Chang Kiki, Barnea-Goraly Naama, Karchemskiy Asya, Simeonova Diana Iorgova, Barnes Patrick, Ketter Terence, Reiss Allan L
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA.
Biol Psychiatry. 2005 Aug 1;58(3):197-203. doi: 10.1016/j.biopsych.2005.03.039.
Morphometric magnetic resonance imaging (MRI) studies of pediatric bipolar disorder (BD) have not reported on gray matter volumes but have reported increased lateral ventricular size and presence of white matter hyperintensities (WMH). We studied gray matter volume, ventricular-to-brain ratios (VBR), and number of WMH in patients with familial, pediatric BD compared with control subjects.
Twenty subjects with BD (aged 14.6 +/- 2.8 years; 4 female) according to the Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia, each with a parent with BD, and 20 age-, gender-, and intelligence quotient-matched healthy control subjects (aged 14.1 +/- 2.8 years; 4 female) were scanned at 3 T. Most subjects were taking psychotropic medications. A high-resolution T1-weighted spoiled gradient echo three-dimensional MRI sequence was analyzed by BrainImage for volumetric measurements, and T2-weighted images were read by a neuroradiologist to determine presence of WMH.
After covarying for age and total brain volume, there were no significant differences between subjects with BD and control subjects in volume of cerebral (p = .09) or prefrontal gray matter (p = .34). Subjects with BD did not have elevated numbers of WMH or greater VBR when compared with control subjects.
Children and adolescents with familial BD do not seem to have decreased cerebral grey matter or increased numbers of WMH, dissimilar to findings in adults with BD. Gray matter decreases and development of WMH might be later sequelae of BD or unique to adult-onset BD.
针对儿童双相情感障碍（BD）的形态学磁共振成像（MRI）研究尚未报道灰质体积情况，但已报道侧脑室大小增加以及存在白质高信号（WMH）。我们对家族性儿童BD患者与对照受试者的灰质体积、脑室与脑比率（VBR）以及WMH数量进行了研究。
根据圣路易斯华盛顿大学儿童情感障碍和精神分裂症量表，选取20名BD患者（年龄14.6±2.8岁；4名女性），每位患者的父母一方患有BD，以及20名年龄、性别和智商匹配的健康对照受试者（年龄14.1±2.8岁；4名女性），在3T条件下进行扫描。大多数受试者正在服用精神药物。通过BrainImage分析高分辨率T1加权扰相梯度回波三维MRI序列以进行体积测量，由神经放射科医生读取T2加权图像以确定WMH的存在。
在对年龄和全脑体积进行协变量调整后，BD患者与对照受试者在脑灰质（p = 0.09）或前额叶灰质体积（p = 0.34）方面无显著差异。与对照受试者相比，BD患者的WMH数量未增加，VBR也未增大。
与成年BD患者的研究结果不同，患有家族性BD的儿童和青少年似乎没有脑灰质减少或WMH数量增加的情况。脑灰质减少和WMH的发展可能是BD的后期后遗症，或者是成人起病BD所特有的。
