Toma Simina, Dimick Mikaela K, Grigorian Anahit, Fiksenbaum Lisa, Robertson Andrew D, Kennedy Kody G, Mitchell Rachel H B, MacIntosh Bradley J, Goldstein Benjamin I
Sunnybrook Health Sciences Centre, Toronto, Canada.
University of Toronto, Toronto, Canada.
JAACAP Open. 2024 Mar 13;3(2):205-215. doi: 10.1016/j.jaacop.2024.01.011. eCollection 2025 Jun.
Multiple prior studies have examined cerebral blood flow (CBF) in relation to mood states in adults with bipolar disorder (BD). This study examined CBF related to mood states in adolescents early in the course of BD, about which little is known.
The study recruited 155 adolescents (mean [SD] age = 17.23 [1.62] years), including 81 with BD (32 hypomanic/mixed, 25 depressed, 24 euthymic) and 74 healthy controls. CBF was ascertained using pseudocontinuous arterial spin labeling magnetic resonance imaging. Region-of-interest analysis (amygdala, anterior cingulate cortex, middle frontal gyrus) controlling for age, sex, and race was complemented by whole-brain voxel-wise analyses. Within-BD regression analysis using age and sex as covariates examined the association of mania and depression severity with CBF.
In region-of-interest analyses, there were no group differences in CBF. Within the overall BD group, higher depression scores were associated with lower anterior cingulate cortex CBF (β = -.27, = .01). In corrected voxel-wise analyses, CBF in the euthymic BD group was significantly higher compared with healthy controls in temporal and precentral regions.
The finding of elevated regional CBF in adolescents with euthymic BD diverges from prior findings of reduced regional CBF in adults with BD. Higher CBF in adolescents with euthymic BD may reflect a developmentally specific compensatory perfusion mechanism required to maintain euthymia. However, longitudinal studies are needed to understand the temporal association of CBF and mood state in adolescents with BD, ideally followed into adulthood.
DIVERSITY & INCLUSION STATEMENT: We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.
多项先前研究探讨了双相情感障碍（BD）成年患者的脑血流量（CBF）与情绪状态的关系。本研究调查了BD病程早期青少年的CBF与情绪状态的关系，对此了解甚少。
该研究招募了155名青少年（平均[标准差]年龄=17.23[1.62]岁），其中包括81名BD患者（32名轻躁狂/混合发作、25名抑郁发作、24名心境正常）和74名健康对照者。使用伪连续动脉自旋标记磁共振成像确定CBF。在控制年龄、性别和种族的情况下，进行感兴趣区域分析（杏仁核、前扣带回皮质、额中回），并辅以全脑体素分析。以年龄和性别作为协变量的BD组内回归分析，研究了躁狂和抑郁严重程度与CBF的关联。
在感兴趣区域分析中，CBF无组间差异。在整个BD组中，抑郁得分越高，前扣带回皮质CBF越低（β=-0.27，P=0.01）。在校正的体素分析中，心境正常的BD组在颞叶和中央前回区域的CBF显著高于健康对照者。
心境正常的BD青少年区域CBF升高的发现与BD成年患者区域CBF降低的先前发现不同。心境正常的BD青少年较高的CBF可能反映了维持心境正常所需的发育特异性代偿性灌注机制。然而，需要进行纵向研究以了解BD青少年CBF与情绪状态的时间关联，理想情况下应跟踪至成年期。
我们努力确保在招募人类参与者时实现性别平衡。我们努力确保在招募人类参与者时实现种族、民族和/或其他类型的多样性。我们努力确保研究问卷以包容性方式编制。本文的一位或多位作者自我认同为科学领域中一个或多个历史上代表性不足的性和/或性别群体的成员。我们积极努力促进作者群体中的性别平衡。我们积极努力促进作者群体中纳入科学领域中历史上代表性不足的种族和/或民族群体。本文的作者名单包括研究开展地点和/或社区的贡献者，他们参与了数据收集、设计、分析和/或对工作的解释。
