Objective

Longitudinal neuroimaging during adolescence/young adulthood, when bipolar disorder (BD) commonly emerges, can help elucidate the neurodevelopmental pathophysiology of BD. Adults with BD have shown reduced structural integrity in the uncinate fasciculus (UF), a white matter (WM) tract providing major connections between the amygdala and ventral prefrontal cortex (vPFC), important in emotion regulation. In this longitudinal diffusion tensor imaging (DTI) study of adolescents/young adults, we hypothesized differences in age- and time-related changes in UF integrity in BD compared to healthy controls (HC).

Method

Two DTI scans were obtained in 27 adolescents/young adults with BD and 37 HC adolescents/young adults, on average approximately 2.5 years apart. Interactions between diagnosis with age and with time for UF fractional anisotropy (FA) were assessed. Exploratory analyses were performed including euthymic-only participants with BD, and for potential influences of demographic and clinical factors. Whole-brain analyses were performed to explore for interactions in other regions.

Results

There were significant interactions between diagnosis with age and with time for UF FA (p < .05). Healthy control adolescents/young adults showed significant UF FA increases with age and over time (p < .05), whereas no significant changes with age or over time were observed in the adolescents/young adults with BD. Significant interactions with age and time were also observed in analyses including euthymic-only participants with BD (p < .05).

Conclusion

These findings provide neuroimaging evidence supporting differences in UF WM structural development during adolescence/young adulthood, suggesting that differences in the development of an amygdala−vPFC system subserving emotion regulation may be a trait feature of BD neurodevelopment.

中文翻译：

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青少年和年轻双相情感障碍成年人的纵向扩散张量成像研究

客观的

当双相情感障碍（BD）普遍出现时，在青春期/成年青年时期的纵向神经成像可以帮助阐明BD的神经发育病理生理学。患有BD的成年人显示出束状筋膜（UF）（白质（WM）束）提供了杏仁核和腹侧前额叶皮层（vPFC）之间的重要连接的结构完整性降低，这在情绪调节中很重要。在这项针对青少年/年轻人的纵向扩散张量成像（DTI）研究中，我们假设与健康对照组（HC）相比，BD的UF完整性在年龄和时间相关的变化方面存在差异。

方法

在27位BD青少年和37位HC青少年/年轻人中进行了两次DTI扫描，平均间隔约2.5年。评估了超滤分数各向异性（FA）随年龄和时间的诊断之间的相互作用。进行了探索性分析，其中包括患有BD的仅接受正常性行为的参与者，以及人口统计学和临床​​因素的潜在影响。进行全脑分析以探索其他区域的相互作用。

结果

UF FA的诊断与年龄和时间之间存在显着的相互作用（p  <.05）。健康对照青少年/青年人显示UF FA随着年龄和时间的推移 而显着增加（p <.05），而在患有BD的青少年/青年人中，未观察到随年龄或时间的显着变化。在分析中还观察到了与年龄和时间的显着相互作用，包括仅患有正常行为的BD患者（p  <.05）。

结论

这些发现提供了神经影像学证据，支持了青春期/年轻成年期UF WM结构发展的差异，表明杏仁核-vPFC系统在维持情绪调节方面的差异可能是BD神经发育的特征。