1 Department of Clinical Neuroscience, Osher Center, Karolinska Institutet, Stockholm, Sweden
1 Department of Clinical Neuroscience, Osher Center, Karolinska Institutet, Stockholm, Sweden.
Brain. 2015 Nov;138(Pt 11):3440-8. doi: 10.1093/brain/awv266. Epub 2015 Sep 15.
Higher numbers of manic episodes in bipolar patients has, in cross-sectional studies, been associated with less grey matter volume in prefrontal brain areas. Longitudinal studies are needed to determine if manic episodes set off progressive cortical changes, or if the association is better explained by premorbid brain conditions that increase risk for mania. We followed patients with bipolar disorder type 1 for 6 years. Structural brain magnetic resonance imaging scans were performed at baseline and follow-up. We compared patients who had at least one manic episode between baseline and follow-up (Mania group, n = 13) with those who had no manic episodes (No-Mania group, n = 18). We used measures of cortical volume, thickness, and area to assess grey matter changes between baseline and follow-up. We found significantly decreased frontal cortical volume (dorsolateral prefrontal and inferior frontal cortex) in the Mania group, but no volume changes in the No-Mania group. Our results indicate that volume decrease in frontal brain regions can be attributed to the incidence of manic episodes.
在横断面研究中，双相情感障碍患者躁狂发作次数较多与前额叶脑区灰质体积减少有关。需要进行纵向研究以确定躁狂发作是否会引发皮质进行性改变，或者这种关联是否可以更好地用增加躁狂风险的潜在脑状况来解释。我们对 1 型双相情感障碍患者进行了 6 年的随访。在基线和随访时进行了结构脑磁共振成像扫描。我们将基线和随访期间至少有一次躁狂发作的患者（躁狂组，n = 13）与无躁狂发作的患者（无躁狂组，n = 18）进行了比较。我们使用皮质体积、厚度和面积的测量值来评估基线和随访之间的灰质变化。我们发现躁狂组的额皮质体积（背外侧前额叶和下额叶皮质）明显减少，但无躁狂组无体积变化。我们的结果表明，额叶脑区的体积减少可能归因于躁狂发作的发生。
