锂和丙戊酸盐对双相情感障碍患者皮质下脑容量的影响：235例个体的大型分析

IF 4.9 2区医学 Q1 CLINICAL NEUROLOGY

Journal of affective disorders Pub Date : 2025-04-04 DOI:10.1016/j.jad.2025.04.019

Naoki Hashimoto , Naohiro Okada , Masaki Fukunaga , Kiyotaka Nemoto , Kenichiro Miura , Junya Matsumoto , Shuhei Ishikawa , Hisashi Narita , Kentaro Morita , Yuka Yasuda , Toshiharu Kamishikiryo , Kenichiro Harada , Maeri Yamamoto , Kazutaka Ohi , Toshio Matsubara , Yoji Hirano , Go Okada , Khin K. Tha , Osamu Abe , Toshiaki Onitsuka , Ryota Hashimoto

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引用次数: 0

摘要

由ENIGMA双相情感障碍工作组进行的大型分析显示，锂对双相情感障碍患者的海马有显著的体积增加作用。然而，该研究没有评估其他药物和其他皮质下区域。方法235例双相情感障碍患者的数据来自日本COCORO联盟进行的大型分析。使用线性混合效应模型评估精神药物处方（锂、丙戊酸盐、抗精神病药、抗抑郁药、苯二氮卓类药物）的影响，以皮质下结构体积为因变量，年龄、性别、颅内容量、疾病持续时间和精神药物处方为自变量；协议的类型被纳入随机效应。结果锂处方与左杏仁核体积增大相关（效应值（ES, Cohen’s d） = 0.36, p = 0.001）。丙戊酸处方与左杏仁核体积较小（ES = -0.45, p = 0.001）和双侧脑室体积较大(ES = 0.68, p <；0.001（左），ES = 0.70, p <；0.001(右))。抗精神病药物处方与左侧苍白球体积增大（ES = 0.33, p = 0.014）、左侧海马体积减小（ES = -0.33, p = 0.024）相关。苯二氮卓类药物处方与左侧脑室变小相关（ES = -0.40, p = 0.029）。抗抑郁药处方与右侧伏隔核体积（ES = -0.22, p = 0.043）、双侧尾状核体积（ES = -0.38, p = 0.013（左）、ES = -0.25, p = 0.050（右））和右侧壳核体积（ES = -0.23, p = 0.024）相关。结论首次在大样本中证实丙戊酸处方与杏仁核变小、侧脑室体积增大有关。样本量大，数据收集方法统一，统计分析稳健是本研究的优势。

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Lithium and valproate affect subcortical brain volumes in individuals with bipolar disorder: Mega-analysis of 235 individuals

Introduction

The mega-analysis conducted by the ENIGMA Bipolar Disorder Working Group revealed significant volume increment effects of lithium on the hippocampus in individual with bipolar disorder. However, the study did not assess other medications and other subcortical regions.

Methods

Data of 235 individuals with bipolar disorder were taken from a mega-analysis conducted by the COCORO consortium in Japan. The effects of psychotropic prescriptions (lithium, valproate, antipsychotics, antidepressants, benzodiazepines) were assessed using a linear mixed-effects model with volumes of subcortical structures as dependent variables, and age, sex, intracranial volume, duration of illness, and psychotropic prescriptions as independent variables; the type of protocol was incorporated as a random effect.

Results

Prescriptions of lithium was associated with larger left amygdala volume (Effect size (ES, Cohen's d) = 0.36, p = 0.001). Prescriptions of valproate was associated with smaller left amygdala volume (ES = -0.45, p = 0.001), and larger bilateral ventricle volumes (ES = 0.68, p < 0.001 (left), ES = 0.70, p < 0.001 (right)). Prescriptions of antipsychotics were associated with larger left globus pallidus volume (ES = 0.33, p = 0.014) and smaller left hippocampus volume (ES = -0.33, p = 0.024). Prescriptions of benzodiazepines were associated with smaller left lateral ventricle (ES = -0.40, p = 0.029). Prescriptions of antidepressants were associated with smaller right accumbens volume (ES = -0.22, p = 0.043), bilateral caudate volumes (ES = -0.38, p = 0.013 (left), ES = -0.25, p = 0.050 (right)) and right putamen volume (ES = -0.23, p = 0.024).

Conclusion

We confirmed the association between prescription of valproate and smaller amygdala and larger lateral ventricle volumes in a large sample for the first time. Large sample size, uniform data collection methodology, and robust statistical analysis are strengths of the current study.

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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.