Diagnostic performance of T1-Weighted MRI in bipolar disorder: A systematic review and meta-analysis

IF 3.2 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research Pub Date : 2025-10-08 DOI:10.1016/j.jpsychires.2025.10.004

Lina M. González-Ojeda , Alejandra Torres-Parga , Lina M. Villegas-Trujillo , Juan F. Cardona

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引用次数: 0

Abstract

Objective

Bipolar affective disorder (BPAD) is a clinically defined psychiatric condition characterized by heterogeneous symptom patterns and a reliance on subjective assessments. Structural neuroimaging, particularly gray matter volume (GMV) from T1-weighted MRI, has been investigated as a complementary diagnostic tool. However, its clinical applicability remains uncertain. This systematic review and meta-analysis evaluated the diagnostic performance of GMV in BPAD by synthesizing sensitivity, specificity, and classification accuracy, while accounting for demographic and methodological variability.

Methods

A comprehensive PRISMA-based literature search identified 15 structural MRI studies including 1645 participants. Of these, eight studies (n = 780) met inclusion criteria for quantitative synthesis based on reporting diagnostic metrics such as sensitivity and specificity. Pooled estimates were calculated, and subgroup and meta-regression analyses were conducted to examine the influence of age, sex, and control group characteristics.

Results

GMV demonstrated moderate diagnostic accuracy, with a pooled sensitivity of 0.69 and a specificity of 0.77. Classification performance was higher in older adults than in younger cohorts. Sex-related GMV differences were observed in healthy controls but were attenuated in BPAD. Meta-regression identified control group size as a significant moderator of heterogeneity, with additional variability likely due to medication exposure and illness subtype.

Conclusions

GMV may provide incremental diagnostic value when integrated with clinical evaluation, particularly in older adults. Nonetheless, methodological heterogeneity and the modest accuracy observed indicate that GMV alone is insufficient as a biomarker. By incorporating the most recent evidence, these findings reinforce the need for multimodal diagnostic approaches that combine structural MRI with genetic, functional, and clinical data.

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t1加权MRI诊断双相情感障碍的表现：系统回顾和荟萃分析

目的双相情感障碍（BPAD）是一种临床定义的精神疾病，其特征是异质性症状模式和依赖于主观评估。结构神经成像，特别是t1加权MRI的灰质体积（GMV），已被研究作为补充诊断工具。然而，其临床适用性仍不确定。本系统综述和meta分析通过综合敏感性、特异性和分类准确性来评估GMV在BPAD中的诊断性能，同时考虑到人口统计学和方法的可变性。方法采用基于prisma的文献检索方法，检索了15项结构MRI研究，包括1645名参与者。其中，8项研究（n = 780）符合基于报告诊断指标（如敏感性和特异性）的定量综合纳入标准。计算汇总估计值，并进行亚组和元回归分析，以检查年龄、性别和对照组特征的影响。结果gmv具有中等的诊断准确性，敏感性为0.69，特异性为0.77。老年人的分类表现高于年轻人。在健康对照组中观察到与性别相关的GMV差异，但在BPAD中减弱。meta回归发现对照组的大小是异质性的显著调节因素，另外的可变性可能是由于药物暴露和疾病亚型。结论gmv与临床评价相结合，对老年人的诊断价值更高。然而，方法的异质性和观察到的适度准确性表明，GMV单独作为生物标志物是不够的。通过结合最新的证据，这些发现加强了将结构MRI与遗传、功能和临床数据相结合的多模式诊断方法的需求。

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 psychiatric research 医学-精神病学

CiteScore

7.30

自引率

2.10%

发文量

622

审稿时长

130 days

期刊介绍： Founded in 1961 to report on the latest work in psychiatry and cognate disciplines, the Journal of Psychiatric Research is dedicated to innovative and timely studies of four important areas of research: (1) clinical studies of all disciplines relating to psychiatric illness, as well as normal human behaviour, including biochemical, physiological, genetic, environmental, social, psychological and epidemiological factors; (2) basic studies pertaining to psychiatry in such fields as neuropsychopharmacology, neuroendocrinology, electrophysiology, genetics, experimental psychology and epidemiology; (3) the growing application of clinical laboratory techniques in psychiatry, including imagery and spectroscopy of the brain, molecular biology and computer sciences;