中国临床心理学杂志

双相障碍患者脑灰质体积变化性别差异性研究

作者：樊丽丹¹ 2 3 赵书俊¹ 吴国伟⁴ 聂彬彬² 3 刘华² 3 王静娟² 3 梁胜祥¹ 2 3 刘哲宁⁴ 单保慈² 3

单位：1. 郑州大学物理工程学院郑州 450001
2. 中国科学院高能物理研究所核分析技术重点实验室北京 100049
3. 北京市射线成像技术与装备工程技术研究中心北京 100049
4. 中南大学湘雅二医院精神卫生研究所长沙 410011

关键词：双相障碍磁共振成像基于体素的形态学分析性别

分类号：R395.1

出版年,卷(期):页码：2016,24(3):395-399

摘要：

目的：寻找不同性别双相障碍患者灰质体积减少脑区差异，探讨不同性别患者临床表现差异性的病理学机制。方法：以26位女性正常人、26例女性双相障碍患者、25位男性正常人、24例男性双相障碍患者作为研究对象，匹配年龄、受教育程度等。进行头部结构磁共振扫描，对平滑后的灰质图像进行双样本t检验，分析不同性别双相障碍患者灰质体积减少的脑区。结果：与女性对照组相比，女性双相障碍患者右侧舌回、右侧楔叶、右侧枕中回、右侧扣带回后部、右侧中央前后回脑区体积下降。与男性对照组相比，男性双相障碍患者体积下降的脑区包括右侧颞上回、右侧颞中回、右侧海马旁回、右侧额中回、右侧额下回、右侧楔前叶、右侧顶下小叶及右侧小脑后叶。结论：双相障碍患者体积下降脑区具有性别差异性，男性患者体积下降的脑区多在右侧颞叶皮层以及额叶及小脑后叶，而女性患者体积下降脑区多在右侧枕叶皮层以及扣带回后部及中央前后回脑区；这种差别可能与双相障碍患者临床表现的性别差异有关。

Objective: To study the brain regions of reduced gray matter volume of the different sexual patients with bipolar disorder.Methods: Twenty-five healthy male subjects,twenty-four male patients with bipolar disorder,twenty-six healthy female subjects and twenty-six female patients with bipolar disorder participated to the study.The MRI brain structural images were scanned.Then two-sample t-tests were performed to investigate the brain regions of reduced gray matter volume in both female patients and male patients with bipolar disorder.Results: Compared with healthy females,female patients with bipolar disorder had decreased volume in Lingual_R,Occipital_Mid_R,Cuneus_R,Postcentral_R.Compared with healthy males,male patients had decreased volume in Temporal_Mid_R,Temporal_Sup_R,Frontal_Mid_R,Fusiform_R,Frontal_Inf_Tri_R,Cerebelum_8_R,Cerebelum_10_R,Cerebelum_Crus1_R.And the brain areas of decreased volume in the male patients and the female patients were all on the right.Conclusion: The brain regions of decreased gray matter volume of different sexual patients with bipolar disorder has their specificity.Male patients had decreased gray matter volume mainly in the temporal lobe,the frontal lobe and the cerebellum posterior lobe;Female patients had decreased gray matter volume mainly in the occipital cortex,the posterior cingulate,the precentral gyrus and the postcentral gyrus.And the brain areas of decreased volume in the male patients and the female patients had lateralization.

