School of Mathematics and Statistics, University of Glasgow, Glasgow, UK; Institute of Mathematics and Statistics, Masaryk University, Brno, Czech Republic; Centre of Experimental Medicine, Slovak Academy of Sciences, Bratislava, Slovakia.
St. John of God Hospital, Stillorgan, Co., Dublin, Ireland; Department of Psychiatry, Trinity Centre for Health Sciences, Tallaght University Hospital, Dublin, Ireland.
Psychiatry Res. 2020 Sep;291:113243. doi: 10.1016/j.psychres.2020.113243. Epub 2020 Jun 18.
As understanding of the genetics of bipolar disorder increases, controversy endures regarding whether the origins of this illness include early maldevelopment. Clarification would be facilitated by a 'hard' biological index of fetal developmental abnormality, among which craniofacial dysmorphology bears the closest embryological relationship to brain dysmorphogenesis. Therefore, 3D laser surface imaging was used to capture the facial surface of 21 patients with bipolar disorder and 45 control subjects; 21 patients with schizophrenia were also studied. Surface images were subjected to geometric morphometric analysis in non-affine space for more incisive resolution of subtle, localised dysmorphologies that might distinguish patients from controls. Complex and more biologically informative, non-linear changes distinguished bipolar patients from control subjects. On a background of minor dysmorphology of the upper face, maxilla, midface and periorbital regions, bipolar disorder was characterised primarily by the following dysmorphologies: (a) retrusion and shortening of the premaxilla, nose, philtrum, lips and mouth (the frontonasal prominences), with (b) some protrusion and widening of the mandible-chin. The topography of facial dysmorphology in bipolar disorder indicates disruption to early development in the frontonasal process and, on embryological grounds, cerebral dysmorphogenesis in the forebrain, most likely between the 10 and 15 week of fetal life.
随着对双相情感障碍遗传基础的认识不断提高，关于这种疾病的起源是否包括早期发育异常仍存在争议。如果有一种“硬性”的胎儿发育异常生物学指标，就能更清楚地区分这种疾病，其中颅面畸形与脑畸形发生的胚胎关系最为密切。因此，我们使用三维激光表面成像技术来获取 21 名双相情感障碍患者和 45 名对照者的面部表面图像；还对 21 名精神分裂症患者进行了研究。对表面图像进行非仿射空间的几何形态测量分析，以更敏锐地分辨可能区分患者和对照者的细微、局部畸形。复杂而更具生物学信息量的非线性变化将双相情感障碍患者与对照者区分开来。在上部面部、上颌骨、中面部和眶周区域存在轻微畸形的背景下，双相情感障碍的特征主要为：（a）前鼻突、鼻子、人中、嘴唇和口（额鼻突）的后缩和缩短，以及（b）下颌-下巴的一些突出和变宽。双相情感障碍的面部畸形的分布表明，额鼻突的早期发育中断，并且根据胚胎学原理，在前脑的脑畸形发生中，最有可能在胎儿生命的第 10 到 15 周之间。
