Yale School of Medicine, New Haven, CT; Yale Child Study Center, New Haven.
Yale School of Medicine, New Haven, CT; Dell Medical School, University of Texas at Austin, TX.
J Am Acad Child Adolesc Psychiatry. 2018 Feb;57(2):111-117. doi: 10.1016/j.jaac.2017.11.014. Epub 2017 Nov 26.
Longitudinal neuroimaging during adolescence/young adulthood, when bipolar disorder (BD) commonly emerges, can help elucidate the neurodevelopmental pathophysiology of BD. Adults with BD have shown reduced structural integrity in the uncinate fasciculus (UF), a white matter (WM) tract providing major connections between the amygdala and ventral prefrontal cortex (vPFC), important in emotion regulation. In this longitudinal diffusion tensor imaging (DTI) study of adolescents/young adults, we hypothesized differences in age- and time-related changes in UF integrity in BD compared to healthy controls (HC).
Two DTI scans were obtained in 27 adolescents/young adults with BD and 37 HC adolescents/young adults, on average approximately 2.5 years apart. Interactions between diagnosis with age and with time for UF fractional anisotropy (FA) were assessed. Exploratory analyses were performed including euthymic-only participants with BD, and for potential influences of demographic and clinical factors. Whole-brain analyses were performed to explore for interactions in other regions.
There were significant interactions between diagnosis with age and with time for UF FA (p < .05). Healthy control adolescents/young adults showed significant UF FA increases with age and over time (p < .05), whereas no significant changes with age or over time were observed in the adolescents/young adults with BD. Significant interactions with age and time were also observed in analyses including euthymic-only participants with BD (p < .05).
These findings provide neuroimaging evidence supporting differences in UF WM structural development during adolescence/young adulthood, suggesting that differences in the development of an amygdala-vPFC system subserving emotion regulation may be a trait feature of BD neurodevelopment.
在青少年/成年早期进行纵向神经影像学研究，此时双相障碍（BD）通常会出现，这有助于阐明 BD 的神经发育病理生理学。BD 成年患者的钩束（UF）结构完整性降低，UF 是连接杏仁核和腹侧前额叶皮层（vPFC）的主要白质（WM）束，在情绪调节中起重要作用。在这项对青少年/成年早期的纵向扩散张量成像（DTI）研究中，我们假设与健康对照组（HC）相比，BD 患者的 UF 完整性在年龄和时间上存在差异。
在 27 名 BD 青少年/成年患者和 37 名 HC 青少年/成年患者中进行了两次 DTI 扫描，两次扫描的平均间隔时间约为 2.5 年。评估了 UF 分数各向异性（FA）的诊断与年龄和时间之间的相互作用。还进行了探索性分析，包括仅患有 BD 的病情稳定的参与者，以及评估人口统计学和临床因素的潜在影响。进行了全脑分析以探索其他区域的相互作用。
UF FA 的诊断与年龄和时间之间存在显著的相互作用（p<0.05）。HC 青少年/成年患者的 UF FA 随年龄和时间的增加而显著增加（p<0.05），而 BD 患者的 UF FA 则没有随年龄或时间的变化。在包括仅患有 BD 的病情稳定的参与者的分析中，也观察到与年龄和时间的显著相互作用（p<0.05）。
这些发现提供了神经影像学证据，支持在青少年/成年早期 UF WM 结构发育存在差异，表明情绪调节的杏仁核-vPFC 系统的发育差异可能是 BD 神经发育的特征性特征。
