Haldane Morgan, Frangou Sophia
Section of Neurobiology of Psychosis (Box P066), Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK.
Prog Neuropsychopharmacol Biol Psychiatry. 2004 Sep;28(6):943-60. doi: 10.1016/j.pnpbp.2004.05.040.
Bipolar affective disorder (BD) is a severe mental illness, characterized by episodes of mania and depression. With the development of Magnetic Resonance Imaging (MRI), neuroimaging methods are now allowing investigation of the neurocircuitry involved in this disorder. This in turn has aided further neuropathological exploration of the brain. Structural MRI and Magnetic Resonance Spectroscopy studies suggest that brain abnormalities in BD are mostly regional, as global measures (cerebral, white and gray matter and ventricular volumes) do not seem to be affected in the majority of patients. The prefrontal and anterior cingulate cortices, and amygdalae are consistently implicated in BD, whilst the evidence for hippocampal involvement is less convincing. Functional studies have found that the activity of the dorsal prefrontal cortex and the anterior cingulate are closely associated with mood symptoms. Activity in the ventral and orbital prefrontal cortex appears reduced both during episodes and in remission. In contrast, amygdala activity shows a persistent increase. We suggest that abnormal interaction between the amygdala and the ventral/orbitofrontal cortex may be a central feature of the pathophysiology of BD.
双相情感障碍（BD）是一种严重的精神疾病，其特征为躁狂和抑郁发作。随着磁共振成像（MRI）技术的发展，神经成像方法如今能够对该疾病所涉及的神经回路进行研究。这反过来又有助于对大脑进行进一步的神经病理学探索。结构MRI和磁共振波谱研究表明，双相情感障碍患者的大脑异常大多是局部性的，因为大多数患者的整体测量指标（脑、白质和灰质以及脑室容积）似乎并未受到影响。前额叶和前扣带回皮质以及杏仁核一直与双相情感障碍有关，而海马体受累的证据则不那么令人信服。功能研究发现，背侧前额叶皮质和前扣带回的活动与情绪症状密切相关。在发作期间和缓解期，腹侧和眶前额叶皮质的活动似乎都会降低。相比之下，杏仁核的活动则持续增加。我们认为，杏仁核与腹侧/眶额叶皮质之间的异常相互作用可能是双相情感障碍病理生理学的一个核心特征。
