Kennedy Kody G, Islam Alvi H, Karthikeyan Sudhir, Metcalfe Arron W S, McCrindle Brian W, MacIntosh Bradley J, Black Sandra, Goldstein Benjamin I
Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, Canada; Department of Pharmacology, University of Toronto, Toronto, ON, Canada.
Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, Canada; Faculty of Medicine, University of Toronto, Toronto, Canada.
J Psychosom Res. 2023 Apr;167:111180. doi: 10.1016/j.jpsychores.2023.111180. Epub 2023 Feb 1.
Mood symptoms and disorders are associated with impaired endothelial function, a marker of early atherosclerosis. Given the increased vascular burden and neurostructural differences among individuals with mood disorders, we investigated the endothelial function and brain structure interface in relation to youth bipolar disorder (BD).
This cross-sectional case-controlled study included 115 youth, ages 13-20 years (n = 66 BD; n = 49 controls [CG]). Cortical thickness and volume for regions of interest (ROI; insular cortex, ventrolateral prefrontal cortex [vlPFC], temporal lobe) were acquired from FreeSurfer processed T1-weighted MRI images. Endothelial function was assessed using pulse amplitude tonometry, yielding a reactive hyperemia index (RHI). ROI and vertex-wise analyses controlling for age, sex, obesity, and intracranial volume investigated for RHI-neurostructural associations, and RHI-by-diagnosis interactions.
In ROI analyses, higher RHI (i.e., better endothelial function) was associated with lower thickness in the insular cortex (β = -0.19, p = 0.03), vlPFC (β = -0.30, p = 0.003), and temporal lobe (β = -0.22, p = 0.01); and lower temporal lobe volume (β = -0.16, p = 0.01) in the overall sample. In vertex-wise analyses, higher RHI was associated with lower cortical thickness and volume in the insular cortex, prefrontal cortex (e.g., vlPFC), and temporal lobe. Additionally, higher RHI was associated with lower vlPFC and temporal lobe volume to a greater extent in youth with BD vs. CG.
Better endothelial function was associated with lower regional brain thickness and volume, contrasting the hypothesized associations. Additionally, we found evidence that this pattern was exaggerated in youth with BD. Future studies examining the direction of the observed associations and underlying mechanisms are warranted.
情绪症状和障碍与内皮功能受损有关，内皮功能受损是早期动脉粥样硬化的一个标志。鉴于情绪障碍患者的血管负担增加和神经结构差异，我们研究了与青少年双相情感障碍（BD）相关的内皮功能与脑结构的关系。
这项横断面病例对照研究纳入了115名13 - 20岁的青少年（n = 66例BD患者；n = 49例对照组[CG]）。通过FreeSurfer处理的T1加权MRI图像获取感兴趣区域（ROI；岛叶皮质、腹外侧前额叶皮质[vlPFC]、颞叶）的皮质厚度和体积。使用脉搏振幅张力测量法评估内皮功能，得出反应性充血指数（RHI）。在控制年龄、性别、肥胖和颅内体积的情况下，进行ROI和逐顶点分析，以研究RHI与神经结构的关联以及RHI与诊断的交互作用。
在ROI分析中，较高的RHI（即更好的内皮功能）与岛叶皮质厚度降低（β = -0.19，p = 0.03）、vlPFC厚度降低（β = -0.30，p = 0.003）、颞叶厚度降低（β = -0.22，p = 0.01）以及总体样本中颞叶体积降低（β = -0.16，p = 0.01）相关。在逐顶点分析中，较高的RHI与岛叶皮质、前额叶皮质（如vlPFC）和颞叶的皮质厚度和体积降低相关。此外，与CG相比，BD青少年中较高的RHI与vlPFC和颞叶体积降低的程度更大相关。
更好的内皮功能与区域脑厚度和体积降低相关，这与假设的关联相反。此外，我们发现有证据表明这种模式在BD青少年中更为明显。有必要进行进一步的研究来检验所观察到的关联方向和潜在机制。
