Altshuler L L, Curran J G, Hauser P, Mintz J, Denicoff K, Post R
Department of Psychiatry and Biobehavioral Sciences, UCLA Center for Health Sciences, USA.
Am J Psychiatry. 1995 Aug;152(8):1139-44. doi: 10.1176/ajp.152.8.1139.
Accumulating evidence suggests a greater number of T2 abnormalities in the brains of patients with bipolar I disorder. The authors sought to evaluate the presence of signal "hyperintensities" in both bipolar I and II subjects and systematically review the existing literature.
Magnetic resonance images of the brain were obtained prospectively for 29 patients with bipolar I disorder, 26 patients with bipolar II disorder, and 20 normal comparison subjects. The presence and location of signal hyperintensities in three brain regions (periventricular white matter, subcortical gray matter, and deep white matter) were evaluated.
No significant differences were found between groups for the presence of subcortical gray or deep white matter hyperintensities. Periventricular hyperintensities were more common in bipolar I patients (62%) than in bipolar II patients (38%) and normal comparison subjects (30%). Within patient groups, medication use was not significantly different for those with or without the presence of white matter hyperintensities. The literature on bipolar disorder and signal hyperintensities is reviewed. A meta-analysis of the pooled data in the literature on bipolar illness and signal hyperintensities revealed that the odds of having a T2 hyperintensity are significantly greater for bipolar I than for normal comparison subjects.
Having bipolar I disorder significantly increases the chance of having white matter changes in the brain. This study suggests that bipolar II patients may be more similar than bipolar I patients to comparison subjects on T2 measures. The possible pathophysiological significance of hyperintensities is discussed.
越来越多的证据表明，双相I型障碍患者大脑中存在更多的T2异常。作者试图评估双相I型和II型受试者中信号“高信号”的存在情况，并系统回顾现有文献。
前瞻性地获取了29例双相I型障碍患者、26例双相II型障碍患者和20名正常对照者的脑部磁共振图像。评估了三个脑区（脑室周围白质、皮质下灰质和深部白质）中信号高信号的存在情况和位置。
在皮质下灰质或深部白质高信号的存在方面，各组之间未发现显著差异。脑室周围高信号在双相I型患者中（62%）比在双相II型患者中（38%）和正常对照者中（30%）更常见。在患者组中，有或没有白质高信号的患者在用药方面没有显著差异。对双相情感障碍和信号高信号的文献进行了综述。对双相情感障碍和信号高信号文献中的汇总数据进行的荟萃分析显示，双相I型患者出现T2高信号的几率明显高于正常对照者。
患有双相I型障碍会显著增加大脑白质发生变化的几率。这项研究表明，在T2测量方面，双相II型患者可能比双相I型患者与对照者更相似。讨论了高信号可能的病理生理意义。
