Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.
Department of Radiology, Nanbu Hospital, Itoman, Okinawa, Japan.
Int J Geriatr Psychiatry. 2019 Jan;34(1):186-192. doi: 10.1002/gps.5009. Epub 2018 Nov 9.
The present study investigated the usefulness of evaluating the existence of volume reduction in brain regions using voxel-based morphometry (VBM) to dissociate major depressive disorder (MDD) from bipolar disorder (BD).
METHODS/DESIGN: This study enrolled 92 individuals with MDD, 32 individuals with BD, and 43 healthy controls (HCs). We focused on gray matter volume (GMV) of the subgenual anterior cingulate cortex (sgACC), subcallosal area (SCA), and hippocampus. The degree of volume reduction in these brain regions was calculated as the z score, and the differences of z scores in these regions were investigated among the MDD, BD, and HC groups. We then performed a receiver operating characteristic curve analysis to dissociate the individuals with MDD and BD from the HCs based on the z scores in the GMV of these brain regions.
While there were no significant differences in the z scores of the hippocampus among the three groups, the z score of the sgACC was significantly higher in the MDD group than in the BD and HC groups, and the SCA z score was significantly higher in the MDD and BD groups than in the HC group.
Our findings suggest that VBM evaluation of GMV reduction in the sgACC may be useful as an objective adjunctive tool to distinguish between MDD and BD.
本研究旨在通过基于体素的形态测量学（VBM）评估脑区体积减少的存在，以区分重度抑郁症（MDD）和双相情感障碍（BD）。
方法/设计：本研究纳入了 92 名 MDD 患者、32 名 BD 患者和 43 名健康对照者（HC）。我们重点关注了前扣带回皮质亚区（sgACC）、胼胝下区（SCA）和海马体的灰质体积（GMV）。这些脑区的体积减少程度以 z 分数表示，并在 MDD、BD 和 HC 组之间研究了这些区域的 z 分数差异。然后，我们基于这些脑区 GMV 的 z 分数，进行了受试者工作特征曲线分析，以区分 MDD 和 BD 患者与 HC。
尽管三组之间的海马体 z 分数没有显著差异，但 MDD 组的 sgACC 的 z 分数显著高于 BD 和 HC 组，MDD 和 BD 组的 SCA z 分数显著高于 HC 组。
我们的研究结果表明，sgACC 的 GMV 减少的 VBM 评估可能是区分 MDD 和 BD 的一种有用的客观辅助工具。
