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双相 II 型障碍中的短暂性胼胝体病变综合征:一例报告,凸显轻躁狂发作期间可逆性脑改变

Transient splenial lesion syndrome in bipolar-II disorder: a case report highlighting reversible brain changes during hypomanic episodes.

作者信息

Zhou Jingyuan, Cao Yuan, Deng Gaoju, Fang Jinbo, Qiu Changjian

机构信息

Mental Health Center, West China Hospital of Sichuan University, Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China.

Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China.

出版信息

Front Psychiatry. 2023 Jul 10;14:1219592. doi: 10.3389/fpsyt.2023.1219592. eCollection 2023.

Abstract

BACKGROUND

Reversible splenial lesion syndrome (RESLES) is a rare neurological condition characterized by temporary abnormalities in the splenium of the corpus callosum, which has been reported in mental disorders. Previous studies on bipolar disorder (BD) primarily focused on aspects such as brain structure and function, neurochemical changes, and genetics. However, there have been no studies reporting the occurrence of this syndrome during hypomanic episodes and its disappearance during the remission phase in bipolar disorder type 2 (BD-II).

CASE PRESENTATION

We present a case report of a 30 years-old female patient with BD-II who exhibited symptoms of RESLES during a hypomanic episode. The patient, with a 12 years psychiatric history, has experienced recurrent depressive episodes initially, with the first hypomanic episode occurring 8 years ago. During this period, this patient made several visits to the outpatient clinic to have her medications adjusted due to repeated suicide attempts. This time, she was admitted to our hospital with a second hypomanic episode due to drug withdrawal during pregnancy. The RESLES was observed on her brain magnetic resonance image, and it was alleviated after treatment with lithium carbonate and quetiapine until achieving remission.

CONCLUSION

We present the first report of identifying RESLES in BD-II with hypomanic episodes, which subsequently disappears during the remission phase. Our case report highlights a potential association between BD and RESLES, emphasizing the need for future studies to explore the underlying mechanisms connecting these two conditions in greater depth.

摘要

背景

可逆性胼胝体压部病变综合征(RESLES)是一种罕见的神经系统疾病,其特征为胼胝体压部出现暂时异常,在精神障碍中已有报道。先前关于双相情感障碍(BD)的研究主要集中在脑结构与功能、神经化学变化以及遗传学等方面。然而,尚无研究报道2型双相情感障碍(BD-II)在轻躁狂发作期间出现该综合征,以及在缓解期消失的情况。

病例报告

我们报告一例30岁BD-II女性患者,在轻躁狂发作期间出现RESLES症状。该患者有12年精神病史,最初经历过多次抑郁发作,首次轻躁狂发作发生在8年前。在此期间,因反复自杀未遂,该患者多次到门诊调整药物治疗。此次,因孕期停药导致第二次轻躁狂发作而入院。在她的脑磁共振成像上观察到RESLES,经碳酸锂和喹硫平治疗后缓解直至病情缓解。

结论

我们首次报告在伴有轻躁狂发作的BD-II中发现RESLES,且该综合征在缓解期消失。我们的病例报告突出了BD与RESLES之间的潜在关联,强调未来有必要开展研究更深入地探索连接这两种疾病的潜在机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9d1/10363742/2c1794c90fdf/fpsyt-14-1219592-g001.jpg

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