Lippard Elizabeth T C, Mazure Carolyn M, Johnston Jennifer A Y, Spencer Linda, Weathers Judah, Pittman Brian, Wang Fei, Blumberg Hilary P
Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.
Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut.
J Neurosci Res. 2017 Jan 2;95(1-2):777-791. doi: 10.1002/jnr.23901.
Substance use disorders and mood disorders are highly comorbid and confer a high risk for adverse outcomes. However, data are limited on the neurodevelopmental basis of this comorbidity. Substance use initiation typically occurs during adolescence, and sex-specific developmental mechanisms are implicated. In this preliminary study, we review the literature and investigate regional gray matter volume (GMV) associated with subsequent substance use problems in adolescents with bipolar disorder (BD) and explore these associations for females and males. Thirty adolescents with DSM-IV-diagnosed BD and minimal alcohol/substance exposure completed baseline structural magnetic resonance imaging scans. At follow-up (on average 6 years post baseline), subjects were administered the CRAFFT interview and categorized into those scoring at high ( ≥ 2: CRAFFT ) vs. low ( < 2: CRAFFT ) risk for alcohol/substance problems. Lower GMV in prefrontal, insular, and temporopolar cortices were observed at baseline among adolescents with BD reporting subsequent alcohol and cannabis use compared to adolescents with BD who did not (P < 0.005, clusters ≥ 20 voxels). Lower dorsolateral prefrontal GMV was associated with future substance use in both females and males. In females, lower orbitofrontal and insula GMV was associated with future substance use, while in males, lower rostral prefrontal GMV was associated with future use. Lower orbitofrontal, insular, and temporopolar GMV was observed in those who transitioned to smoking tobacco. Findings indicate that GMV development is associated with risk for future substance use problems in adolescents with BD, with results implicating GMV development in regions subserving emotional regulation in females and regions subserving executive processes and attention in males. © 2016 Wiley Periodicals, Inc.
物质使用障碍和情绪障碍高度共病，且会带来不良后果的高风险。然而，关于这种共病的神经发育基础的数据有限。物质使用起始通常发生在青春期，且涉及性别特异性的发育机制。在这项初步研究中，我们回顾了文献，并调查了与双相情感障碍（BD）青少年后续物质使用问题相关的区域灰质体积（GMV），并探讨了女性和男性之间的这些关联。30名被诊断为DSM-IV标准的BD且酒精/物质暴露极少的青少年完成了基线结构磁共振成像扫描。在随访时（平均在基线后6年），对受试者进行CRAFFT访谈，并将其分为酒精/物质问题高风险（≥2分：CRAFFT）和低风险（<2分：CRAFFT）两组。与未报告后续酒精和大麻使用的BD青少年相比，报告了后续酒精和大麻使用的BD青少年在基线时前额叶、岛叶和颞极皮质的GMV较低（P<0.005，聚类≥20体素）。背外侧前额叶GMV较低与女性和男性未来的物质使用均相关。在女性中，眶额和岛叶GMV较低与未来物质使用相关，而在男性中，前额叶喙部GMV较低与未来使用相关。在转为吸烟的人群中观察到眶额、岛叶和颞极GMV较低。研究结果表明，GMV发育与BD青少年未来物质使用问题的风险相关，结果表明女性中参与情绪调节区域以及男性中参与执行过程和注意力区域的GMV发育存在关联。©2016威利期刊公司。
