Janiri Delfina, Sani Gabriele, Rossi Pietro De, Piras Fabrizio, Iorio Mariangela, Banaj Nerisa, Giuseppin Giulia, Spinazzola Edoardo, Maggiora Matteo, Ambrosi Elisa, Simonetti Alessio, Spalletta Gianfranco
Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy.
NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Sapienza University of Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy.
Bipolar Disord. 2017 Aug;19(5):353-362. doi: 10.1111/bdi.12516. Epub 2017 Jul 12.
Volumetric studies on deep gray matter structures in bipolar disorder (BP) have reported contrasting results. Childhood trauma, a relevant environmental stressor for BP, could account for the variability of the results, modulating differences in the amygdala and hippocampus in patients with BP compared with healthy controls (HC). Our study aimed to test this hypothesis.
We assessed 105 outpatients, diagnosed with bipolar disorder type I (BP-I) or bipolar disorder type II (BP-II) according to DSM-IV-TR criteria, and 113 HC subjects. History of childhood trauma was obtained using the Childhood Trauma Questionnaire (CTQ). High-resolution magnetic resonance imaging was performed on all subjects and volumes of the amygdala, hippocampus, nucleus accumbens, caudate, pallidum, putamen, and thalamus were measured using FreeSurfer.
Patients with BP showed a global reduction of deep gray matter volumes compared to HCs. However, childhood trauma modulated the impact of the diagnosis specifically on the amygdala and hippocampus. Childhood trauma was associated with bilateral decreased volumes in HCs and increased volumes in patients with BP.
The results suggest that childhood trauma may have a different effect in health and disease on volumes of gray matter in the amygdala and hippocampus, which are brain areas specifically involved in response to stress and emotion processing.
关于双相情感障碍（BP）深部灰质结构的体积研究报告了相互矛盾的结果。童年创伤是BP的一个相关环境应激源，它可能是造成结果差异的原因，与健康对照者（HC）相比，调节了BP患者杏仁核和海马体的差异。我们的研究旨在验证这一假设。
我们评估了105名门诊患者，根据《精神疾病诊断与统计手册》第四版修订版（DSM-IV-TR）标准诊断为I型双相情感障碍（BP-I）或II型双相情感障碍（BP-II），以及113名HC受试者。使用儿童创伤问卷（CTQ）获取童年创伤史。对所有受试者进行高分辨率磁共振成像，并使用FreeSurfer测量杏仁核、海马体、伏隔核、尾状核、苍白球、壳核和丘脑的体积。
与HC相比，BP患者深部灰质体积总体减少。然而，童年创伤特别调节了诊断对杏仁核和海马体的影响。童年创伤与HC双侧体积减少以及BP患者体积增加有关。
结果表明，童年创伤在健康和疾病状态下可能对杏仁核和海马体的灰质体积产生不同影响，而杏仁核和海马体是专门参与应激反应和情绪处理的脑区。
