Moon Chung-Man, Jeong Gwang-Woo
Research Institute for Medical Imaging, Chonnam National University Hospital, Gwangju, Republic of Korea.
Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, 501-757, Republic of Korea.
Neuroradiology. 2015 Nov;57(11):1127-34. doi: 10.1007/s00234-015-1572-y. Epub 2015 Aug 21.
Only a few morphological studies have focused on changes in white matter (WM) volume in patients with generalized anxiety disorder (GAD). We evaluated alterations in WM volume and its correlation with symptom severity and duration of illness in adults with GAD.
The 44 subjects were comprised of 22 patients with GAD (13 males and nine females) diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) and 22 age-matched healthy controls (13 males and nine females). High-resolution magnetic resonance imaging (MRI) data were processed by voxel-based morphometry (VBM) analysis based on diffeomorphic anatomical registration using the exponentiated Lie algebra (DARTEL) algorithm in SPM8.
Patients with GAD showed significantly reduced WM volume, particularly in the dorsolateral prefrontal cortex (DLPFC), anterior limb of the internal capsule (ALIC), and midbrain. In addition, DLPFC volume was negatively correlated with GAD-7 score and illness duration. ALIC volume was negatively correlated with GAD-7 score. Female patients had significantly less orbitofrontal cortex volume compared to that in male patients.
The findings demonstrate localized changes in WM volume associated with cognitive and emotional dysfunction in patients with GAD. The finding will be helpful for understanding the neuropathology in patients with GAD.
仅有少数形态学研究关注广泛性焦虑障碍(GAD)患者白质(WM)体积的变化。我们评估了成年GAD患者WM体积的改变及其与症状严重程度和病程的相关性。
44名受试者包括22例根据《精神障碍诊断与统计手册》第四版修订版(DSM-IV-TR)诊断的GAD患者(13名男性和9名女性)以及22名年龄匹配的健康对照者(13名男性和9名女性)。使用SPM8中的基于指数李代数(DARTEL)算法的基于模板的形态学分析(VBM)对高分辨率磁共振成像(MRI)数据进行处理。
GAD患者的WM体积显著减少,尤其是在背外侧前额叶皮质(DLPFC)、内囊前肢(ALIC)和中脑。此外,DLPFC体积与GAD-7评分和病程呈负相关。ALIC体积与GAD-7评分呈负相关。女性患者的眶额皮质体积明显小于男性患者。
研究结果表明GAD患者的WM体积存在与认知和情感功能障碍相关的局部变化。这一发现将有助于理解GAD患者的神经病理学。