Background The hypothalamus is central to many hormonal and autonomous nervous system pathways. Emerging evidence indicates that these pathways may be disrupted in schizophrenia and bipolar disorder. Yet, few studies have examined the volumes of hypothalamic subunits in these patient groups. We compared hypothalamic subunit volumes in individuals with psychotic disorders to healthy controls. Study Design We included 344 patients with schizophrenia spectrum disorders (SCZ), 340 patients with bipolar disorders (BPD), and 684 age- and-sex-matched healthy controls (CTR). Total hypothalamus and five hypothalamic subunit volumes were extracted from T1-weighted magnetic resonance imaging (MRI) using an automated Bayesian segmentation method. Regression models, corrected for age, age2, sex, and segmentation-based intracranial volume (sbTIV), were used to examine diagnostic group differences, interactions with sex, and associations with clinical symptoms, antipsychotic medication, antidepressants and mood stabilizers. Study Results SCZ had larger volumes in the left inferior tubular subunit and smaller right anterior-inferior, right anterior-superior, and right posterior hypothalamic subunits compared to CTR. BPD did not differ significantly from CTR for any hypothalamic subunit volume, however, there was a significant sex-by-diagnosis interaction. Analyses stratified by sex showed smaller right hypothalamus and right posterior subunit volumes in male patients, but not female patients, relative to same-sex controls. There was a significant association between BPD currently taking antipsychotic medication and the left inferior tubular subunits volumes. Conclusions Our results show regional-specific alterations in hypothalamus subunit volumes in individuals with SCZ, with relevance to HPA-axis dysregulation, circadian rhythm disruption, and cognition impairment.

中文翻译：

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精神分裂症和双向情感障碍中的下丘脑亚基体积

背景 下丘脑是许多激素和自主神经系统通路的中心。新的证据表明，这些途径可能在精神分裂症和双相情感障碍中受到破坏。然而，很少有研究检查这些患者组中下丘脑亚单位的体积。我们将精神障碍患者的下丘脑亚单位体积与健康对照者进行了比较。研究设计 我们纳入了 344 名精神分裂症谱系障碍 (SCZ) 患者、340 名双相情感障碍 (BPD) 患者和 684 名年龄和性别匹配的健康对照 (CTR)。使用自动贝叶斯分割方法从 T1 加权磁共振成像 (MRI) 中提取下丘脑总体积和五个下丘脑亚单位体积。使用针对年龄、年龄2、性别和基于分割的颅内容积 (sbTIV) 进行校正的回归模型来检查诊断组差异、与性别的相互作用以及与临床症状、抗精神病药物、抗抑郁药物和情绪稳定剂的关联。研究结果 与 CTR 相比，SCZ 的左下管状亚基体积较大，右下丘脑前下亚基、右前上亚基和右下丘脑后亚基体积较小。对于任何下丘脑亚基体积，BPD 与 CTR 没有显着差异，但是，诊断之间存在显着的性别交互作用。按性别分层的分析显示，相对于同性对照，男性患者的右下丘脑和右后亚基体积较小，但女性患者则不然。目前服用抗精神病药物的 BPD 与左下肾小管亚单位体积之间存在显着相关性。结论 我们的结果显示 SCZ 个体下丘脑亚单位体积的区域特异性变化，与 HPA 轴失调、昼夜节律紊乱和认知障碍相关。