Highfield Family and Adolescent Unit, Warneford Hospital Oxford Centre for Functional MRI of the Brain (FMRIB), John Radcliffe Hospital, Oxford GSK Clinical Imaging Centre, Imperial College London, London, UK.
Bipolar Disord. 2011 Feb;13(1):16-27. doi: 10.1111/j.1399-5618.2011.00891.x.
To identify neuropsychological and structural brain changes using a combination of high-resolution structural and diffusion tensor imaging in pediatric bipolar disorder (PBD) with psychosis (presence of delusions and or hallucinations).
We recruited 15 patients and 20 euthymic age- and gender-matched healthy controls. All subjects underwent high-resolution structural and diffusion tensor imaging. Voxel-based morphometry (VBM), tract-based spatial statistics (TBSS), and probabilistic tractography were used to analyse magnetic resonance imaging data.
The PBD subjects had normal overall intelligence with specific impairments in working memory, executive function, language function, and verbal memory. Reduced gray matter (GM) density was found in the left orbitofrontal cortex, left pars triangularis, right premotor cortex, occipital cortex, right occipital fusiform gyrus, and right crus of the cerebellum. TBSS analysis showed reduced fractional anisotropy (FA) in the anterior corpus callosum. Probabilistic tractography from this cluster showed that this region of the corpus callosum is connected with the prefrontal cortices, including those regions whose density is decreased in PBD. In addition, FA change was correlated with verbal memory and working memory, while more widespread reductions in GM density correlated with working memory, executive function, language function, and verbal memory.
The findings suggest widespread cortical changes as well as specific involvement of interhemispheric prefrontal tracts in PBD, which may reflect delayed myelination in these tracts.
通过结合高分辨率结构和弥散张量成像，识别出具有精神病性症状（妄想和/或幻觉存在）的儿科双相障碍（PBD）患者的神经心理学和结构脑变化。
我们招募了 15 名患者和 20 名病情稳定的年龄和性别匹配的健康对照者。所有受试者均接受高分辨率结构和弥散张量成像。采用基于体素的形态学（VBM）、基于束的空间统计学（TBSS）和概率追踪技术分析磁共振成像数据。
PBD 患者的总体智力正常，但在工作记忆、执行功能、语言功能和言语记忆方面存在特定的损伤。左眶额皮质、左三角部、右运动前皮质、枕叶皮质、右枕叶梭状回和小脑右侧小脑脚的灰质（GM）密度降低。TBSS 分析显示前胼胝体的各向异性分数（FA）降低。从该簇进行的概率追踪显示，胼胝体的这一区域与前额皮质相连，包括在 PBD 中密度降低的那些区域。此外，FA 的变化与言语记忆和工作记忆相关，而 GM 密度的更广泛减少与工作记忆、执行功能、语言功能和言语记忆相关。
这些发现表明 PBD 存在广泛的皮质变化以及双侧额间皮质束的特定参与，这可能反映了这些束中的髓鞘形成延迟。
