School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, China.
Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China.
Depress Anxiety. 2019 Apr;36(4):353-364. doi: 10.1002/da.22866. Epub 2018 Nov 26.
Bipolar disorder (BD) is a common and destructive psychiatric illness worldwide. Although it is known that BD is associated with morphological abnormalities of the brain, the regions implicated in BD remain unclear. Therefore, we aimed to update current knowledge on potential structural imaging biomarkers of BD.
Studies published up to January 31, 2018, were identified by a comprehensive literature search of PubMed, EBSCO, and BrainMap voxel-based morphometry (VBM) database. Whole-brain VBM studies that examined gray matter (GM) abnormalities of group comparisons between BD and healthy controls (HC) and reported results as coordinates in a standard reference space were included. Different meta-analyses were performed by activation likelihood estimation (ALE) algorithm.
A total of 46 studies with 56 experiments, including 1720 subjects and 268 foci were included. Seven different meta-analyses were calculated separately across experiments reporting decreased or increased GM volume among BD, BDΙ, BD-adults, and BD-youths groups. Fifteen regions of significantly different GM volume between four groups and HC were identified. There were extensive GM deficits in the prefrontal and temporal cortex, and enlargements in the putamen, cingulate cortex, and precuneus.
The results revealed that the thinning of prefrontal cortex was a key region in the pathophysiology of BD. The enlargement of the cingulate cortex may be implicated in a compensatory mechanism. It underscored important differences between BD-adults and BD-youths and specific biomarkers of three subgroups.
双相情感障碍（BD）是一种常见且具有破坏性的精神疾病，在全球范围内都有发生。尽管已知 BD 与大脑形态异常有关，但涉及的区域仍不清楚。因此，我们旨在更新目前关于 BD 的潜在结构成像生物标志物的知识。
通过对 PubMed、EBSCO 和 BrainMap 体素形态计量学（VBM）数据库进行全面的文献检索，确定了截至 2018 年 1 月 31 日发表的研究。纳入了研究组间 BD 和健康对照组（HC）的全脑 VBM 研究，这些研究检查了灰质（GM）异常，并以标准参考空间中的坐标报告了结果。使用激活似然估计（ALE）算法进行了不同的荟萃分析。
共纳入了 46 项研究，包括 56 个实验，涉及 1720 名受试者和 268 个焦点。对报告 BD、BDΙ、BD 成人和 BD 青少年组 GM 体积减少或增加的实验分别进行了七项不同的荟萃分析。确定了四个组和 HC 之间 GM 体积存在显著差异的 15 个区域。在前额叶和颞叶皮层存在广泛的 GM 缺陷，而纹状体、扣带回皮层和楔前叶增大。
结果表明，前额叶皮层变薄是 BD 病理生理学的关键区域。扣带回皮层的扩大可能与代偿机制有关。它强调了 BD 成人和 BD 青少年之间以及三个亚组的特定生物标志物之间的重要差异。
