Lower N-Acetyl-Aspartate Levels in Prefrontal Cortices in Pediatric Bipolar Disorder: A 1H Magnetic Resonance Spectroscopy Study
Lower N-Acetyl-Aspartate Levels in Prefrontal Cortices in Pediatric Bipolar Disorder: A 1H Magnetic Resonance Spectroscopy Study
复制标题
DOI：
10.1016/j.jaac.2010.10.007
复制
发表时间：
2011-01-01
影响因子：
13.3
通讯作者：
Soares, Jair C.
中科院分区：
文献类型：
--
作者：
Caetano, Sheila C.;Olvera, Rene L.;Soares, Jair C.
目的：少数应用单体素（1）氢光谱在儿童和青少年双相情感障碍（BD）中的研究报告了背外侧前额叶皮层（DLPFC）的N-乙酰天冬氨酸（NAA）水平较低，前扣带回的肌醇/磷酸肌酸+肌酸（PCr+Cr）比值较高。本研究的目的是评估NAA，甘油磷酸胆碱加磷酸胆碱（GPC+PC）和PCr+Cr在不同的额叶皮质区的儿童和青少年BD。我们假设，在前额叶皮质NAA水平较低的BD患者比健康对照组，表明在前者的神经发育改变。方法：我们研究了43名患有DSM-IV BD的儿科患者（19名女性，平均年龄13.2 ± 2.9岁）和38名健康对照（79名女性，平均年龄13.9 ± 2.7岁）。我们在1.5特斯拉下使用272 ms的长回波时间进行多体素体内H-1光谱测量，以获得内侧前额叶皮质（MPFC）、DLPFC（白色和灰质）、扣带回（前部和后部）和枕叶的双侧代谢物水平。我们使用非参数Mann-Whitney U检验来比较组间的神经化学水平。结果如下：在儿童BD患者中，双侧MPFC的NAA和GPC+PC水平以及左侧MPFC的PCr+Cr水平低于对照组。在左侧DLPFC白色物质中，BD患者的NAA和PCr+Cr水平也低于对照组。结论：较低的NAA和PCr+Cr水平在PFC的儿童和青少年BD可能是指示异常的树突状分支和神经突起，提示神经发育异常。J. Am. Acad.儿童青少年精神病学，2011;50（1）：85-94.
Objective: The few studies applying single-voxel(1)H spectroscopy in children and adolescents with bipolar disorder (BD) have reported low N-acetyl-aspartate (NAA) levels in the dorsolateral prefrontal cortex (DLPFC), and high myo-inositol / phosphocreatine plus creatine (PCr+Cr) ratios in the anterior cingulate. The aim of this study was to evaluate NAA, glycerophosphocholine plus phosphocholine (GPC+PC) and PCr+Cr in various frontal cortical areas in children and adolescents with BD. We hypothesized that NAA levels within the prefrontal cortex are lower in BD patients than in healthy controls, indicating neurodevelopmental alterations in the former. Method: We studied 43 pediatric patients with DSM-IV BD (19 female, mean age 13.2 +/- 2.9 years) and 38 healthy controls (79 female, mean age 13.9 +/- 2.7 years). We conducted multivoxel in vivo H-1 spectroscopy measurements at 1.5 Tesla using a long echo time of 272 ms to obtain bilateral metabolite levels from the medial prefrontal cortex (MPFC), DLPFC (white and gray matter), cingulate (anterior and posterior), and occipital lobes. We used the nonparametric Mann-Whitney U test to compare neurochemical levels between groups. Results: In pediatric BD patients, NAA and GPC+PC levels in the bilateral MPFC, and PCr+Cr levels in the left MPFC were lower than those seen in the controls. In the left DLPFC white matter, levels of NAA and PCr+Cr were also lower in BD patients than in controls. Conclusions: Lower NAA and PCr+Cr levels in the PFC of children and adolescents with BD may be indicative of abnormal dendritic arborization and neuropil, suggesting neurodevelopmental abnormalities. J. Am. Acad. Child Adolesc. Psychiatry, 2011;50(1):85-94.