Department of Anatomy and Neurobiology, Dalhousie University, Halifax, Nova Scotia, Canada.
J Psychiatr Res. 2011 Jan;45(1):76-82. doi: 10.1016/j.jpsychires.2010.04.019. Epub 2010 May 20.
White matter hyperintensities (WMHs) are among the most replicated neuroimaging findings in bipolar disorder (BD). It is not clear whether these lesions are an artifact of comorbid conditions, or whether they are directly associated with the disorder, or even represent biological risk factor for BD.
To test whether WMHs meet criteria for an endophenotype of BD, we conducted a high-risk design study and recruited 35 affected, 44 unaffected relatives of bipolar probands (age range 15-30 years), matched by age and sex with 49 healthy controls without any personal or family history of psychiatric disorders. The presence of WMHs was determined from Fluid Attenuated Inversion Recovery (FLAIR) scans acquired on a 1.5 Tesla scanner using a validated semi-quantitative scale.
We found mostly low grade WMHs in all groups. The proportion of WMH-positive subjects was comparable between the unaffected high-risk, affected familial and control groups.
White matter hyperintensities did not meet criteria for an endophenotype of BD. Bipolar disorder in young subjects without comorbid conditions was not associated with increased rate of WMHs.
脑白质高信号（WMHs）是双相障碍（BD）中最具复制性的神经影像学发现之一。目前尚不清楚这些病变是合并症的一种假象，还是与该疾病直接相关，甚至是否代表 BD 的生物学风险因素。
为了检验 WMH 是否符合 BD 内表型的标准，我们进行了一项高危设计研究，招募了 35 名受影响的、44 名无病的双相障碍先证者亲属（年龄在 15-30 岁之间），按年龄和性别与 49 名没有任何精神疾病个人或家族史的健康对照相匹配。使用经过验证的半定量量表，从在 1.5T 扫描仪上获取的液体衰减反转恢复（FLAIR）扫描中确定 WMH 的存在。
我们在所有组中都发现了主要是低级别 WMH。在无病高危、受影响的家族和对照组中，WMH 阳性患者的比例相似。
脑白质高信号不符合 BD 内表型的标准。无合并症的年轻双相障碍患者的 WMH 发生率并没有增加。
