Department of Psychiatry and Psychotherapy, Georg-August-University Goettingen, von-Siebold-Str. 5, 37075, Goettingen, Germany.
Eur Arch Psychiatry Clin Neurosci. 2010 Dec;260(8):601-7. doi: 10.1007/s00406-010-0100-7. Epub 2010 Feb 3.
There are several hypotheses on functional neuronal networks that modulate mood states and which might form the neuroanatomical basis of bipolar disorder. The thalamus has been reported to be a key structure within the circuits that modulate mood states and might thus play an important role within the aetiology of the bipolar affective disorder. Nevertheless, structural brain imaging studies on the thalamus volume of bipolar patients have shown heterogeneous results. Using structural MRI scanning, we compared the thalamus volume of 41 euthymic bipolar patients to the thalamus volume of 41 well-matched healthy controls. Taking the concomitant medication as a co-variable within the patient group, the analysis of variance revealed a significantly smaller relative volume of the right thalamus in patients not treated with lithium when compared with healthy controls. In contrast, there are no significant differences concerning the thalamus volume between all euthymic bipolar patients and healthy controls. The study only shows findings of a transverse section. No longitudinal analysis was performed. More detailed information on patients' pharmacological histories could not be obtained. In conclusion, this result may be interpreted as an indication of the impact of the thalamus in the pathogenesis of the bipolar I disorder and emphasises the need for further longitudinal studies in bipolar patients with special attention paid to the concomitant medication, in particular to the role of lithium.
有几种关于调节情绪状态的功能性神经网络的假说，这些假说可能构成双相情感障碍的神经解剖学基础。已有报道称，丘脑是调节情绪状态的回路中的关键结构，因此在双相情感障碍的发病机制中可能发挥重要作用。然而，对双相情感障碍患者丘脑体积的结构性脑影像学研究结果存在差异。我们使用结构磁共振成像扫描，比较了 41 名病情稳定的双相情感障碍患者和 41 名匹配良好的健康对照组的丘脑体积。在患者组中，将同时服用的药物作为协变量，方差分析显示，与健康对照组相比，未服用锂的患者右侧丘脑的相对体积明显较小。相比之下，所有病情稳定的双相情感障碍患者和健康对照组之间的丘脑体积没有显著差异。该研究仅显示横断面的结果。未进行纵向分析。无法获得关于患者药物治疗史的更详细信息。总之，这一结果可以解释为丘脑在双相 I 型障碍发病机制中的作用的一个迹象，并强调需要对双相情感障碍患者进行进一步的纵向研究，特别要关注伴随药物治疗，特别是锂的作用。
