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Sex differences in brain structure among adolescents with bipolar disorder

机译：双相障碍青少年脑结构性差异

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Objectives Bipolar disorder ( BD ) is twice as prevalent amongst female as amongst male adolescents. Thus far, little is known regarding the neurostructural substrates underlying this disparity. We therefore examined sex differences in neurostructural magnetic resonane imaging ( MRI ) phenotypes amongst adolescents with BD . Methods T1‐weighted structural MRI was acquired from 44 BD (25 female [F] and 19 male [M]) and 58 (28 F and 30 M) healthy control ( HC ) adolescents (13‐21?years old). Whole‐brain and region‐of‐interest ( ROI ) analyses examined structural volume and cortical thickness using FreeSurfer. ROI s included the ventrolateral prefrontal cortex (vl PFC ), anterior cingulate cortex ( ACC ), amygdala and hippocampus. General linear models evaluated sex‐by‐diagnosis interactions, controlling for age and intracranial volume. Results Whole‐brain analysis revealed sex‐by‐diagnosis interactions in the left supramarginal gyrus ( SMG ) ( P? = ? .02, η 2 ?=?0.02) and right inferior parietal lobule ( IPL ) volumes ( P?=? .04, η 2 ?=?0.01). Sex differences in HC s were found in the SMG (M??F) and IPL (F??M). In BD , sex differences were reversed and of smaller magnitude in the SMG (M??F) and of greater magnitude in the IPL (F??M), driven by trends towards smaller SMG and IPL in BD vs HC male participants ( P? = ? .05 and .14). Whole‐brain analyses for cortical thickness, and ROI analyses for volume and cortical thickness, were not significant. Conclusions Normative sex differences may be disrupted in adolescent BD in the SMG and IPL , heteromodal association network hubs responsible for higher order integration of cognitive and emotional processing. Unexpectedly, these findings may inform our understanding of aberrant brain structure in adolescent BD male patients, rather than female patients. Future work should focus on replication, as well as the impact of puberty status and sex hormones on measures of brain structure and function.
机译：目标双极性障碍（BD）是女性中的两倍，如雄性青少年之间的普遍存在。到目前为止，关于这种差异的神经结构基质很少。因此，我们在BD中检查了青少年中神经结构磁性共生成像（MRI）表型的性差异。方法采用44bd（25个雌性[F]和19次雄性[M]）和58（28°F和30米）的健康对照（HC）青少年（13-21岁）获得T1加权结构MRI。全脑和兴趣区域（ROI）分析使用FreeSurfer检查检查的结构体积和皮质厚度。 ROI S包括腹外侧前额叶皮质（VL PFC），前刺型皮质（ACC），Amygdala和海马。一般线性模型评估性逐诊断相互作用，控制年龄和颅内体积。结果全脑分析揭示了左髁上的逐诊断相互作用（P？=Δ02，η2？= 0.02）和右下旁瓣（IPL）体积（P？=？。 04，η2？=？0.01）。在SMG（M？＆ΔF）和IPL（F？＆ΔM）中发现了HC S的性差异。在BD中，性别差异颠倒和在SMG（m≤≤f）中呈现较小的幅度，并且在IPL（f？＆μ）中，由较小的SMG和IPL中的趋势驱动的IPL（F'＆Δm）中的更大幅度男性参与者（p？=？.05和.14）。用于皮质厚度的全脑分析，以及体积和皮质厚度的ROI分析并不重要。结论在SMG和IPL中的青少年BD中可能中断规范性性别差异，异常协会网络中心负责认知和情绪处理的高阶整合。出乎意料地，这些发现可能会通知我们对青少年BD男性患者的异常脑结构，而不是女性患者。未来的工作应该专注于复制，以及青春期状态和性激素对大脑结构和功能措施的影响。

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