Campbell Stephanie, MacQueen Glenda
McMaster University Medical Centre, Hamilton, Ontario, Canada.
Curr Opin Psychiatry. 2006 Jan;19(1):25-33. doi: 10.1097/01.yco.0000194371.47685.f2.
Structural brain changes are apparent in some magnetic resonance imaging studies of patients with mood disorders, but results are inconsistent. The focus of this review is to examine whether there are demographic or clinical characteristics of people with mood disorders that are associated with regional brain volume changes. A systematic search of the literature in English, from January 2004 to July 2005, was performed on MEDLINE. References cited in all reports were searched iteratively to identify missing studies.
Recent studies have focused on factors that might help to reconcile the divergent reports of regional brain volume changes in major depressive disorder and bipolar disorder. Small hippocampal volumes are apparent in patients with recurrent major depressive disorder, but not generally reported early in the course of adult onset depression. Small hippocampal volumes may be apparent in patients with childhood onset illness. Small hippocampal volumes are infrequently reported in bipolar disorder, but studies to date have not accounted for illness history or treatment status. Changes in amygdala volumes are inconsistently reported in patients with major depressive disorder or bipolar disorder. There are relatively fewer reports of other brain regions, including the areas of the frontal cortex and striatum. An extensive preclinical literature suggests that various psychotropic medications may have neurotrophic and neuroprotective effects, making documentation of treatment history essential.
Patients' age, sex, age at onset of disease, course of illness and treatment status may affect the detection of regional brain volume changes in people with mood disorders.
在一些对情绪障碍患者的磁共振成像研究中，脑结构变化是明显的，但结果并不一致。本综述的重点是研究情绪障碍患者是否存在与脑区体积变化相关的人口统计学或临床特征。于2004年1月至2005年7月在MEDLINE上对英文文献进行了系统检索。对所有报告中引用的参考文献进行迭代检索以识别遗漏的研究。
近期研究聚焦于可能有助于调和关于重度抑郁症和双相情感障碍脑区体积变化的不同报告的因素。复发性重度抑郁症患者海马体体积较小，但在成人起病抑郁症病程早期一般未报告。儿童期起病疾病的患者可能出现海马体体积较小的情况。双相情感障碍患者较少报告海马体体积较小，但迄今为止的研究未考虑疾病史或治疗状态。重度抑郁症或双相情感障碍患者杏仁核体积变化的报告不一致。包括额叶皮质和纹状体区域在内的其他脑区的报告相对较少。大量临床前文献表明，各种精神药物可能具有神经营养和神经保护作用，因此记录治疗史至关重要。
患者的年龄、性别、发病年龄、病程和治疗状态可能会影响对情绪障碍患者脑区体积变化的检测。
