Sassi R B, Nicoletti M, Brambilla P, Harenski K, Mallinger A G, Frank E, Kupfer D J, Keshavan M S, Soares J C
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA.
Biol Psychiatry. 2001 Aug 15;50(4):271-80. doi: 10.1016/s0006-3223(01)01086-1.
Neuroendocrinologic investigations in bipolar disorder have suggested abnormalities in pituitary function. However, few imaging studies have evaluated possible anatomical differences in this brain structure in mood disorder patients. Our aim was to examine potential abnormalities in pituitary volume in patients with bipolar and in a comparison group of patients with unipolar disorder.
We measured the volumes of the pituitary gland in 23 patients with bipolar disorder (mean +/- s.d. = 34.3 +/- 9.9 years) and 13 patients with unipolar disorder (41.2 +/- 9.6 years), and 34 healthy control subjects (36.6 +/- 9.6 years) using 1.5 mm thick T1-weighted coronal 1.5 T MRI images. All measurements were done blindly by a trained rater.
Patients with bipolar disorder had significantly smaller pituitary volumes than healthy control subjects (mean volume +/- s.d. = 0.55 +/- 0.15 ml and 0.68 +/- 0.20 ml, respectively; ANCOVA, F = 8.66, p = 0.005), and than patients with unipolar disorder (0.70 +/- 0.12 ml, F = 5.98, p = 0.02). No differences were found between patients with unipolar disorder and healthy control subjects (F = 0.01, p = 0.91).
To our knowledge, this is the first study that reports smaller pituitary volumes in bipolar disorder. Our findings suggest that detectable abnormalities in pituitary size are present in patients with bipolar disorder, which may reflect a dysfunctional HPA axis.
双相情感障碍的神经内分泌学研究提示垂体功能存在异常。然而，很少有影像学研究评估情绪障碍患者该脑结构可能存在的解剖学差异。我们的目的是检查双相情感障碍患者以及单相情感障碍患者对照组垂体体积的潜在异常。
我们使用1.5毫米厚的1.5T T1加权冠状位MRI图像，测量了23例双相情感障碍患者（平均±标准差=34.3±9.9岁）、13例单相情感障碍患者（41.2±9.6岁）和34名健康对照者（36.6±9.6岁）的垂体体积。所有测量均由一名经过培训的评分者在不知情的情况下进行。
双相情感障碍患者的垂体体积显著小于健康对照者（平均体积±标准差分别为0.55±0.15毫升和0.68±0.20毫升；协方差分析，F = 8.66，p = 0.005），也小于单相情感障碍患者（0.70±0.12毫升，F = 5.98，p = 0.02）。单相情感障碍患者与健康对照者之间未发现差异（F = 0.01，p = 0.91）。
据我们所知，这是第一项报告双相情感障碍患者垂体体积较小的研究。我们的研究结果表明，双相情感障碍患者存在可检测到的垂体大小异常，这可能反映了下丘脑-垂体-肾上腺（HPA）轴功能失调。
