Frey Benicio N, Zunta-Soares Giovana B, Caetano Sheila C, Nicoletti Mark A, Hatch John P, Brambilla Paolo, Mallinger Alan G, Soares Jair C
Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.
Eur Neuropsychopharmacol. 2008 Oct;18(10):717-22. doi: 10.1016/j.euroneuro.2008.04.015. Epub 2008 Jun 12.
Previous studies have suggested that bipolar disorder (BD) is associated with alterations in neuronal plasticity, but the effects of the progression of illness on brain anatomy have been poorly investigated. We studied the correlation between length of illness, age, age at onset, and the number of previous episodes and total brain, total gray, and total white matter volumes in BD, unipolar (UP) and healthy control (HC) subjects. Thirty-six BD, 31 UP and 55 HCs underwent a 1.5 T brain magnetic resonance imaging scan, and gray and white matter volumes were manually traced blinded to the subjects' diagnosis. Partial correlation analysis showed that length of illness was inversely correlated with total gray matter volume after adjusting for total intracranial volume in BD (r(p)= -0.51; p=0.003) but not in UP subjects (r(p)= -0.23; p=0.21). Age at illness onset and the number of previous episodes were not significantly correlated with gray matter volumes in BD or UP subjects. No significant correlation with total white matter volume was observed. These results suggest that the progression of illness may be associated with abnormal cellular plasticity. Prospective longitudinal studies are necessary to elucidate the long-term effects of illness progression on brain structure in major mood disorders.
以往研究表明，双相情感障碍（BD）与神经元可塑性改变有关，但疾病进展对脑解剖结构的影响尚未得到充分研究。我们研究了BD、单相抑郁（UP）和健康对照（HC）受试者的病程长度、年龄、发病年龄、既往发作次数与全脑、全灰质和全白质体积之间的相关性。36例BD患者、31例UP患者和55例HC受试者接受了1.5T脑磁共振成像扫描，在对受试者诊断不知情的情况下手动追踪灰质和白质体积。偏相关分析显示，在调整颅内总体积后，BD患者的病程长度与全灰质体积呈负相关（r(p)= -0.51；p=0.003），而UP患者则无此相关性（r(p)= -0.23；p=0.21）。BD或UP患者的发病年龄和既往发作次数与灰质体积无显著相关性。未观察到与全白质体积有显著相关性。这些结果表明，疾病进展可能与异常的细胞可塑性有关。有必要进行前瞻性纵向研究，以阐明疾病进展对主要情绪障碍脑结构的长期影响。
