Frazier Jean A, Breeze Janis L, Makris Nikos, Giuliano Anthony S, Herbert Martha R, Seidman Larry, Biederman Joseph, Hodge Steven M, Dieterich Megan E, Gerstein Emily D, Kennedy David N, Rauch Scott L, Cohen Bruce M, Caviness Verne S
Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
Bipolar Disord. 2005 Dec;7(6):555-69. doi: 10.1111/j.1399-5618.2005.00258.x.
Few magnetic resonance imaging (MRI) studies of bipolar disorder (BPD) have investigated the entire cerebral cortex. Cortical gray matter (GM) volume deficits have been reported in some studies of adults with BPD; this study assessed the presence of such deficits in children with BPD.
Thirty-two youths with DSM-IV BPD (mean age 11.2 +/- 2.8 years) and 15 healthy controls (HC) (11.2 +/- 3.0 years) had structured and clinical interviews, neurological examinations, neurocognitive testing, and MRI scanning on a 1.5 T GE Scanner. Image parcellation divided the neocortex into 48 gyral-based units per hemisphere, and these units were combined into frontal (FL), temporal (TL), parietal (PL), and occipital (OL) lobe volumes. Volumetric differences were examined using univariate linear regression models with alpha = 0.05.
Relative to controls, the BPD youth had significantly smaller bilateral PL, and left TL. Analysis of PL and TL gyri showed significantly smaller volume in bilateral postcentral gyrus, and in left superior temporal and fusiform gyri, while the parahippocampal gyri were bilaterally increased in the BPD group. Although the FL overall did not differ between groups, an exploratory analysis showed that the right middle frontal gyrus was also significantly smaller in the BPD group.
Children with BPD showed deficits in PL and TL cortical GM. Further analyses of the PL and TL found differences in areas involved in attentional control, facial recognition, and verbal and declarative memory. These cortical deficits may reflect early age of illness onset.
很少有关于双相情感障碍（BPD）的磁共振成像（MRI）研究对整个大脑皮层进行调查。在一些针对成年BPD患者的研究中报告了皮质灰质（GM）体积减少；本研究评估了BPD儿童中是否存在此类减少。
32名符合《精神疾病诊断与统计手册》第四版（DSM-IV）标准的BPD青少年（平均年龄11.2±2.8岁）和15名健康对照者（HC）（11.2±3.0岁）接受了结构化和临床访谈、神经学检查、神经认知测试，并在1.5T的GE扫描仪上进行了MRI扫描。图像分割将每个半球的新皮层划分为48个基于脑回的单元，这些单元被合并为额叶（FL）、颞叶（TL）、顶叶（PL）和枕叶（OL）体积。使用α=0.05的单变量线性回归模型检查体积差异。
与对照组相比，BPD青少年的双侧顶叶和左侧颞叶明显较小。对顶叶和颞叶脑回的分析显示，双侧中央后回以及左侧颞上回和梭状回的体积明显较小，而BPD组的海马旁回双侧增大。尽管两组之间额叶总体上没有差异，但一项探索性分析显示，BPD组的右侧额中回也明显较小。
BPD儿童在顶叶和颞叶皮质GM方面存在缺陷。对顶叶和颞叶的进一步分析发现，在涉及注意力控制、面部识别以及言语和陈述性记忆的区域存在差异。这些皮质缺陷可能反映了疾病的早期发病年龄。
