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

机译:从青年中的单极抑郁症分化双相障碍:神经影像研究研究的系统文献综述

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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.
机译:区分双相障碍和单极抑郁症是儿科精神病学实践中最困难的临床问题之一,因为误诊可能会对受影响的儿童造成严重影响。这项研究的目的是检查现有文献,研究儿童双相和单极情绪障碍之间的大脑差异,直接跨越所有神经成像模式。我们通过PubMed、PsycINFO、Embase和Medline数据库进行了系统的文献搜索,并确定了纳入和排除标准。系统定性综述包括九项研究,包括三项结构MRI研究、五项功能MRI研究和一项MR波谱研究。提取相关变量,定性分析儿童和健康对照者的双相和单极情绪障碍之间的大脑差异。在这九项研究中,我们的综述包括228名诊断为双相情感障碍的受试者、268名诊断为重度抑郁症的受试者和299名健康对照者。其中六项研究区分了双相和单极情绪障碍。分化最常见于前扣带回皮质(ACC)、岛叶和背侧纹状体(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,呈现出极低的概括性。

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