Department of Psychiatry, Ankara Yıldırım Beyazıt University Medical School, Ankara, Turkey; Department of Psychiatry, Ankara Atatürk Training and Education Hospital, Ankara, Turkey.
Center for Comparative NeuroImaging, Department of Psychiatry and Radiology, University of Massachusetts Medical School, Worcester, MA, USA.
J Affect Disord. 2018 Aug 1;235:15-19. doi: 10.1016/j.jad.2018.04.010. Epub 2018 Apr 4.
Despite the diagnostic challenges in categorizing bipolar disorder subtypes, bipolar I and II disorders (BD-I and BD-II respectively) are valid indices for researchers. Subtle neurobiological differences may underlie clinical differences between mood disorder subtypes. The aims of this study were to investigate neurochemical differences between bipolar disorder subtypes.
Euthymic BD-II patients (n = 21) are compared with BD-I (n = 28) and healthy comparison subjects (HCs, n = 30). Magnetic Resonance Imaging (MRI) and proton spectroscopy (H MRS) were performed on a 3T Siemens Tim Trio system. MRS voxels were located in the left/right superior temporal cortices, and spectra acquired with the single voxel Point REsolved Spectroscopy Sequence (PRESS). The spectroscopic data were analyzed with LCModel (Version 6.3.0) software.
There were significant differences between groups in terms of glutamate [F = 6.27, p = 0.003], glutamate + glutamine [F = 6.08, p = 0.004], inositol containing compounds (Ino) (F = 9.25, p < 0.001), NAA [F = 7.63, p = 0.001] and creatine + phosphocreatine [F = 11.06, p < 0.001] in the left hemisphere and Ino [F = 5.65, p = 0.005] in the right hemisphere. Post-hoc comparisons showed that the BD-I disorder group had significantly lower metabolite levels in comparison to the BD-II and the HC groups.
This was a cross-sectional study with a small sample size. In addition, patients were on various psychotropic medications, which may have impacted the results.
Neurochemical levels, in the superior temporal cortices, measured with H-MRS discriminated between BD-II and BD-I. Although further studies are needed, one may speculate that the superior temporal cortices (particularly left hemispheric) play a critical role, whose pathology may be related to subtyping bipolar disorder.
尽管在分类双相障碍亚型方面存在诊断挑战，但双相 I 型和 II 型障碍（分别为 BD-I 和 BD-II）是研究人员的有效指标。情绪障碍亚型之间的临床差异可能源于微妙的神经生物学差异。本研究旨在探讨双相障碍亚型之间的神经化学差异。
本研究比较了 21 例双相 II 型障碍（BD-II）患者与 28 例双相 I 型障碍（BD-I）患者和 30 例健康对照（HC）。在 3T 西门子 Tim Trio 系统上进行磁共振成像（MRI）和质子波谱（H MRS）。MRS 体素位于左侧/右侧颞上回，采用单体素点分辨波谱序列（PRESS）采集光谱。使用 LCModel（版本 6.3.0）软件分析波谱数据。
组间谷氨酸[F=6.27，p=0.003]、谷氨酸+谷氨酰胺[F=6.08，p=0.004]、肌醇含化合物（Ino）[F=9.25，p<0.001]、N-乙酰天门冬氨酸[NAA][F=7.63，p=0.001]和肌酸+磷酸肌酸[F=11.06，p<0.001]在左侧半球以及肌醇[F=5.65，p=0.005]在右侧半球存在显著差异。事后比较显示，BD-I 障碍组的代谢物水平明显低于 BD-II 障碍组和 HC 组。
这是一项横断面研究，样本量较小。此外，患者正在服用各种精神药物，这可能会影响结果。
使用 H-MRS 测量的颞上回神经化学水平可区分 BD-II 和 BD-I。尽管还需要进一步的研究，但人们可能会推测颞上回（特别是左半球）起着关键作用，其病理可能与双相障碍的亚型有关。
