Anomalous prefrontal-subcortical activation in familial pediatric bipolar disorder - A functional magnetic resonance imaging investigation
Anomalous prefrontal-subcortical activation in familial pediatric bipolar disorder - A functional magnetic resonance imaging investigation
复制标题
DOI：
10.1001/archpsyc.61.8.781
复制
发表时间：
2004-08-01
影响因子：
--
通讯作者：
Reiss, A
中科院分区：
文献类型：
--
作者：
Chang, K;Adleman, NE;Reiss, A
背景：儿童双相情感障碍(BD)的神经生物学特征很大程度上是未知的。儿童和青少年的BD可能是重要的研究功能神经影像技术，因为他们的独特地位早发性BD和较高的家庭负担的疾病。成人BD患者的神经成像研究表明背外侧前额叶皮质(DLPFC)和前扣带回皮质(ACC)参与了这种疾病的发展。目的：通过使用认知和情感任务通过功能磁共振成像研究BD儿童和青少年，并检查DLPFC和ACC以及选定的皮质下区域在儿童家族性BD中可能的异常。设计：我们评估了12名9至18岁的BD男性受试者，他们的父母中至少有一人患有BD，以及10名年龄和智商匹配的健康男性对照。兴奋剂被停用至少24小时；其他药物仍在继续。受试者在3T进行功能磁共振成像，同时执行两个背靠背的视觉空间工作记忆任务和一项情感任务，包括正、中、负效价图片的可视化。背景：来自加利福尼亚州旧金山湾区的学术参考环境。结果：与对照组相比，在视觉空间工作记忆任务中，BD患者在双侧ACC、左侧壳核、左侧丘脑、左侧DLPFC和右侧额下回等多个区域有更多的激活。对照组的小脑蠕虫有更大的激活。在观看负值图像时，BD受试者在双侧DLPFC、额叶下回和右侧脑岛有更大的激活。对照组在右侧后扣带回有更大的激活。对于正价图，BD受试者在双侧尾状核和丘脑、左侧额中/上回和左侧ACC有更大的激活。对照组没有更大的激活区域。结论：患有BD的儿童和青少年可能在前额叶-皮质下环路的调节方面存在潜在的异常。需要对注意力和情绪进行进一步的功能磁共振成像研究，样本量更大。
Background: The neurobiological features of pediatric bipolar disorder (BD) are largely unknown. Children and adolescents with BD may be important to study with functional neuroimaging techniques because of their unique status of early-onset BD and high familial loading for the disorder. Neuroimaging studies of adults with BD have implicated the dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC) in the development of this disorder.Objectives: To study children and adolescents with BD via functional magnetic resonance imaging using cognitive and affective tasks and to examine possible abnormalities in the DLPFC and ACC, as well as selected subcortical areas, in pediatric familial BD.Design: We evaluated 12 male subjects aged 9 to 18 years with BD who had at least 1 parent with BD as well as 10 age- and IQ-matched healthy male controls. Stimulants were discontinued for at least 24 hours; other medications were continued. Subjects underwent functional magnetic resonance imaging at 3 T while performing a 2-back visuospatial working memory task and an affective task involving the visualization of positively, neutrally, or negatively valenced pictures.Setting: An academic referral setting, drawing from the Bay Area of San Francisco, Calif.Results: Compared with controls, for the visuospatial working memory task, subjects with BD had greater activation in several areas including the bilateral ACC, left putamen, left thalamus, left DLPFC, and right inferior frontal gyrus. Controls had greater activation in the cerebellar vermis. In viewing negatively valenced pictures, subjects with BD had greater activation in the bilateral DLPFC, inferior frontal gyrus, and right insula. Controls had greater activation in the right posterior cingulate gyrus. For positively valenced pictures, subjects with BD had greater activation in the bilateral caudate and thalamus, left middle/superior frontal gyrus, and left ACC, whereas. controls had no areas of greater activation.Conclusions: Children and adolescents with BD may have underlying abnormalities in the regulation of prefrontal-subcortical circuits. Further functional magnetic resonance imaging studies of attention and mood with greater sample sizes are needed.