ABSTRACT
Objective To investigate the abnormal change of gray matter volume in patients with euthymic bipolar disorder Ⅰ (BD-Ⅰ),and to elucidate the relationship between the use of different mood stabilizers and brain structure variations.Methods Voxel-based morphometry (VBM) was used to analyze the volume of local gray matter in 35 patients with BD-Ⅰ and 30 healthy controls(HC).The patients were divided into BD-Ⅰ with lithium group and BD-Ⅰ with valproate group according to different mood stabilizers.The volume differences of gray matter of the three groups were compared by one-way ANOVA.Results Compared with HC,BD-Ⅰ patients showed significantly reduced gray matter volume in the medial frontal cortex (MNI (x,y,z):2,34,-18),orbital frontal cortex (MNI(x,y,z):-32,22,-4),frontal operculum (MNI(x,y,z):38,18,4) and insula cortex (MNI(x,y,z):-32,22,-4) (P＜0.05).There was no significant difference in thevolume of gray matter between BD-Ⅰ with lithium group and BD-Ⅰ with valproate group(P＞0.05).Conclusion Emotional disturbance in patients with BD-Ⅰ may be associated with reduced gray matter volume in the medial frontal cortex,orbital frontal cortex,frontal operculum and insula cortex.There are not significant difference about the effects of lithium carbonate and valproate on cerebral gray matter volume in patients with BD-Ⅰ.
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Objective To study the relationship between suicidal attitude and childhood trauma in bipolar disorders.Methods 67 patients with bipolar disorder and 101 healthy individuals were assessed with the Questionnaire of Suicidal Attitude (QSA) and Childhood Trauma Questionnaire(CTQ).Results There was no statistical difference between the patients group and healthy control group in the results of suicidal attitude (P＞0.05).The scores of emotional neglect (M =10)and physical neglect (M =9) in patients group were significantly higher than those of the healthy control group(M =8,M =6)(P＜0.05).The attitude to suicidal behavior was negative correlation with emotion neglect(r=-0.181,P＜0.05)in patients group.Conclusion Emotional and physical neglect are the main types of trauma in patients with BD,and may increase the risk of suicide.It is important to survey the patients with BD on childhood trauma,and intervention is necessary.
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Objective To investigate the characteristic of regional cerebral blood flow (r-CBF) in patients with major depression disorder (MDD) and bipolar depressed (BPD). Methods The r-CBF imaging was detected by using sin?gle emission computed tomography (SPECT) in 22 treatment naive patients with MDD, 22 treatment naive patients with BPD and 15 healthy controls. The r-CBF was compared between patients and controls. Results Compared to controls, the r-CBF in the bilateral temporal lobe, parietal lobe and basal ganglia significantly decreased in MDD and BPD pa?tients (P<0.001). The r-CBF in the basal ganglia was significantly lower in MDD patients than in BPD patients. Conclu?sion The r-CBF is abnormal in MDD and BPD at the resting state. The r-CBF in the basal ganglia is the main differ?ence between MDD and BPD. The difference might be regarded as a biomarker in distinguishing BPD patients from MDD patients.
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Objective To analyze the correlation of cerebral perfusion characteristics and cognitive function on patients with unipolar and bipolar depression. Methods The r-CBF imaging was detected by SPECT forall subjects. Evaluated cognitive function of subjects using WAIS-CR and WMA, and analysed data using SPSS.Results Data showed that some regions in the brain, e.g. temporal lobe, frontal lobe, hippocampus, and basal ganglia, had significant alterations of r-CBF in depressed patients as compared with healthy controls (P ＜ 0. 05 ).Compared with UPD, BPD showed increased perfusion in basal ganglia ( 0,22.73%; 4.54%, 36. 36% ) (P ＜0.05 ). Furthermore there was no significant different incognitive deficits between UPD and BPD(P ＞ 0. 05 ) , and correlations between cognitive impairment and hypoperfusion of rCBF (P ＜ 0. 05 ). Conclusion There be exist difference in r-CBF between UPD and BPD. The perfusion of r-CBF in BPD is significantly increased than that in UPD,and it suggest that hyperperfusion in basal ganglia may be the biological basis when bipolar depression turning to manic.