锂预防双相情感障碍患者的灰质萎缩：一项国际多中心研究。
Lithium prevents grey matter atrophy in patients with bipolar disorder: an international multicenter study.
机构信息
Department of Psychiatry, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Corentin-Celton, Issy-les-Moulineaux, France.
Paris Descartes University, PRES Sorbonne Paris Cité, Paris, France.
出版信息
Psychol Med. 2021 May;51(7):1201-1210. doi: 10.1017/S0033291719004112. Epub 2020 Jan 27.
BACKGROUND
Lithium (Li) is the gold standard treatment for bipolar disorder (BD). However, its mechanisms of action remain unknown but include neurotrophic effects. We here investigated the influence of Li on cortical and local grey matter (GM) volumes in a large international sample of patients with BD and healthy controls (HC).
METHODS
We analyzed high-resolution T1-weighted structural magnetic resonance imaging scans of 271 patients with BD type I (120 undergoing Li) and 316 HC. Cortical and local GM volumes were compared using voxel-wise approaches with voxel-based morphometry and SIENAX using FSL. We used multiple linear regression models to test the influence of Li on cortical and local GM volumes, taking into account potential confounding factors such as a history of alcohol misuse.
RESULTS
Patients taking Li had greater cortical GM volume than patients without. Patients undergoing Li had greater regional GM volumes in the right middle frontal gyrus, the right anterior cingulate gyrus, and the left fusiform gyrus in comparison with patients not taking Li.
CONCLUSIONS
Our results in a large multicentric sample support the hypothesis that Li could exert neurotrophic and neuroprotective effects limiting pathological GM atrophy in key brain regions associated with BD.
背景
锂（Li）是双相情感障碍（BD）的金标准治疗方法。然而，其作用机制仍不清楚，但包括神经营养作用。我们在这里研究了 Li 对大型国际 BD 患者和健康对照（HC）样本的皮质和局部灰质（GM）体积的影响。
方法
我们分析了 271 名 I 型 BD 患者（120 名接受 Li 治疗）和 316 名 HC 的高分辨率 T1 加权结构磁共振成像扫描。使用基于体素的形态学和 SIENAX 使用 FSL 的基于体素的方法比较皮质和局部 GM 体积。我们使用多元线性回归模型来测试 Li 对皮质和局部 GM 体积的影响，考虑到酒精滥用史等潜在混杂因素。
结果
服用 Li 的患者的皮质 GM 体积大于未服用 Li 的患者。与未服用 Li 的患者相比，服用 Li 的患者右侧额中回、右侧前扣带回和左侧梭状回的局部 GM 体积更大。
结论
我们在大型多中心样本中的结果支持 Li 可能发挥神经营养和神经保护作用、限制与 BD 相关的关键大脑区域病理性 GM 萎缩的假设。
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