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Differentiating bipolar disorder from unipolar depression in youth: A systematic literature review of neuroimaging research studies.

青年双相情感障碍与单相抑郁症的鉴别: 神经影像学研究的系统文献综述。

  • 影响因子:2.70
  • DOI:10.1016/j.pscychresns.2020.111201
  • 作者列表:"Kelberman C","Biederman J","Green A","Spera V","Maiello M","Uchida M
  • 发表时间:2021-01-30
Abstract

:Differentiating bipolar disorder from unipolar depression is one of the most difficult clinical questions posed in pediatric psychiatric practices, as misdiagnosis can lead to severe repercussions for the affected child. This study aimed to examine the existing literature that investigates brain differences between bipolar and unipolar mood disorders in children directly, across all neuroimaging modalities. We performed a systematic literature search through PubMed, PsycINFO, Embase, and Medline databases with defined inclusion and exclusion criteria. Nine research studies were included in the systematic qualitative review, including three structural MRI studies, five functional MRI studies, and one MR spectroscopy study. Relevant variables were extracted and brain differences between bipolar and unipolar mood disorders in children as well as healthy controls were qualitatively analyzed. Across the nine studies, our review included 228 subjects diagnosed with bipolar disorder, 268 diagnosed with major depressive disorder, and 299 healthy controls. Six of the reviewed studies differentiated between bipolar and unipolar mood disorders. Differentiation was most commonly found in the anterior cingulate cortex (ACC), insula, and dorsal striatum (putamen and caudate) brain areas. Despite its importance, the current neuroimaging literature on this topic is scarce and presents minimal generalizability.

摘要

: 双相情感障碍与单相抑郁症的鉴别是儿科精神科实践中提出的最困难的临床问题之一,因为误诊可能导致受影响儿童的严重影响。这项研究旨在研究现有的文献,这些文献直接调查所有神经成像模式中儿童双相和单极情绪障碍之间的大脑差异。我们通过PubMed、PsycINFO、Embase和Medline数据库进行了系统的文献检索,定义了纳入和排除标准。9项研究纳入了系统定性综述,包括3项结构性MRI研究、5项功能性MRI研究和一项MR波谱学研究。提取相关变量,定性分析儿童和健康对照中双相和单极情绪障碍之间的大脑差异。在9项研究中,我们的综述包括228名被诊断为双相情感障碍的受试者,268名被诊断为重度抑郁症的受试者和299名健康对照者。其中六项回顾研究区分了双相情感障碍和单相情感障碍。分化最常见于前扣带皮层 (ACC) 、脑岛和背侧纹状体 (壳核和尾状核) 脑区。尽管它很重要,但目前关于这一主题的神经影像学文献很少,并且具有最小的普遍性。

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DOI:10.1007/s11033-021-06155-w
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影响因子:2.68
发表时间:2021-02-01
DOI:10.1080/14656566.2020.1814255
作者列表:["Sawada H","Oeda T","Kohsaka M","Tomita S","Umemura A","Park K","Yamamoto K","Kiyohara K"]

METHODS:BACKGROUND:Cholinergic neurotransmission regulates neuroinflammation in Parkinson disease (PD). RESEARCH DESIGN AND METHODS:The authors conducted a delayed-start study of donepezil for cognitive decline in non-demented PD patients. The study consisted of a 96-week randomized placebo-controlled double-blind phase 1, followed by a 24-week donepezil extension phase 2. The primary outcome measure was a change in the Mini-Mental State Examination (MMSE) at week 120. RESULTS:A total of 98 patients were randomly allocated to the early-start (donepezil-to-donepezil) and delayed-start (placebo-to-donepezil) groups. Mean (SD) of the baseline MMSE was 27.6 (2.0) and 28.0 (2.1), respectively. MMSE change at week 120 was better in the early-start group than in the delayed-start group, but the difference was not significant. The MMSE declined in apolipoprotein ε4 carriers, but not in non-carriers, and the factor interaction (intervention × ε4 genotype) was highly significant (P < 0.001). Analyzed with the interaction, the difference was significant (group difference 1.95 [0.33 to 3.57], P = 0.018). The MMSE decline slope in phase 1 was significantly better in the early-start group than in the delayed-start group (P = 0.048). CONCLUSIONS:Cognitive function deteriorated in ε4 carriers, but not in non-carriers, and early-start donepezil may postpone cognitive decline in the former.

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影响因子:2.06
发表时间:2021-03-24
DOI:10.1007/s11033-021-06299-9
作者列表:["Louvrier A","Terranova L","Meyer C","Meyer F","Euvrard E","Kroemer M","Rolin G"]

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