Berretta Sabina, Pantazopoulos Harry, Lange Nicholas
Translational Neuroscience Laboratory, McLean Hospital, Belmont, Massachusetts 02478, USA.
Biol Psychiatry. 2007 Oct 15;62(8):884-93. doi: 10.1016/j.biopsych.2007.04.023. Epub 2007 Aug 14.
Growing evidence supports a pivotal role for the amygdala in the pathogenesis of bipolar disorder (BD) and schizophrenia (SZ). However, the occurrence of morphologic changes in the amygdala is currently controversial.
Total number and numeric density of neurons, neuronal somata size, and volume of the lateral (LN), basal (BN), accessory basal (ABN), and cortical (CO) nuclei of the amygdala were measured in 12 normal control, 10 BD, and 16 SZ subjects.
In BD subjects, reductions of total numbers (41.1%; p = .01) and numeric densities of neurons (14.5%, p = .01), as well as volume (29.0%; p = .01), were detected in LN. Density of neurons was also decreased in ABN of the same subjects (20.8%; p = .0005). These changes were not related to antipsychotics or lithium salt exposure. In SZ subjects, a decrease of total numbers of neurons was detected in LN (23.6%; p = .04). This effect was no longer significant once exposure to antipsychotics was taken into account.
These findings offer structural evidence for an involvement of the amygdala in BD. Consequent loss of amygdalar function may account for abnormalities in emotion processing typical of BD subjects. In contrast, changes in SZ were limited and may have been induced by pharmacologic treatment.
越来越多的证据支持杏仁核在双相情感障碍(BD)和精神分裂症(SZ)的发病机制中起关键作用。然而,杏仁核形态学变化的发生目前存在争议。
在12名正常对照者、10名双相情感障碍患者和16名精神分裂症患者中,测量杏仁核的神经元总数、神经元数字密度、神经元胞体大小以及外侧核(LN)、基底核(BN)、副基底核(ABN)和皮质核(CO)的体积。
在双相情感障碍患者中,外侧核的神经元总数减少(41.1%;p = 0.01)、神经元数字密度降低(14.5%,p = 0.01)以及体积减小(29.0%;p = 0.01)。同一患者的副基底核神经元密度也降低(20.8%;p = 0.0005)。这些变化与抗精神病药物或锂盐暴露无关。在精神分裂症患者中,外侧核的神经元总数减少(23.6%;p = 0.04)。一旦考虑到抗精神病药物暴露,这种效应就不再显著。
这些发现为杏仁核参与双相情感障碍提供了结构证据。杏仁核功能的相应丧失可能解释了双相情感障碍患者典型的情绪处理异常。相比之下,精神分裂症患者的变化有限,可能是由药物治疗引起的。