Carreño Ruiz Giancarlo, Zapata Ospina Juan Pablo, Vargas Cristian, Aguirre Acevedo Daniel Camilo, López-Jaramillo Carlos
Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
Instituto de Investigaciones Médicas, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
Rev Colomb Psiquiatr (Engl Ed). 2020 Dec 27. doi: 10.1016/j.rcp.2020.10.005.
Predominant polarity (PP) has been proposed as a specifier of bipolar disorder (BD) due to its relationship with clinical and prognostic variables. It is possible that this is due to a different underlying neurobiology, in such a way that the changes found by structural nuclear magnetic resonance imaging (sMRI) in BD are different and specific.
To explore findings of structural neuroimaging in patients with BD type I (BD-I) according to PP.
Cross-sectional study that evaluated 77 patients with BD-I using the DIGS interview. PP was established using the operative definition of two-thirds of all affective episodes throughout life to classify PP as manic (MPP), depressive (DPP) or indeterminate (IPP). MRIwas performed during the euthymia phase to measure intracranial structures. The data obtained was analysed using a linear regression model adjusted for confounding variables (drug use, alcohol use, psychoactive substance use) and were compared between the three groups finding the standardised mean difference (SMD).
Differences with adequate effect size were found in three brain structures after adjusting for confounding variables, specifically in the right fusiform gyrus and the left lingual gyrus, which were greater in the DPP group than in the MPP group (SMD = 0.92; 95% CI = 0.34 to 1.49 and SMD = 0.78; 95% CI = 0.21 to 1.35). Likewise, in the right thalamus, it was shown to be greater in the IPP group compared to MPP group (SMD 0.89, 95% CI = 0.31 to 1.46).
A reduction in the thickness of the right fusiform gyrus and the left lingual gyrus, as well as the right thalamic volume was observed in patients with BD-I with PPM, which supports the hypothesis that PP has a plausible neurobiological correlate and could have potential utility as a BD specifier.
由于优势极性（PP）与临床及预后变量相关，它已被提出作为双相情感障碍（BD）的一种分类指标。这可能是由于其潜在的神经生物学机制不同，以至于在BD中通过结构核磁共振成像（sMRI）发现的变化是不同且具有特异性的。
根据PP探索I型双相情感障碍（BD-I）患者的结构神经影像学研究结果。
采用横断面研究，通过DIGS访谈评估77例BD-I患者。使用一生中所有情感发作的三分之二这一操作性定义来确定PP，将PP分为躁狂型（MPP）、抑郁型（DPP）或不确定型（IPP）。在心境正常期进行MRI以测量颅内结构。使用针对混杂变量（药物使用、酒精使用、精神活性物质使用）进行调整的线性回归模型对获得的数据进行分析，并在三组之间进行比较以得出标准化平均差（SMD）。
在对混杂变量进行调整后，在三个脑结构中发现了具有足够效应量的差异，具体为右侧梭状回和左侧舌回，DPP组的这些脑区比MPP组更大（SMD = 0.92；95% CI = 0.34至1.49以及SMD = 0.78；95% CI = 0.21至1.35）。同样，在右侧丘脑，IPP组比MPP组更大（SMD = 0.89，95% CI = 0.31至1.46）。
在具有PPM的BD-I患者中观察到右侧梭状回和左侧舌回厚度以及右侧丘脑体积减小，这支持了PP具有合理的神经生物学相关性且可能作为BD分类指标具有潜在效用的假设。
