双相情感障碍患者处于病情稳定期时，其颞叶灰质体积增加，且与认知功能有关。

Increased grey matter volumes in the temporal lobe and its relationship with cognitive functioning in euthymic patients with bipolar disorder.

机构信息

Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Mental Health Department, Unitat de Neurociència Traslacional, Parc Tauli University Hospital, Institut d'Investigació i Innovació Sanitària Parc Taulí (I3PT), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain.

Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; CIBERSAM, Carlos III Health Institute, Madrid, Spain.

出版信息

Prog Neuropsychopharmacol Biol Psychiatry. 2024 Jun 8;132:110962. doi: 10.1016/j.pnpbp.2024.110962. Epub 2024 Feb 15.

DOI:10.1016/j.pnpbp.2024.110962

PMID:38365103

Abstract

BACKGROUND

Bipolar disorder (BD) is characterized by episodic mood dysregulation, although a significant portion of patients suffer persistent cognitive impairment during euthymia. Previous magnetic resonance imaging (MRI) research suggests BD patients may have accelerated brain aging, observed as lower grey matter volumes. How these neurostructural alterations are related to the cognitive profile of BD is unclear.

METHODS

We aim to explore this relationship in euthymic BD patients with multimodal structural neuroimaging. A sample of 27 euthymic BD patients and 24 healthy controls (HC) underwent structural grey matter MRI and diffusion-weighted imaging (DWI). BD patient's cognition was also assessed. FreeSurfer algorithms were used to obtain estimations of regional grey matter volumes. White matter pathways were reconstructed using TRACULA, and four diffusion metrics were extracted. ANCOVA models were performed to compare BD patients and HC values of regional grey matter volume and diffusion metrics. Global brain measures were also compared. Bivariate Pearson correlations were explored between significant brain results and five cognitive domains.

RESULTS

Euthymic BD patients showed higher ventricular volume (F(1, 46) = 6.04; p = 0.018) and regional grey matter volumes in the left fusiform (F(1, 46) = 15.03; pFDR = 0.015) and bilateral parahippocampal gyri compared to HC (L: F(1, 46) = 12.79, pFDR = 0.025/ R: F(1, 46) = 15.25, pFDR = 0.015). Higher grey matter volumes were correlated with greater executive function (r = 0.53, p = 0.008).

LIMITATIONS

We evaluated a modest sample size with concurrent pharmacological treatment.

CONCLUSIONS

Higher medial temporal volumes in euthymic BD patients may be a potential signature of brain resilience and cognitive adaptation to a putative illness neuroprogression. This knowledge should be integrated into further efforts to implement imaging into BD clinical management.

摘要

背景

双相情感障碍（BD）的特征是发作性情绪失调，尽管很大一部分患者在病情稳定时仍持续存在认知障碍。先前的磁共振成像（MRI）研究表明，BD 患者可能存在加速的大脑老化，表现为灰质体积较低。这些神经结构改变与 BD 的认知特征有何关系尚不清楚。

方法

我们旨在通过多模态结构神经影像学研究来探索这一关系。一组 27 名病情稳定的 BD 患者和 24 名健康对照（HC）接受了结构灰质 MRI 和弥散加权成像（DWI）检查。还评估了 BD 患者的认知功能。使用 FreeSurfer 算法获得区域灰质体积的估计值。使用 TRACULA 重建白质通路，并提取四个扩散指标。使用协方差分析模型比较 BD 患者和 HC 的区域灰质体积和扩散指标值。还比较了大脑的整体指标。对显著的大脑结果与五个认知领域之间进行双变量 Pearson 相关性分析。

结果

病情稳定的 BD 患者的脑室体积（F（1, 46）= 6.04;p=0.018）和左侧梭状回（F（1, 46）= 15.03;pFDR=0.015）以及双侧海马旁回的灰质体积高于 HC（左：F（1, 46）= 12.79;pFDR=0.025/右：F（1, 46）= 15.25;pFDR=0.015）。较高的灰质体积与更好的执行功能呈正相关（r=0.53;p=0.008）。