双相情感障碍老年患者终生疾病持续时间的神经进行性影响。
Neuroprogressive effects of lifetime illness duration in older adults with bipolar disorder.
作者信息
Gildengers Ariel G, Chung Kuo-Hsuan, Huang Shou-Hung, Begley Amy, Aizenstein Howard J, Tsai Shang-Ying
机构信息
Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
出版信息
Bipolar Disord. 2014 Sep;16(6):617-23. doi: 10.1111/bdi.12204. Epub 2014 Apr 10.
OBJECTIVE
The aim of the present study was to examine the long-term effects of bipolar disorder (BD) on brain structure (gray matter volumes).
METHODS
Fifty-four adults with BD [mean (standard deviation) age = 64.4 (5.4) years] underwent brain MR imaging along with comprehensive clinical assessment. Total gray matter, hippocampal, and amygdala volumes were extracted using methods developed through the Geriatric Neuroimaging Laboratory at the University of Pittsburgh (Pittsburgh, PA, USA).
RESULTS
Lower total gray matter volumes were related to longer duration of BD, even when controlling for current age and cerebrovascular accident (CVA) risk/burden. Additionally, longer exposure to antipsychotic medication was related to lower gray matter volumes. Lower hippocampal volumes were related to total years of antipsychotic agent exposure and CVA risk/burden scores. Older age was related to lower total gray matter, hippocampal, and amgydala volumes.
CONCLUSIONS
Our study of older adults with BD supports the understanding that BD is a neuroprogressive disorder with a longer duration of illness and more antipsychotic agent exposure related to lower gray matter volume.
目的
本研究旨在探讨双相情感障碍（BD）对脑结构（灰质体积）的长期影响。
方法
54名患有双相情感障碍的成年人[平均（标准差）年龄=64.4（5.4）岁]接受了脑部磁共振成像以及全面的临床评估。使用美国匹兹堡大学（宾夕法尼亚州匹兹堡）老年神经影像实验室开发的方法提取总灰质、海马体和杏仁核的体积。
结果
即使在控制当前年龄和脑血管意外（CVA）风险/负担的情况下，较低的总灰质体积也与双相情感障碍的病程较长有关。此外，较长时间使用抗精神病药物与较低的灰质体积有关。较低的海马体体积与抗精神病药物暴露的总年数以及CVA风险/负担评分有关。年龄较大与较低的总灰质体积、海马体体积和杏仁核体积有关。
结论
我们对患有双相情感障碍的老年人的研究支持这样一种认识，即双相情感障碍是一种神经进行性疾病，病程较长且使用抗精神病药物的时间越长，灰质体积越低。
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