Journal of Affective Disorders ( IF 6.6 ) Pub Date : 2021-07-18 , DOI: 10.1016/j.jad.2021.07.046 Susanna Lucini-Paioni 1 , Letizia Squarcina 1 , David Andrew Cousins 2 , Paolo Brambilla 3
Background
Lithium is one of the most effective medications for bipolar disorder episode prevention, but its mechanism of action is still largely unknown. The hippocampus is a subcortical cerebral structure involved in the formation of emotional responses, cognition and various primitive functions, altered during affective episodes. Deviations in the anatomy or physiology of the hippocampus would partially explain the symptomatology of bipolar subjects, and restoration may reflect treatment response.
Methods
In this mini review, we summarize the studies which have investigated the effect of lithium intake on the volume of hippocampus, measured using magnetic resonance imaging (MRI). We performed a bibliographic search on PubMed, using the terms terms “hippocampus”, “lithium”, “bipolar disorder”, “volume” and “MRI”. Only original studies were considered.
Results
Thirteen studies met the inclusion criteria. Nine studies demonstrated increased total hippocampal volume or hippocampal subfield volumes in BD patients on lithium treatment (Li BD) compared to those not taking lithium (non-Li BD), while four failed to show significant differences between groups. When healthy controls were compared to either the Li subjects or the non-Li ones, the findings were more heterogeneous.
Limitations
Heterogeneity in the methodology and definition of groups limits the comparison of study results.
Conclusions
Lithium may be associated with increased hippocampal volume in BD, potentially due to its putative neurotrophic action, but further research is needed better define the morphological alterations of hippocampus in BD and the longitudinal effects of lithium in the short and long-term.
中文翻译:
锂对双相情感障碍患者海马体积的影响
背景
锂是预防双相情感障碍发作最有效的药物之一,但其作用机制仍然很大程度上未知。海马是皮层下的大脑结构,参与情绪反应、认知和各种原始功能的形成,在情感发作期间发生改变。海马体解剖学或生理学的偏差可以部分解释双相情感障碍患者的症状,恢复可能反映治疗反应。
方法
在这篇小型综述中,我们总结了使用磁共振成像 (MRI) 测量锂摄入量对海马体积影响的研究。我们使用术语“海马”、“锂”、“双相情感障碍”、“体积”和“MRI”在 PubMed 上进行了书目搜索。仅考虑原始研究。
结果
十三项研究符合纳入标准。九项研究表明,与未服用锂的患者(非锂 BD)相比,锂治疗的 BD 患者(Li BD)的总海马体积或海马亚区体积增加,而四项研究未能显示组间显着差异。当将健康对照组与李氏受试者或非李氏受试者进行比较时,发现结果更加异质。
限制
方法学和组定义的异质性限制了研究结果的比较。
结论
锂可能与 BD 中海马体积的增加有关,这可能是由于其假定的神经营养作用,但需要进一步的研究来更好地确定 BD 中海马的形态学改变以及锂在短期和长期的纵向效应。