White matter changes in paediatric bipolar disorder: A systematic review of diffusion magnetic resonance imaging studiesA systematic review of diffusion magnetic resonance imaging studies

IF 4.9 2区医学 Q1 CLINICAL NEUROLOGY

Journal of affective disorders Pub Date : 2024-12-15 DOI:10.1016/j.jad.2024.12.042

Iman Kiani , Mohammad Hadi Aarabi , Giulia Cattarinussi , Fabio Sambataro , Virginia Favalli , Chiara Moltrasio , Giuseppe Delvecchio

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引用次数: 0

Abstract

Background

Paediatric bipolar disorder (PBD) is characterized by severe mood fluctuations that deviate from typical childhood emotional development. Despite the efforts, the pathophysiology of this disorder is not well understood yet. In this review, we aimed to synthesize existing diffusion magnetic resonance imaging (dMRI) research findings in PBD.

Methods

A literature search was conducted using PubMed, Embase, Scopus, and Web of Science databases to identify relevant studies published before April 2024.

Results

A total of 23 studies were included in the review. The findings showed variations of fractional anisotropy (FA), axial diffusivity, radial diffusivity, and apparent diffusion coefficient in PBD compared to healthy controls (HCs). Key findings included decreased FA in the anterior cingulate, anterior corona radiata, and corpus callosum, particularly the genu, which correlated with clinical symptoms. Furthermore, longitudinal studies emphasized the significance of the uncinate fasciculus as having atypical developmental trajectories in PBD compared to HCs. In addition, graph analysis revealed widespread changes in structural connectivity, especially affecting the orbitofrontal cortex, frontal gyrus, and basal ganglia. Lastly, machine learning models showed promising results in differentiating PBD from HCs.

Limitations

Cross-sectional design of the studies, small sample sizes, and different imaging protocols preclude integration of the findings.

Conclusion

PBD seems to be associated with widespread structural changes compared to HC. Understanding these changes, which might account for the clinical manifestations of this disorder, increase our knowledge of the neurobiological underpinnings of PBD. This, in turn, may help develop more effective treatments for this disorder.

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儿童双相情感障碍的白质改变：扩散磁共振成像研究的系统回顾。

背景：儿童双相情感障碍（PBD）的特征是严重的情绪波动，偏离了典型的儿童情绪发展。尽管做出了努力，但这种疾病的病理生理学尚未得到很好的理解。在本文中，我们旨在综合现有的以PBD为重点的扩散磁共振成像（dMRI）研究成果。方法：检索PubMed、Embase、Scopus、Web of Science等数据库，检索2024年4月前发表的相关研究。结果：共有23项研究符合纳入标准并被纳入本综述。结果显示，与健康对照（HC）相比，PBD患者的分数各向异性（FA）、轴向扩散率、径向扩散率和表观扩散系数都有所不同。主要发现包括前扣带、前辐射冠和胼胝体FA减少，其中胼胝体的亚区即胼胝体膝与临床症状相关。此外，纵向研究强调了钩状肌束在PBD患者中具有非典型发育轨迹的重要性。此外，图分析显示结构连通性的广泛变化，特别是影响眶额皮质、额回和基底神经节。最后，机器学习模型在区分PBD和HC方面显示了令人鼓舞的结果。局限性：横断面研究，小样本量和不同的成像方案妨碍了结果的整合。结论：与HC相比，PBD与广泛的结构改变有关。由于这些变化可能是这种疾病的临床表现的原因，增加我们对PBD的神经生物学基础的理解可能有助于确定更有效的治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of affective disorders 医学-精神病学

CiteScore

10.90

自引率

6.10%

发文量

1319

审稿时长

9.3 weeks

期刊介绍： The Journal of Affective Disorders publishes papers concerned with affective disorders in the widest sense: depression, mania, mood spectrum, emotions and personality, anxiety and stress. It is interdisciplinary and aims to bring together different approaches for a diverse readership. Top quality papers will be accepted dealing with any aspect of affective disorders, including neuroimaging, cognitive neurosciences, genetics, molecular biology, experimental and clinical neurosciences, pharmacology, neuroimmunoendocrinology, intervention and treatment trials.