双相障碍成年患者在不同状态下脑灰质体积改变的基于体素的荟萃分析。
Brain grey-matter volume alteration in adult patients with bipolar disorder under different conditions: a voxel-based meta-analysis.
机构信息
From the Department of Psychiatry, the Fourth People’s Hospital of Chengdu, Chengdu, China (Duan, He, H. Wang, S. Wang, X. Wang); the Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China (Luo, Jia); the Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China (Tian, Jia); the Department of Radiology, West China Second University Hospital of Sichuan University, Chengdu, China (Cheng); and the Department of Radiology, the Second People’s Hospital of Yibin, Yibin, China (Qiu).
出版信息
J Psychiatry Neurosci. 2019 Mar 1;44(2):89-101. doi: 10.1503/jpn.180002.
BACKGROUND
The literature on grey-matter volume alterations in bipolar disorder is heterogeneous in its findings.
METHODS
Using effect-size differential mapping, we conducted a meta-analysis of grey-matter volume alterations in patients with bipolar disorder compared with healthy controls.
RESULTS
We analyzed data from 50 studies that included 1843 patients with bipolar disorder and 2289 controls. Findings revealed lower grey-matter volumes in the bilateral superior frontal gyri, left anterior cingulate cortex and right insula in patients with bipolar disorder and in patients with bipolar disorder type I. Patients with bipolar disorder in the euthymic and depressive phases had spatially distinct regions of altered grey-matter volume. Meta-regression revealed that the proportion of female patients with bipolar disorder or bipolar disorder type I was negatively correlated with regional grey-matter alteration in the right insula; the proportion of patients with bipolar disorder or bipolar disorder type I taking lithium was positively correlated with regional grey-matter alterations in the left anterior cingulate/paracingulate gyri; and the proportion of patients taking antipsychotic medications was negatively correlated with alterations in the anterior cingulate/paracingulate gyri.
LIMITATIONS
This study was cross-sectional; analysis techniques, patient characteristics and clinical variables in the included studies were heterogeneous.
CONCLUSION
Structural grey-matter abnormalities in patients with bipolar disorder and bipolar disorder type I were mainly in the prefrontal cortex and insula. Patients' mood state might affect grey-matter alterations. Abnormalities in regional grey-matter volume could be correlated with patients' specific demographic and clinical features.
背景
双相情感障碍患者的灰质体积改变的文献结果存在异质性。
方法
我们使用效应量差异映射对双相情感障碍患者与健康对照者的灰质体积改变进行了荟萃分析。
结果
我们分析了 50 项研究的数据，这些研究包括 1843 例双相情感障碍患者和 2289 例对照者。结果显示，双相情感障碍患者双侧额上回、左前扣带回和右侧岛叶灰质体积降低，且双相情感障碍 I 型患者也存在这种情况。处于缓解期和抑郁期的双相情感障碍患者存在灰质体积改变的不同空间区域。元回归显示，双相情感障碍或双相情感障碍 I 型患者中女性患者的比例与右侧岛叶的灰质改变呈负相关；双相情感障碍或双相情感障碍 I 型患者中使用锂的比例与左前扣带回/旁扣带回皮质的灰质改变呈正相关；而使用抗精神病药物的患者比例与前扣带回/旁扣带回皮质的改变呈负相关。
局限性
本研究为横断面研究；纳入研究中的分析技术、患者特征和临床变量存在异质性。
结论
双相情感障碍和双相情感障碍 I 型患者的结构灰质异常主要在前额叶皮质和岛叶。患者的情绪状态可能影响灰质改变。区域灰质体积的异常可能与患者的特定人口统计学和临床特征相关。
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