Department of Child Psychology, The Children's Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, National Children's Regional Medical Center, No. 3333 Binsheng Road, Hangzhou, 310003, Zhejiang, China.
Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang Key Laboratory of Precision Psychiatry, Zhejiang Engineering Center for Mathematical Mental Health, No. 79 Qingchun Road, Hangzhou, 310003, Zhejiang, China.
BMC Psychiatry. 2024 Nov 1;24(1):762. doi: 10.1186/s12888-024-06208-x.
Bipolar disorder may begin as depression or mania, which can affect the treatment and prognosis. The physiological and pathological differences among pediatric bipolar disorder (PBD) patients with different onset symptoms are not clear. The aims of the present study were to investigate subcortical structural alterations in PBD patients with first-episode depressive (PBD-FED) and first-episode manic (PBD-FEM).
A total of 59 individuals including 28 PBD-FED, 13 PBD-FEM, and 18 healthy controls (HCs) underwent high-resolution structural magnetic resonance scans. FreeSurfer 7.2 was used to detect changes in subcortical volumes. Simultaneously, thalamic, hippocampal, and amygdala subregion volumes were compared between the three groups.
Analysis of covariance controlling for age, sex, education, and estimated intracranial volume shows third and fourth ventricle enlargement in patients with PBD. Compared with the PBD-FED and HCs, the PBD-FEM group had reduced gray matter volume in the left thalamus, bilateral hippocampus, and right amygdala. Subsequent subregion analyses showed right cortico-amygdaloid transient, bilateral accessory-basal nucleus, left hippocampal tail, right hippocampal head, and body volume reduction in the PBD-FEM group.
The present findings provided evidence of decreased subcortical structure in PBD-FEM patients, which might present its trait feature.
双相障碍可能始于抑郁或躁狂,这可能会影响治疗和预后。具有不同起始症状的儿科双相障碍(PBD)患者的生理和病理差异尚不清楚。本研究旨在探讨首发抑郁(PBD-FED)和首发躁狂(PBD-FEM)PBD 患者的皮质下结构改变。
共纳入 59 名参与者,包括 28 名 PBD-FED、13 名 PBD-FEM 和 18 名健康对照(HC),所有参与者均接受了高分辨率结构磁共振扫描。使用 FreeSurfer 7.2 检测皮质下容积的变化。同时比较三组间丘脑、海马和杏仁核亚区的体积。
协方差分析控制年龄、性别、教育和估计的颅内体积后显示,PBD 患者第三和第四脑室增大。与 PBD-FED 和 HCs 相比,PBD-FEM 组左丘脑、双侧海马和右侧杏仁核的灰质体积减少。进一步的亚区分析显示,PBD-FEM 组右侧皮质杏仁核瞬态、双侧基底附属核、左侧海马尾部、右侧海马头部和体部体积减少。
本研究结果为 PBD-FEM 患者皮质下结构减少提供了证据,这可能是其特征性表现。