基金项目：

国家自然科学基金（81201147，81471741）

作者简介：

参考文献：

1 张晨, 方贻儒. 线粒体 DNA 与双相障碍发病的相关性研究. 上海交通大学学报 (医学版), 2009, 29(8):994-996
2 李恒, 赵书俊, 吴国伟, 等. 双相障碍患者脑白质完整性的初步研究. 中国临床心理学杂志, 2013, 21(5):727-730
3 Eker C, Simsek F, Yilmazer EE, et al. Brain regions associated with risk and resistance for bipolar I disorder:a voxelbased MRI study of patients with bipolar disorder and their healthy siblings. Bipolar Disord, 2014, 16(3):249-261
4 Townsend J, Bookheimer SY, Foland-Ross LC, et al. fMRI abnormalities in dorsolateral prefrontal cortex during a working memory task in manic, euthymic and depressed bipolar subjects. Psychiatry Res, 2010, 182(1):22-29
5 张萌, 赵旭东. 情感障碍患者的疾病感知. 中国临床心理学杂志, 2015, 23(1):104-107
6 胡爱民, 薛志敏, 刘哲宁. 基于功能磁共振的单相与双相抑郁障碍神经生物机制研究进展. 中国临床心理学杂志, 2015, 23(5):878-880
7 翟书涛. 妇女双相障碍的临床特征. 中国精神科杂志, 2008, 41(2):125-126
8 Erol A, Winham SJ, McElroy SL, et al. Sex differences in the risk of rapid cycling and other indicators of adverse illness course in patients with bipolar I and Ⅱ disorder. Bipolar Disorders, 2015, 17(6):670-676
9 Izabela Kawa, Janet D Carter, Peter R Joyce, et al. Gender differences in bipolar disorder:Age of onset, course, comorbidity, and symptom presentation. Bipolar Disorders, 2005, 7 (2):119-125
10 Nivoli AMA, Pacchiarotti I, Rosa AR, et al. Gender differences in a cohort study of 604 bipolar patients:The role of predominant polarity. Journal of Affective Disorders, 2011, 133(3):443-449
11 Freeman MP, Arnold LM, McElroy SL. Women's mental health:a comprehensive textbook. New York:The Guilford Press, 2002. 166-181
12 Rasgon N, Bauer M, Grof P, et al.Sex-specific self-reported mood changes by patients with bipolar disorder. Journal of Psychiatric Research, 2005, 39(1):77-83
13 Arnold LM. Gender differences in bipolar disorder. Psychiatric Clinics of North America, 2003, 26(3):595-620
14 Adler CM, Levine AD, DelBello MP, et al. Changes in gray matter volume in patients with bipolar disorder. Biol Psychiatry, 2005, 58(2):151-157
15 Lochhead RA, Parsey RVO, quendo MA, et al. Regional brain gray matter volume differences in patients with bipolar disorder as assessed by optimized voxel-based morphometry. Biol Psychiatry, 2004, 55(12):1154-1162
16 崔立谦, 邓伟, 蒋莉君, 等. 偏执型精神分裂症和双相情感障碍躁狂患者脑灰质体积的比较分析. 四川大学学报, 2010, 41(1):5-9
17 王鹏. 单、双相抑郁障碍患者脑灰质体积的研究. 湘雅二医院硕士学位论文, 2013. 1-50
18 邹文锦, 曹莉萍, 崔立谦, 等. 情感障碍Ⅰ型脑灰质基于体素形态学初步研究. 实用放射学杂志, 2014, 30(7):1075-1079
19 Almeida JR, Akkal D, Hassel S, et al. Reduced gray matter volume in ventral prefrontal cortex but not amygdala in bipolar disorder:Significant effects of gender and trait anxiety. Psychiatry Res, 2009, 171(1):54-68
20 Luders E, Steinmetz H, Jancke L. Brain size and grey matter volume in the healthy human brain. Neuroreport, 2002, 13 (17):2371-2374
21 Peters M, Jancke L, staiger JF, et al. Unsolved problems in comparing brain sizes in Homo sapiens. Brain and Cognition, 1998, 37(2):254-285
22 Pearlson GD, Barta PE, Powers RE, et al. Medial and superior temporal gyral volumes and cerebral asymmetry in schizophrenia versus bipolar disorder. Biological Psychiatry, 1997, 41(1):1-14
23 Watson DR, Anderson JME, Bai F, et al. A voxel based morphometry study investigating brain structural changes in first episode psychosis. Behavioural Brain Research, 2012, 227 (1):91-99
24 Arnone D, Cavanagh J, Gerber D, et al. Magnetic resonance imaging studies in bipolar disorder and schizophrenia:metaanalysis. British Journal of Psychiatry, 2009, 195(3):194-201
25 Lopez-Larson MP, DelBello MP, Zimmerman ME, et al. Regional prefrontal gray and white matter abnormalities in bipolar disorder. Biological Psychiatry, 2002, 52(2):93-100
26 周千. 精神分裂症与双相障碍患者静息态脑功能磁共振低频振幅的比较研究. 中国医科大学硕士学位论文, 2013. 1-63
27 Mitchell RLC, Elliott R, Barry M, et al. Neural response to emotional prosody in schizophrenia and in bipolar affective disorder. British Journal of Psychiatry, 2004, 184(3):223-230
28 Fuentes P, Barros-Loscertales A, Bustamante JC, et al. Individual differences in the Behavioral Inhibition System are associated with orbitofrontal cortex and precuneus gray matter volume. Cognitive Affective & Behavioral Neuroscience, 2012, 12(3):491-498
29 Mincic AM. Neural substrate of the cognitive and emotional interference processing in healthy adolescents. Acta Neurobiologiae Experimentalis, 2010, 70(4):406-422
30 Koziol LF, Budding D, Andreasen N, et al. Consensus paper:the cerebellum's role in movement and cognition. Cerebellum, 2014, 13(1):151-77
31 Strata P. The Emotional Cerebellum. Cerebellum, 2015, 14 (5):570-577

服务与反馈：

【文章下载】【加入收藏】