Towards further understanding of the co-morbidity between attention deficit hyperactivity disorder and bipolar disorder: a MRI study of brain volumes
Towards further understanding of the co-morbidity between attention deficit hyperactivity disorder and bipolar disorder: a MRI study of brain volumes
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DOI：
10.1017/s0033291707001791
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发表时间：
2008-07-01
影响因子：
6.9
通讯作者：
Seidman, L. J.
中科院分区：
文献类型：
--
作者：
Biederman, J.;Makris, N.;Seidman, L. J.
背景虽然注意缺陷多动障碍（ADHD）和双相情感障碍（BPD）共同发生频繁，并代表了两种疾病的一种特别病态的临床形式，神经影像学研究解决这种共同发病率是稀缺的。我们的目的是评估ADHD与BPD共病的形态测量磁共振成像（MRI）基础，检验这一共病受试者与这两种疾病的神经解剖学相关性的假设。比较了31例ADHD和BPD成人与18例BPD、26例ADHD和23例健康对照者的形态测量MRI结果。使用线性回归模型估计我们感兴趣区域（ROI）的体积（cm（3））作为ADHD状态、BPD状态、年龄、性别和综合脑体积的函数。当BPD与显著较小的眶前额叶皮层和较大的右丘脑相关时，在ADHD和BPD的共病受试者中发现了这种模式。同样，当ADHD与显著较少的新皮层灰质、较少的额叶和上级前额叶皮质体积、较少的右前扣带回皮质和较少的小脑灰质相关时，ADHD合并BPD受试者也是如此。我们的研究结果支持这一假设，ADHD和BPD独立地有助于选择性和不同的大脑结构的体积改变。在ADHD加BPD的共病状态下，脑体积异常的轮廓由在两种疾病中单独改变的结构组成。注意共病是必要的，以帮助澄清BPD和ADHD的异质性神经解剖。
Background. Although attention deficit hyperactivity disorder (ADHD) and bipolar disorder (BPD) co-occur frequently and represent a particularly morbid clinical form of both disorders, neuroimaging research addressing this co-morbidity is scarce. Our aim was to evaluate the morphometric magnetic resonance imaging (MRI) underpinnings of the co-morbidity of ADHD with BPD, testing the hypothesis that subjects with this co-morbidity would have neuro-anatomical correlates of both disorders.Method. Morphometric MRI findings were compared between 31 adults with ADHD and BPD and with those of 18 with BPD, 26 with ADHD, and 23 healthy controls. The volumes (cm(3)) of our regions of interest (ROIs) were estimated as a function of ADHD status, BPD status, age, sex, and omnibus brain volume using linear regression models.Results. When BPD was associated with a significantly smaller orbital prefrontal cortex and larger right thalamus, this pattern was found in co-morbid subjects with ADHD plus BPD. Likewise, when ADHD was associated with significantly less neocortical gray matter, less overall frontal lobe and superior prefrontal cortex volumes, a smaller right anterior cingulate cortex and less cerebellar gray matter, so did co-morbid ADHD plus BPD subjects.Conclusions. Our results support the hypothesis that ADHD and BPD independently contribute to volumetric alterations of selective and distinct brain structures. In the co-morbid state of ADHD plus BPD, the profile of brain volumetric abnormalities consists of structures that are altered in both disorders individually. Attention to co-morbidity is necessary to help clarify the heterogeneous neuroanatomy of both BPD and ADHD.