Neurodevelopmental subtypes of bipolar disorder are related to cortical folding patterns: An international multicenter study.
Neurodevelopmental subtypes of bipolar disorder are related to cortical folding patterns: An international multicenter study.
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双相情感障碍的神经发育亚型与皮质折叠模式有关：一项国际多中心研究。
作者：
Sarrazin,Samuel;Cachia,Arnaud;Hozer,Franz;McDonald,Colm;Emsell,Louise;Cannon,DaraM;Wessa,Michele;Linke,Julia;Versace,Amelia;Hamdani,Nora;D'Albis,Marc-Antoine;Delavest,Marine;Phillips,MaryL;Brambilla,Paolo;Bellani,Marcella;P
目的脑沟是神经发育过程的间接标志。对双相情感障碍皮质沟的研究产生了不同的结果，可能是由于临床表型的高度变异性。我们对高神经发育负荷患者的大样本研究了全脑皮质沟裂。方法 一项多中心磁共振成像 (MRI) 研究纳入了总共 263 名双相情感障碍 I 患者和 320 名对照患者。所有受试者均接受了高分辨率 T1 加权脑部 MRI 检查。使用自动化管道处理图像，从覆盖整个大脑的 12 个先验确定的大脑区域中提取全局脑沟指数 (g-SI) 和局部脑沟指数 (l-SI)。我们比较了患有和不患有早发性双相情感障碍的患者以及有和没有精神病史的患者之间的 l-SI 和 g-SI，并调整了年龄、性别和惯用手。结果早发性双相情感障碍患者的右前额叶背外侧区域的 l-SI 较高。精神病性双相情感障碍患者左上顶叶皮层的 l-SI 降低。健康受试者和整个患者队列之间未发现 g-SI 或 l-SI 存在组间差异。我们可以在一个独立的队列中复制早发型的发现。结论我们的工作表明，双相情感障碍与普遍的脑沟异常无关，而是与仅限于神经发育负荷较重的患者的皮质折叠的局部变化有关。这些发现支持双相情感障碍具有异质性但可以通过 MRI 解开的假设，并表明需要对该疾病的神经发育偏差进行研究。
ObjectivesBrain sulcation is an indirect marker of neurodevelopmental processes. Studies of the cortical sulcation in bipolar disorder have yielded mixed results, probably due to high variability in clinical phenotype. We investigated whole‐brain cortical sulcation in a large sample of selected patients with high neurodevelopmental load.MethodsA total of 263 patients with bipolar disorder I and 320 controls were included in a multicentric magnetic resonance imaging (MRI) study. All subjects underwent high‐resolution T1‐weighted brain MRI. Images were processed with an automatized pipeline to extract the global sulcal index (g‐SI) and the local sulcal indices (l‐SIs) from 12 a priori determined brain regions covering the whole brain. We compared l‐SI and g‐SI between patients with and without early‐onset bipolar disorder and between patients with and without a positive history of psychosis, adjusting for age, gender and handedness.ResultsPatients with early‐onset bipolar disorder had a higher l‐SI in the right prefrontal dorsolateral region. Patients with psychotic bipolar disorder had a decreased l‐SI in the left superior parietal cortex. No group differences in g‐SI or l‐SI were found between healthy subjects and the whole patient cohort. We could replicate the early‐onset finding in an independent cohort.ConclusionsOur work suggests that bipolar disorder is not associated with generalized abnormalities of sulcation, but rather with localized changes of cortical folding restricted to patients with a heavy neurodevelopmental loading. These findings support the hypothesis that bipolar disorder is heterogeneous but may be disentangled using MRI, and suggest the need for investigations into neurodevelopmental deviations in the disorder.
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DOI：
--
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