Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway.
NORMENT/K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo and Oslo University Hospital, Oslo, Norway.
Bipolar Disord. 2015 Aug;17(5):496-506. doi: 10.1111/bdi.12295. Epub 2015 Mar 24.
Results from magnetic resonance imaging (MRI) studies are heterogeneous with regard to hippocampal and amygdala volume alterations in bipolar disorder (BD). Lithium treatment may influence both structures. It is unknown if lithium treatment has distinct effects on hippocampal subfield volumes and if subfield volumes change over the course of illness in BD.
MRI scans were obtained for 34 lithium-treated patients with BD (Li+), 147 patients with BD who were not treated with lithium (Non-Li), and 300 healthy controls. Hippocampal total and subfield volumes and amygdala volumes were automatically estimated using Freesurfer. General linear models were used to investigate volume differences between groups and the effects of illness course and lithium treatment.
The Non-Li BD group displayed significantly smaller bilateral cornu ammonis (CA) 2/3 and CA4/dentate gyrus (DG) subfields, total hippocampal volumes, right CA1 and right subiculum subfields, and left amygdala volume compared to healthy controls. There were no differences between the Li+ BD and either the Non-Li BD or the healthy control groups. In patients with numerous affective episodes, Non-Li BD patients had smaller left CA1 and CA2/3 volumes compared to Li+ BD patients and healthy controls. There were positive associations between lithium treatment duration and left amygdala volume.
Hippocampal subfield and amygdala volumes were reduced in Non-Li BD patients compared to healthy controls, whereas the Li+ BD volumes were no different from those in Non-Li BD patients or healthy controls. Over the course of BD, lithium treatment might counteract reductions specifically in the left CA1 and CA2/3 hippocampal subfields and amygdala volumes, in accordance with the suggested neuroprotective effects of lithium.
磁共振成像（MRI）研究结果显示，双相障碍（BD）患者的海马和杏仁核体积存在异质性。锂治疗可能会影响这两个结构。尚不清楚锂治疗是否对海马亚区体积有独特的影响，以及在 BD 病程中这些亚区体积是否会发生变化。
对 34 名锂治疗的 BD 患者（Li+）、147 名未接受锂治疗的 BD 患者（Non-Li）和 300 名健康对照者进行 MRI 扫描。使用 Freesurfer 自动估计海马总体积和亚区体积以及杏仁核体积。采用一般线性模型比较组间体积差异，以及疾病病程和锂治疗的影响。
Non-Li BD 组双侧角回（CA）2/3 和 CA4/齿状回（DG）亚区、总海马体积、右侧 CA1 和右侧下托体积以及左侧杏仁核体积均明显小于健康对照组。Li+ BD 组与 Non-Li BD 组或健康对照组之间均无差异。在有大量情感发作的患者中，Non-Li BD 患者的左侧 CA1 和 CA2/3 体积小于 Li+ BD 患者和健康对照组。锂治疗持续时间与左侧杏仁核体积呈正相关。
与健康对照组相比，Non-Li BD 患者的海马亚区和杏仁核体积减小，而 Li+ BD 患者的海马亚区和杏仁核体积与 Non-Li BD 患者或健康对照组无差异。在 BD 病程中，锂治疗可能会抵消左 CA1 和 CA2/3 海马亚区以及杏仁核体积的减少，这与锂的神经保护作用相符。
