Structural brain magnetic resonance imaging of limbic and thalamic volumes in pediatric bipolar disorder
Structural brain magnetic resonance imaging of limbic and thalamic volumes in pediatric bipolar disorder
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DOI：
10.1176/appi.ajp.162.7.1256
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发表时间：
2005-07-01
影响因子：
17.7
通讯作者：
Biederman, J
中科院分区：
文献类型：
--
作者：
Frazier, JA;Chiu, SF;Biederman, J
背景：双相情感障碍的青年是研究疾病病理生理学的理想选择，鉴于他们的早期表现，缺乏扩展治疗和高遗传负荷。成人双相情感障碍MRI研究越来越集中于边缘结构和丘脑，因为它们在情绪和认知中的作用。基于成人研究，作者假设先验是躁郁症的年轻人患有杏仁核，海马和丘脑量异常。 20位女性）和20个健康比较受试者（12名男性，八个女性）的年龄相似，性别进行了结构化和临床访谈，神经检查和认知测试。在对数尺度上，边缘和丘脑脑体积的差异使用双向（诊断和性别）单变异分析测试，具有总的大脑体积和年龄控制。回归：双相情感障碍的受试者的海马体积较小。进一步的分析表明，这种作用主要由女性躁郁症受试者驱动。此外，患有双相情感障碍的男性和女性年轻人的脑力明显较小。结论：这些发现支持以下假设：边缘系统，特别是海马，可能与小儿双相情感障碍的病理生理有关。虽然该报告可能代表了迄今为止对小儿双相情感障碍的最大MRI研究，但需要做更多的工作来确认这些发现并确定它们是否是小儿双相情感障碍所独有的。
Background: Youths with bipolar disorder are ideal for studying illness pathophysiology given their early presentation, lack of extended treatment, and high genetic loading. Adult bipolar disorder MRI studies have focused increasingly on limbic structures and the thalamus because of their role in mood and cognition. On the basis of adult studies, the authors hypothesized a priori that youths with bipolar disorder would have amygdalar, hippocampal, and thalamic volume abnormalities.Method: Forty-three youths 6 - 16 years of age with DSM-IV bipolar disorder (23 male, 20 female) and 20 healthy comparison subjects (12 male, eight female) similar in age and sex underwent structured and clinical interviews, neurological examination, and cognitive testing. Differences in limbic and thalamic brain volumes, on the logarithmic scale, were tested using a two-way (diagnosis and sex) univariate analysis of variance, with total cerebral volume and age controlled.Results: The subjects with bipolar disorder had smaller hippocampal volumes. Further analysis revealed that this effect was driven predominantly by the female bipolar disorder subjects. In addition, both male and female youths with bipolar disorder had significantly smaller cerebral volumes. No significant hemispheric effects were seen.Conclusions: These findings support the hypothesis that the limbic system, in particular the hippocampus, may be involved in the pathophysiology of pediatric bipolar disorder. While this report may represent the largest MRI study of pediatric bipolar disorder to date, more work is needed to confirm these findings and to determine if they are unique to pediatric bipolar disorder.