，BD相比，其他精神疾病，与WMH的风险增加。锂的使用可能与WMH有微妙的联系。我们的研究结果与先前的研究一致，该研究发现心血管疾病，高龄和WMH的存在之间存在关联，尽管我们的分析似乎是独特的，因为它将心血管疾病作为患有精神疾病的年轻人的危险因素。
Magnetic resonance imaging (MRI) provides detailed images of brain anatomy, with especially clear definition of gray and white matter structures. Several brain MRI studies have suggested that adults with bipolar disorder (BD) are more likely to have "white matter hyperintensities" (WMH) than adults without BD. The disproportionately greater frequency of these lesions in otherwise physically healthy patients suggests that the illness itself, or treatments used to control the illness, may be risk factors for the development of white matter changes. Similarly, WMH may be an etiological factor for some types of BD.In addition to reviewing the relevant literature, this research study attempted to determine whether lithium treatment is associated with an increased prevalence of WMH in young adults with psychiatric illness. To test this hypothesis, we evaluated over 600 brain MRI scans from inpatients at McLean Hospital, Belmont, Massachusetts. We controlled for possible confounding variables such as age, vascular disease, substance abuse, and markers of illness severity.We found that individuals with BD were no more likely to have WMH than other psychiatric patients. Lithium use was nonsignificantly associated with the presence of WMH. A multivariate regression model for the presence of WMH showed that heart disease, female gender, and multiple psychiatric admissions were significant predictors of WMH.This study does not support previous findings that BD, compared to other psychiatric illnesses, was associated with increased risk of WMH. Lithium use may be subtly associated with WMH. Our results are consistent with previous research that found an association between cardiovascular disease, advanced age, and the presence of WMH, though our analysis appears to be unique in its inclusion of cardiovascular disease as a risk factor in young adults with psychiatric illness.