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伴有和不伴有精神病性特征的双相情感障碍患者的胼胝体区域:一项国际多中心研究

Corpus callosum area in patients with bipolar disorder with and without psychotic features: an international multicentre study.

作者信息

Sarrazin Samuel, d'Albis Marc-Antoine, McDonald Colm, Linke Julia, Wessa Michèle, Phillips Mary, Delavest Marine, Emsell Louise, Versace Amelia, Almeida Jorge, Mangin Jean-François, Poupon Cyril, Le Dudal Katia, Daban Claire, Hamdani Nora, Leboyer Marion, Houenou Josselin

机构信息

From AP-HP, Hôpital H. Mondor - A. Chenevier, DHU PePSY, Pôle de Psychiatrie, Créteil, France (Sarrazin, d'Albis, Daban, Hamdani, Leboyer, Houenou); Université Paris-Est, UMR_S955, UPEC, F-94000, Créteil, France (Sarrazin, Leboyer); Fondation FondaMental, fondation de coopération scientifique, F-94000, Créteil, France (Sarrazin, d'Albis, Daban, Hamdani, Leboyer, Houenou); UNIACT, Neurospin, Commissariat à l'Energie Atomique, Centre d'études de Saclay, Gif sur Yvette (Sarrazin, d'Albis, Houenou); INSERM, U955, Equipe Psychopathologie des maladies psychiatriques, F-94000, Créteil, France (Sarrazin, d'Albis, Daban, Hamdani, Leboyer, Houenou); Clinical Science Institute, National University of Ireland, Galway, Ireland (McDonald); Institute for Psychology Johannes Gutenberg-University of Mainz, Department of Clinical Psychology and Neuropsychology, Mainz, Germany (Linke, Wessa); Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. (Phillips, Versace, Almeida); AP-HP, Hôpital Fernand Widal-Lariboisière, Service de psychiatrie, Paris, France (Delavest); Translational MRI, Department of Imaging and Pathology, KU Leuven and Radiology, University Hospitals Leuven, Belgium (Emsell); UNATI, Neurospin, Commissariat à l'Energie Atomique, Centre d'études de Saclay, Gif sur Yvette, France (Mangin); UNIRS, Neurospin, Commissariat à l'Energie Atomique, Centre d'études de Saclay, Gif sur Yvette, France (Poupon); AP-HP, Centre d'Investigation Clinique et Plateforme de Ressources Biologiques, Hôpitaux Henri Mondor, Créteil, France (Le Dudal).

出版信息

J Psychiatry Neurosci. 2015 Sep;40(5):352-9. doi: 10.1503/jpn.140262.

Abstract

BACKGROUND

Previous studies have reported MRI abnormalities of the corpus callosum (CC) in patients with bipolar disorder (BD), although only a few studies have directly compared callosal areas in psychotic versus nonpsychotic patients with this disorder. We sought to compare regional callosal areas in a large international multicentre sample of patients with BD and healthy controls.

METHODS

We analyzed anatomic T1 MRI data of patients with BD-I and healthy controls recruited from 4 sites (France, Germany, Ireland and the United States). We obtained the mid-sagittal areas of 7 CC subregions using an automatic CC delineation. Differences in regional callosal areas between patients and controls were compared using linear mixed models (adjusting for age, sex, handedness, brain volume, history of alcohol abuse/dependence, lithium or antipsychotic medication status, symptomatic status and site) and multiple comparisons correction. We also compared regional areas of the CC between patients with BD with and without a history of psychotic features.

RESULTS

We included 172 patients and 146 controls in our study. Patients with BD had smaller adjusted mid-sagittal CC areas than controls along the posterior body, the isthmus and the splenium of the CC. Patients with a positive history of psychotic features had greater adjusted area of the rostral CC region than those without a history of psychotic features.

LIMITATIONS

We found small to medium effect sizes, and there was no calibration technique among the sites.

CONCLUSION

Our results suggest that BD with psychosis is associated with a different pattern of interhemispheric connectivity than BD without psychosis and could be considered a relevant neuroimaging subtype of BD.

摘要

背景

既往研究报道了双相情感障碍(BD)患者胼胝体(CC)的MRI异常,不过仅有少数研究直接比较了该疾病中伴有精神病性症状与不伴有精神病性症状患者的胼胝体区域。我们旨在比较一个大型国际多中心BD患者样本与健康对照者的胼胝体区域。

方法

我们分析了从4个地点(法国、德国、爱尔兰和美国)招募的I型双相情感障碍患者及健康对照者的解剖学T1加权MRI数据。我们使用自动胼胝体描绘法获取了7个CC亚区域的正中矢状面面积。采用线性混合模型(校正年龄、性别、利手、脑容量、酒精滥用/依赖史、锂盐或抗精神病药物使用情况、症状状态和地点)及多重比较校正,比较患者与对照者之间胼胝体区域的差异。我们还比较了有和没有精神病性特征病史的BD患者之间的CC区域面积。

结果

我们的研究纳入了172例患者和146例对照者。BD患者在CC后体部、峡部和压部的校正正中矢状面CC面积小于对照者。有精神病性特征阳性病史的患者,其CC嘴部区域的校正面积大于无精神病性特征病史的患者。

局限性

我们发现效应量小到中等,且各地点之间没有校准技术。

结论

我们的结果表明,伴有精神病性症状的双相情感障碍与不伴有精神病性症状的双相情感障碍具有不同的半球间连接模式,可被视为双相情感障碍的一种相关神经影像学亚型。

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