Monkul E Serap, Ozerdem Ayşegül
Turk Psikiyatri Derg. 2003 Fall;14(3):225-32.
To review structural MRI studies in bipolar disorder. A computer-assisted literature search of the Medline Ovid files for the period 1966 to November 2002 was performed, augmented by the use of articles meeting the criteria of this study from recent reviews. The studies included in this review show that there are abnormalities in the regions playing a role in the prefrontal-subcortical circuits that have been implicated in the pathophysiology of bipolar disorder, rather than generalized abnormalities like cerebral volume reduction or ventricular enlargement. The most widely studied and frequently reported finding of T2 signal hyperintensities is not considered to be specific to bipolar disorder. The findings of dorsolateral and subgenual prefrontal cortical volumetric reductions are in agreement with the findings of few neuropathological studies of bipolar disorder and suggest that prefrontal cortex plays an important role in the pathophysiology of the disorder. Among the medial temporal structures, the increase in amygdala volume seems to be specific to bipolar disorder. The findings in structures like the striatum and thalamus are conflicting, due to difficulties in the detailed measuring of the volumes of these structures with current techniques. Bipolar disorder is associated with brain abnormalities detected with structural MRI. Studies integrating structural neuroimaging methods with functional neuroimaging are needed to specifically determine how these abnormalities affect the function of these brain regions.
回顾双相情感障碍的结构磁共振成像（MRI）研究。利用计算机辅助检索了1966年至2002年11月期间的Medline Ovid数据库文件，并补充了近期综述中符合本研究标准的文章。本综述纳入的研究表明，双相情感障碍病理生理学中涉及的前额叶 - 皮质下回路相关区域存在异常，而非像脑容量减少或脑室扩大这样的广泛性异常。对T2信号高强度的研究最为广泛且报道频繁，但并不认为其对双相情感障碍具有特异性。背外侧和膝下前额叶皮质体积减少的研究结果与少数双相情感障碍神经病理学研究结果一致，提示前额叶皮质在该疾病的病理生理学中起重要作用。在内侧颞叶结构中，杏仁核体积增加似乎是双相情感障碍所特有的。由于目前技术在详细测量纹状体和丘脑等结构体积方面存在困难，这些结构的研究结果相互矛盾。双相情感障碍与结构MRI检测到的脑异常有关。需要将结构神经影像学方法与功能神经影像学相结合的研究，以具体确定这些异常如何影响这些脑区的功能。
