Nery Fabiano G, Chen Hua-Hsuan, Hatch John P, Nicoletti Mark A, Brambilla Paolo, Sassi Roberto B, Mallinger Alan G, Keshavan Matcheri S, Soares Jair C
Department of Psychiatry, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
Bipolar Disord. 2009 Mar;11(2):145-53. doi: 10.1111/j.1399-5618.2009.00662.x.
Functional and postmortem studies suggest that the orbitofrontal cortex (OFC) is involved in the pathophysiology of bipolar disorder (BD). This anatomical magnetic resonance imaging (MRI) study examined whether BD patients have smaller OFC gray matter volumes compared to healthy comparison subjects (HC).
Twenty-eight BD patients were compared to 28 age- and gender-matched HC. Subjects underwent a 1.5T MRI with 3D spoiled gradient recalled acquisition. Total OFC and medial and lateral subdivisions were manually traced by a blinded examiner. Images were segmented and gray matter volumes were calculated using an automated method.
Analysis of covariance, with intracranial volume as covariate, showed that BD patients and HC did not differ in gray matter volumes of total OFC or its subdivisions. However, total OFC gray matter volume was significantly smaller in depressed patients (n = 10) compared to euthymic patients (n = 18). Moreover, total OFC gray matter volumes were inversely correlated with depressive symptom intensity, as assessed by the Hamilton Depression Rating Scale. OFC gray matter volumes were not related to lithium treatment, age at disease onset, number of episodes, or family history of mood disorders.
Our results suggest that abnormal OFC gray matter volumes are not a pervasive characteristic of BD, but may be associated with specific clinical features of the disorder.
功能及尸检研究表明，眶额皮质（OFC）参与双相情感障碍（BD）的病理生理过程。本解剖磁共振成像（MRI）研究旨在探讨BD患者与健康对照者（HC）相比，其OFC灰质体积是否更小。
将28例BD患者与28例年龄和性别匹配的HC进行比较。受试者接受1.5T MRI检查，采用三维扰相梯度回波采集序列。由一位不知情的检查者手动勾勒出整个OFC以及内侧和外侧亚区。对图像进行分割，并使用自动方法计算灰质体积。
以颅内体积作为协变量的协方差分析显示，BD患者与HC在整个OFC或其亚区的灰质体积上没有差异。然而，与病情缓解的患者（n = 18）相比，抑郁患者（n = 10）的整个OFC灰质体积明显更小。此外，根据汉密尔顿抑郁量表评估，整个OFC灰质体积与抑郁症状强度呈负相关。OFC灰质体积与锂盐治疗、发病年龄、发作次数或情绪障碍家族史无关。
我们的结果表明，OFC灰质体积异常并非BD的普遍特征，但可能与该疾病的特定临床特征相关。
