中国临床心理学杂志

儿童青少年双相躁狂患者的弥散张量成像研究

作者：高维佳¹ 钟元² 戚荣丰² 卢大力¹ 肖茜¹ 焦青³ 陆邵佳¹ 胥传健² 卢光明² 苏林雁¹

单位：1. 中南大学湘雅二医院精神卫生研究所精神病学与精神卫生学湖南省重点实验室长沙 410011
2. 南京军区南京总医院医学影像科南京 210002
3. 泰山医学院影像科泰安 271016

分类号：R395.2

出版年,卷(期):页码：2013,21(5):723-726

摘要：

目的：利用弥散张量成像(Diffusion tensor imaging,DTI)技术,探讨儿童青少年双相情感障碍躁狂发作(Pediatric bipolar disorder mania,PBD-mania)患者脑白质完整性的改变。方法：在湘雅二医院儿童精神科门诊收集21例年龄在10-18岁的PBD-mania患者(男/女:8/13)作为患者组,另在一学校选取18例年龄、性别与之匹配的健康受试作为对照组。所有研究对象进行磁共振扫描采集DTI数据。运用基于体素的分析法(voxel-based analysis,VBA)对DTI数据进行全脑白质的各向异性分数(Fractional anisotropy,FA)分析。结果：与正常对照组相比,PBD-mania患者右侧前扣带和左侧丘脑的FA值显著下降,未发现有FA增高的脑区。上述两区域的FA值与PBD-mania患者的疾病病程、起病年龄、发作次数以及Young躁狂量表(Young mania rating scale,YMRS)得分间均无显著的相关性。结论：前扣带与丘脑微观结构的改变可能是儿童青少年双相情感障碍发病的重要因素。

Objective: The aim of the present study was to investigate brain white matter(WM) changes in pediatric bipolar disorder mania(PBD-mania) using diffusion tensor imaging technique. Methods: Twenty-one children and adolescents with bipolar mania(male/female: 8/13) aged 10-18 years and 18 age-and sex-matched healthy controls were included in the present study. Diffusion tensor imaging(DTI) data were obtained on a Siemens 3.0 Tesla scanner. Voxel-based analyses(VBA) were conducted to compare the WM fractional anisotropy(FA) values between patients and controls. Correlations of the MRI data of each survived area with clinical characteristics in PBD patients were further analyzed. Results:As compared with the control group, PBD-mania patients showed decreased FA values in the right anterior cingulate(AC)and the left thalamus. No region of increased FA value was observed in PBD-mania. There was no significant correlation of FA values of the two survived areas with the illness duration, onset age, number of episodes, or mania score measured as Young mania rating scale(YMRS) in PBD mania patients. Conclusion: The present findings suggested that microstructural abnormality of the anterior cingulate and thalamus might contribute to the pathophysiology of PBD-mania.

基金项目：

国家自然科学基金(81171291;81371531)

作者简介：

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