Adler Caleb M, Adams John, DelBello Melissa P, Holland Scott K, Schmithorst Vince, Levine Ari, Jarvis Kelly, Strakowski Stephen M
Department of Psychiatry, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH 45267-0559, USA.
Am J Psychiatry. 2006 Feb;163(2):322-4. doi: 10.1176/appi.ajp.163.2.322.
Previous diffusion tensor imaging findings have supported suggestions that bipolar disorder is characterized by subtle white matter changes. The chronic nature of the study population, however, has limited interpretation of these findings. In this study the authors utilized diffusion tensor imaging to study white matter tracts of adolescents in their first episode of mania to address whether abnormalities are present in early bipolar disorder.
Eleven medication-naive adolescents in their first episode of mania and 17 healthy subjects underwent diffusion tensor imaging scans. Fractional anisotropy and trace apparent diffusion coefficients of prefrontal and posterior regions of interest were compared between groups.
Bipolar adolescents showed significantly decreased fractional anisotropy only in superior-frontal white matter tracts. Trace apparent diffusion coefficients did not significantly differ in any regions examined.
These findings suggest that prefrontal white matter abnormalities are present early in bipolar disorder and may consist largely of axonal disorganization. The presence of changes in young first-episode patients also suggests that white matter pathology may represent an early marker of bipolar disorder.
既往扩散张量成像研究结果支持双相情感障碍以细微白质改变为特征的观点。然而，研究人群的慢性病程限制了对这些结果的解读。在本研究中，作者利用扩散张量成像研究首次发作躁狂的青少年的白质束，以探讨双相情感障碍早期是否存在异常。
11名首次发作躁狂且未服用过药物的青少年和17名健康受试者接受了扩散张量成像扫描。比较了两组之间前额叶和后感兴趣区域的分数各向异性和迹表观扩散系数。
双相情感障碍青少年仅在额上白质束中分数各向异性显著降低。在所检查的任何区域，迹表观扩散系数均无显著差异。
这些结果表明，双相情感障碍早期存在前额叶白质异常，可能主要由轴突紊乱组成。年轻的首次发作患者出现变化也表明，白质病变可能是双相情感障碍的早期标志物。
