基于扩散张量成像的双相障碍Ⅰ型患者全脑白质完整性研究

White matter integrity in patients with bipolar Ⅰ disorder: a whole brain fractional anisotropy study

目的比较双相情感障碍(BD)Ⅰ型患者和健康对照组脑白质部分各向异性分数(FA),探索BD-Ⅰ型患者的脑白质完整性。方法 2012年1月-2014年7月于中南大学湘雅二医院纳入符合《精神障碍诊断与统计手册(第4版)》(DSM-Ⅳ)诊断标准的BD-Ⅰ型患者22例为患者组,同期在中南大学湘雅二医院周边社区招募性别、年龄及受教育年限与患者组匹配的24名健康者为对照组。采用3.0T磁共振成像系统采集所有被试的脑白质结构相数据,使用FSL、SPM完成FA参数图计算、空间标准化、高斯平滑,采用两独立样本t检验分析患者组与对照组FA值差异有统计学意义的脑区。结果与对照组相比,患者组FA值增高的脑区为右侧小脑后叶(P<0.01),降低的脑区包括颞上回、小脑前叶、左侧岛叶和左侧尾状核(P均<0.01)。结论 BD-Ⅰ型患者白质完整性受损,边缘系统、颞叶和小脑白质完整性受损可能与BD-Ⅰ型的病理生理学机制有关。

Objective To compare white matter fractional anisotropy (FA) between bipolar I disorder patients and healthy controls, in order to explore the white matter integrity of bipolar I patients. Methods During January 2012 to July 2014, 22 patients meeting Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria for bipolar I disorder were enrolled from the Second Xiangya Hospital of Central South University. During the same period, 24 healthy individuals which match on the gender , age and education were randomly enrolled from surrounding communities as healthy controls. All subjects underwent 3.0T magnetic resonance imaging scan to obtain white matter structural data. Subsequently, FA image, spatial standardization and Gauss smoothing were processed using FSL and SPM toolbox. Two independent sample t-tests was used to analyze smoothed white matter map and compare differences in fractional anisotropy between the two groups. Results Compared with healthy controls, bipolar I disorder patients showed elevated FA value in the right cerebellum posterior lobe( P <0.01) and decreased FA value in superior temporal gyrus, cerebellum anterior lobe, left insula and left caudate( P <0.01). Conclusion There was impaired white matter integrity in bipolar I disorder patients. The impaired integrity in the limbic sys tem, temporal lobe and cerebellar white matter may be related to the pathophysiological mechanism of bipolar I disorder.