Three-dimensional mapping of hippocampal anatomy in unmedicated and lithium-treated patients with bipolar disorder
Three-dimensional mapping of hippocampal anatomy in unmedicated and lithium-treated patients with bipolar disorder
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DOI：
10.1038/sj.npp.1301507
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发表时间：
2008-05-01
影响因子：
7.6
通讯作者：
Soares, Jair C.
中科院分区：
文献类型：
--
作者：
Bearden, Carrie E.;Thompson, Paul M.;Soares, Jair C.
陈述性记忆障碍在双相情感障碍患者中很常见，这表明存在潜在的海马病理学。然而，双相情感障碍中很少观察到海马体积缺陷。在这里，我们使用基于表面的解剖图来检查接受锂治疗的双相情感障碍患者相对于匹配的对照受试者和未接受药物治疗的双相情感障碍患者的海马解剖结构。从 33 名双相情感障碍患者（其中 21 名接受锂治疗，12 名未接受药物治疗）和 62 名人口统计匹配的健康对照受试者中获取了高分辨率脑部磁共振图像。三维参数化网格模型是根据海马结构的手动追踪创建的。与健康对照组（增加 10.3%；p=0.001）和未接受药物治疗的双相患者（增加 13.9%；p=0.003）相比，锂治疗的双相患者的海马总体积显着更大。通过排列测试证实的统计绘图结果显示，与正常对照（p=0.01）和锂治疗的双相情感障碍患者（p=0.03）相比，未接受药物治疗的双相情感障碍患者的右侧海马体（主要对应于角竖条子区域的区域）存在局部缺陷。这些发现证明了这些解剖图测方法对于检测双相情感障碍海马结构的细微变化的敏感性。在未接受药物治疗的双相情感障碍患者中观察到的海马部分区域的减少表明，这种疾病中经常报告的记忆缺陷可能与神经相关。此外，锂治疗的双相情感障碍患者海马体积的增加可能反映了该药物的假定神经营养作用，这种可能性值得在纵向研究中进行进一步研究。
Declarative memory impairments are common in patients with bipolar illness, suggesting underlying hippocampal pathology. However, hippocampal volume deficits are rarely observed in bipolar disorder. Here we used surface-based anatomic mapping to examine hippocampal anatomy in bipolar patients treated with lithium relative to matched control subjects and unmedicated patients with bipolar disorder. High-resolution brain magnetic resonance images were acquired from 33 patients with bipolar disorder ( 21 treated with lithium and 12 unmedicated), and 62 demographically matched healthy control subjects. Three-dimensional parametric mesh models were created from manual tracings of the hippocampal formation. Total hippocampal volume was significantly larger in lithium-treated bipolar patients compared with healthy controls (by 10.3%; p=0.001) and unmedicated bipolar patients ( by 13.9%; p=0.003). Statistical mapping results, confirmed by permutation testing, revealed localized deficits in the right hippocampus, in regions corresponding primarily to cornu ammonis vertical bar subfields, in unmedicated bipolar patients, as compared to both normal controls (p=0.01), and in lithium-treated bipolar patients (p=0.03). These findings demonstrate the sensitivity of these anatomic mapping methods for detecting subtle alterations in hippocampal structure in bipolar disorder. The observed reduction in subregions of the hippocampus in unmedicated bipolar patients suggests a possible neural correlate for memory deficits frequently reported in this illness. Moreover, increased hippocampal volume in lithium-treated bipolar patients may reflect postulated neurotrophic effects of this agent, a possibility warranting further study in longitudinal investigations.