Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, 100 Stokes St, Toronto, ON, M6J 1H4, Canada; Department of Affective Disorders, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, No. 36 MingXin Road, LiWan District, Guangzhou, Guangdong, 510370, China; Postgraduate Medical Education, University of Toronto, ON, 602-500 University Avenue Toronto, ON, M5G 1V7, Canada.
Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, 100 Stokes St, Toronto, ON, M6J 1H4, Canada; Department of Pharmacology and Toxicology, University of Toronto, Medical Science Building, Rm 4207 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.
J Affect Disord. 2021 Mar 1;282:1315-1322. doi: 10.1016/j.jad.2020.12.146. Epub 2020 Dec 29.
Bipolar disorder (BD) is highly heritable and often severe, particularly when illness onset occurs early in life. There is limited knowledge regarding the clinical and neurostructural correlates of family history of BD among youth with BD.
Clinical characteristics were evaluated in 197 youth with BD, ages 13-20 years, including 87 with familial BD and 110 with non-familial BD. Structural neuroimaging was examined in a subsample of familial BD (n=39), non-familial BD (n=42), and healthy control (HC, n=58) youth. Region of interest (ROI) analyses of anterior cingulate cortex (ACC), inferior frontal gyrus (IFG), and amygdala were complemented by whole-brain vertex-wise analyses.
Youth with familial BD had more family history of other psychiatric disorders, less severe worst manic episode, and less treatment with lithium, selective serotonin reuptake inhibitor (SSRI) antidepressants, and any lifetime psychiatric medications. None of these findings survived after correction for multiple comparisons. There were no significant between-group differences in ROI analyses. In whole-brain analyses, significant differences in cortical thickness were as follows: familial and non-familial BD < HC in left precentral gyrus and right inferior parietal lobe; familial BD < HC in left superior frontal gyrus; non-familial BD < HC in right precentral gyrus.
Relatives did not complete full diagnostic interviews.
There were relatively few differences in clinical and neurostructural correlates related to family history of BD in youth with BD. Current findings suggest that family history of BD is not a strong contributor to the clinical or neuroimaging phenotypes in youth with BD.
双相障碍（BD）具有高度遗传性，且通常较为严重，尤其是在疾病早期发病时。对于双相障碍青年患者中，有 BD 家族史的临床和神经结构相关性知之甚少。
对 197 名年龄在 13-20 岁的双相障碍青年患者进行临床特征评估，其中 87 名有 BD 家族史，110 名无 BD 家族史。对有 BD 家族史的青年患者亚组（n=39）、无 BD 家族史的青年患者亚组（n=42）和健康对照组（HC，n=58）进行结构神经影像学检查。对前扣带皮层（ACC）、下额前回（IFG）和杏仁核进行感兴趣区（ROI）分析，并辅以全脑顶点分析。
有 BD 家族史的青年患者有更多的其他精神障碍家族史，严重程度最低的躁狂发作，以及较少接受锂、选择性 5-羟色胺再摄取抑制剂（SSRI）抗抑郁药和任何终生精神科药物治疗。这些发现均未在多次比较校正后存活。在 ROI 分析中，三组之间无显著差异。在全脑分析中，皮质厚度存在显著差异：左中央前回和右顶下小叶的家族性和非家族性 BD<HC；左额上回的家族性 BD<HC；右中央前回的非家族性 BD<HC。
亲属未完成完整的诊断访谈。
在双相障碍青年患者中，与 BD 家族史相关的临床和神经结构相关性差异相对较少。目前的研究结果表明，BD 家族史不是导致双相障碍青年患者临床或神经影像学表型的主要因素。
