Department of Psychiatry and Human Behavior, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan.
Prog Neuropsychopharmacol Biol Psychiatry. 2011 Mar 30;35(2):439-45. doi: 10.1016/j.pnpbp.2010.11.030. Epub 2010 Nov 27.
Although rapid cycling (RC), a course specifier of bipolar I or II disorder, is particularly common among bipolar II patients compared with bipolar I patients, the pathophysiological lines of evidence regarding bipolar II with RC are still limited. In this preliminary study with a cross-sectional design, we examined the regional gray matter (GM) volume in 14 bipolar II patients with RC, 17 patients without RC and 84 healthy controls by whole-brain and region-of-interest (ROI) analysis methods, using magnetic resonance imaging with voxel-based morphometry. Whole-brain analysis in this study revealed that the bipolar II patients with RC showed GM volume reductions in the bilateral hemispheres of the medial orbital prefrontal cortex, ventromedial prefrontal cortex, anterior cingulate, insula and parahippocampus, in the left hemisphere of the inferior temporal cortex and cerebellum, and in the brainstem, compared with the healthy controls. Moreover, ROI analysis focusing on the ventral prefrontal cortex, i.e., Brodmann areas 10, 11 and 47, revealed that the bipolar II patients with RC showed GM volume reduction in the ventromedial prefrontal cortex, compared with the patients without RC. The findings of our pilot study suggest that the ventromedial prefrontal cortex is associated with the generation of RC in bipolar II disorder.
尽管与双相 I 型患者相比，双相 II 型患者中快速循环（RC）更为常见，RC 是双相 I 或 II 障碍的一种病程特征，但目前关于伴有 RC 的双相 II 型的病理生理学证据仍然有限。在这项采用横断面设计的初步研究中，我们通过基于体素的形态测量学，使用磁共振成像对 14 名伴有 RC 的双相 II 型患者、17 名无 RC 的患者和 84 名健康对照者的全脑和感兴趣区（ROI）进行了区域性灰质（GM）体积检查。本研究的全脑分析显示，与健康对照者相比，伴有 RC 的双相 II 型患者双侧眶额内侧前额皮质、腹内侧前额皮质、前扣带、岛叶和海马旁回、左侧颞下回和小脑以及脑干 GM 体积减少。此外，针对腹侧前额皮质（即布罗德曼区 10、11 和 47）的 ROI 分析显示，伴有 RC 的双相 II 型患者的腹内侧前额皮质 GM 体积减少，与无 RC 的患者相比。我们的初步研究结果表明，腹内侧前额皮质与双相 II 型障碍中 RC 的产生有关。
