Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Department of Pharmacology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Bipolar Disord. 2019 Mar;21(2):124-131. doi: 10.1111/bdi.12719. Epub 2018 Dec 13.
Cardiovascular disease (CVD) is excessive and premature among individuals with bipolar disorder (BD). Cerebrovascular reactivity (CVR), reflecting vasodilatory capacity of cerebral blood vessels in response to vasoactive substances, is a marker of cerebrovascular health. Despite informative findings in other diseases, CVR has not previously been examined in BD.
Twenty-five adolescents with BD and 25 age and sex-matched psychiatrically healthy controls (HCs) completed six 15-second breath-holds (BHs) during functional magnetic resonance imaging (fMRI) at 3-Tesla. CVR was determined by comparing blood-oxygenation-level dependent (BOLD) signal changes. Voxel-wise contrasts were analyzed. Body mass index (BMI) was examined as a potential confound.
CVR in the posterior cingulate gyrus and periventricular white matter was lower in BD vs HC. After controlling for differences in BMI, additional between-group CVR differences were observed in the temporal poles, supramarginal gyrus, and lingual gyrus. There were no regions in which CVR was significantly greater in BD vs HC. CVR was not associated with mood symptoms.
This preliminary study provides evidence of cerebrovascular dysfunction in BD, including regions known to be susceptible to cerebrovascular dysfunction and/or disease. These findings warrant additional research on the causes and consequences of cerebrovascular dysfunction in early-onset BD.
双相障碍（BD）患者中存在心血管疾病（CVD）的过度和过早发生。脑血管反应性（CVR）反映了脑血管对血管活性物质的舒张能力，是脑血管健康的标志物。尽管在其他疾病中已有相关信息，但 CVR 在 BD 中尚未被检测到。
25 名青少年 BD 患者和 25 名年龄和性别匹配的精神病健康对照者（HCs）在 3T 磁共振成像（fMRI）中完成了 6 次 15 秒的屏气（BHs）。通过比较血氧水平依赖性（BOLD）信号变化来确定 CVR。分析了体素对比。体重指数（BMI）被视为潜在的混杂因素。
BD 患者的后扣带回和脑室周围白质的 CVR 低于 HC。在控制 BMI 差异后，在颞极、缘上回和舌回中观察到了额外的组间 CVR 差异。BD 与 HC 相比，没有 CVR 明显更大的区域。CVR 与情绪症状无关。
这项初步研究提供了 BD 中脑血管功能障碍的证据，包括已知易患脑血管功能障碍和/或疾病的区域。这些发现需要进一步研究早期 BD 中脑血管功能障碍的原因和后果。
