Lorefice L, Fenu G, Carta E, Frau J, Coghe G, Contu F, Barracciu M A, Carta M G, Cocco E
Multiple Sclerosis Centre, Binaghi Hospital, ATS Sardegna, ASSL Cagliari, Italy.
Multiple Sclerosis Centre, Binaghi Hospital, ATS Sardegna, ASSL Cagliari, Italy.
Mult Scler Relat Disord. 2020 Nov;46:102564. doi: 10.1016/j.msard.2020.102564. Epub 2020 Oct 4.
Bipolar disorder (BD) is frequently observed in patients affected by multiple sclerosis (MS), presenting a lifetime estimate of around 8%. However, uncertainty exists on the brain damage associated with this psychiatric comorbidity. This study aimed to investigate the effect of brain atrophy, particularly that of the subcortical grey matter (scGM) structures that notoriously regulate the affective functioning, on the co-occurrence of BD in patients with MS.
A group of patients with MS affected by BD and a control group of patients with MS without any mood/psychiatric disorder, as defined using standardised diagnostic tools (Advanced Neuropsychiatric Tools and Assessment Schedule), were recruited. The patients underwent brain MRI, and the volumes of the whole brain (WB), white matter (WM), and grey matter (GM) were estimated using SIENAX. Thus, the scGM volumes of the putamen, caudate, thalamus, hippocampus, amygdala, nucleus accumbens, and pallidus were estimated using the FIRST tool.
The sample included 61 patients with MS, amongst whom 15 (24.6%) had BD. No differences in the WB, WM, and cortical GM volumes were observed between the patients with MS with and without BD. Conversely, the multiple regression analysis revealed a significant association of BD with lower volumes of the putamen (p = 0.032), nucleus accumbens (p = 0.029), and pallidus (p = 0.061; with a trend towards significance), independently from the demographic and MS clinical features.
Our preliminary results indicated that the nucleus accumbens and putamen are smaller in MS patients with BD. Further investigations in larger cohorts of MS patients with affective disorders are necessary to confirm these data and understand the structural brain damage underlying this psychiatric comorbidity.
双相情感障碍（BD）在多发性硬化症（MS）患者中较为常见，终生患病率约为8%。然而，这种精神科共病所伴随的脑损伤情况尚不确定。本研究旨在探讨脑萎缩，尤其是众所周知的调节情感功能的皮质下灰质（scGM）结构的萎缩，对MS患者中BD共病的影响。
招募一组患有BD的MS患者以及一组使用标准化诊断工具（高级神经精神工具和评估量表）定义的无任何情绪/精神障碍的MS患者作为对照组。患者接受脑部MRI检查，使用SIENAX估算全脑（WB）、白质（WM）和灰质（GM）的体积。因此，使用FIRST工具估算壳核、尾状核、丘脑、海马体、杏仁核、伏隔核和苍白球的scGM体积。
样本包括61例MS患者，其中有15例（24.6%）患有BD。患有和未患有BD的MS患者在WB、WM和皮质GM体积上未观察到差异。相反，多元回归分析显示，BD与壳核体积减小（p = 0.032）、伏隔核体积减小（p = 0.029）和苍白球体积减小（p = 0.061；有显著趋势）显著相关，且与人口统计学和MS临床特征无关。
我们的初步结果表明，患有BD的MS患者的伏隔核和壳核较小。有必要对更大规模的患有情感障碍的MS患者队列进行进一步研究，以证实这些数据并了解这种精神科共病背后的脑结构损伤。
