Aylward E H, Roberts-Twillie J V, Barta P E, Kumar A J, Harris G J, Geer M, Peyser C E, Pearlson G D
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD.
Am J Psychiatry. 1994 May;151(5):687-93. doi: 10.1176/ajp.151.5.687.
Accumulating evidence suggests an association between abnormalities of the basal ganglia and affective disorders. The authors hypothesized that patients with bipolar disorder would demonstrate smaller basal ganglia volumes and a greater number of hyperintensities on magnetic resonance imaging than comparison subjects who were matched on age, race, sex, and education.
Volumes of the caudate, putamen, and globus pallidus were measured in 30 patients with bipolar disorder and 30 matched normal comparison subjects. The presence, number, and location of hyperintensities were also assessed.
Male patients with bipolar disorder demonstrated larger caudate volumes than male comparison subjects. Older, but not younger, patients with bipolar disorder demonstrated more hyperintensities than comparison subjects, primarily in frontal lobe white matter.
These results are not consistent with those of previous studies showing reduced basal ganglia volume in subjects with affective disorders, but they are consistent with previous findings of increased white matter hyperintensities, especially in older patients with bipolar disorder. Considered together with results from other studies, the findings suggest that the nature of basal ganglia/subcortical white matter involvement may differ according to the type of depression (unipolar versus bipolar) and the age and sex of the patient.
越来越多的证据表明基底神经节异常与情感障碍之间存在关联。作者推测，与年龄、种族、性别和教育程度相匹配的对照受试者相比，双相情感障碍患者在磁共振成像上会表现出基底神经节体积更小且高信号更多。
测量了30例双相情感障碍患者和30例匹配的正常对照受试者的尾状核、壳核和苍白球体积。还评估了高信号的存在、数量和位置。
双相情感障碍男性患者的尾状核体积大于男性对照受试者。年龄较大（而非较年轻）的双相情感障碍患者的高信号比对照受试者更多，主要位于额叶白质。
这些结果与先前研究中显示情感障碍患者基底神经节体积减小的结果不一致，但与先前关于白质高信号增加的发现一致，尤其是在年龄较大的双相情感障碍患者中。结合其他研究结果来看，这些发现表明基底神经节/皮质下白质受累的性质可能因抑郁症类型（单相与双相）以及患者的年龄和性别而异。
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