Brambilla P, Harenski K, Nicoletti M, 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, PA 15213, USA.
J Psychiatr Res. 2001 Nov-Dec;35(6):313-22. doi: 10.1016/s0022-3956(01)00036-x.
Previous brain imaging studies have suggested anatomical abnormalities in posterior fossa structures and brain ventricles in bipolar patients. Such abnormalities could possibly be implicated in the pathophysiology of bipolar disorder. Twenty-two DSM-IV bipolar outpatients (mean age+/-S.D.=36+/-10 years) and 22 healthy controls (mean age+/-S.D.=38+/-10 years) underwent an 1.5T MRI (3D-gradient echo-imaging SPGR), performed in the coronal plane (TR=25 ms, TE=5 ms, slice thickness=1.5 mm). The brain structures of interest were traced blindly with a semi-automated software. No significant differences were found between bipolar patients and healthy controls for any posterior fossa measures, or for measures of third or lateral ventricles (MANOVA, age covariate, P>0.05). Age was directly correlated with 3rd ventricle volumes in bipolar patients (Pearson correlation coefficient=0.458, P=0.032), but not in healthy controls (Pearson correlation coefficient=0.313, P=0.155). There was a significant direct correlation between the number of prior illness episodes and right lateral ventricle volumes (Partial correlation coefficient=0.658, P=0.011). Familial patients had smaller left and right cerebellar hemispheres and total vermis volumes, and larger left lateral ventricle volumes compared with non-familial ones (MANOVA, age covariate, P<0.05). In this preliminary study, we were not able to replicate previous findings of abnormalities in cerebellum or brain ventricles in bipolar individuals. However, there were suggestions that abnormalities in cerebellum, vermis, and lateral ventricle sizes may be present in familial cases of the disorder, which should be further examined in future studies with larger patient samples.
以往的脑成像研究表明，双相情感障碍患者后颅窝结构和脑室存在解剖学异常。此类异常可能与双相情感障碍的病理生理学有关。22名符合《精神疾病诊断与统计手册》第四版（DSM-IV）标准的双相情感障碍门诊患者（平均年龄±标准差=36±10岁）和22名健康对照者（平均年龄±标准差=38±10岁）接受了1.5T磁共振成像（3D梯度回波成像SPGR）检查，扫描层面为冠状面（重复时间=25毫秒，回波时间=5毫秒，层厚=1.5毫米）。使用半自动软件对感兴趣的脑结构进行盲法追踪。双相情感障碍患者与健康对照者在任何后颅窝测量指标、第三脑室或侧脑室测量指标上均未发现显著差异（多变量方差分析，年龄作为协变量，P>0.05）。年龄与双相情感障碍患者的第三脑室体积直接相关（皮尔逊相关系数=0.458，P=0.032），但与健康对照者无关（皮尔逊相关系数=0.313，P=0.155）。既往发病次数与右侧脑室体积之间存在显著的直接相关性（偏相关系数=0.658，P=0.011）。与非家族性患者相比，家族性患者的左右小脑半球和小脑蚓部总体积较小，左侧脑室体积较大（多变量方差分析，年龄作为协变量，P<0.05）。在这项初步研究中，我们未能重复先前关于双相情感障碍患者小脑或脑室异常的研究结果。然而，有迹象表明，在该疾病的家族性病例中可能存在小脑、蚓部和侧脑室大小的异常，这一点应在未来更大样本量患者的研究中进一步探讨。
