Psikiyatrik Bozukluklarda Orta Hat Cavum Varyantları ve Adhesio Interthalamica: Prevalans ve MRI Morfometrisi

Öz

Cavum septum pellucidum (CSP), cavum vergae (CV), cavum veli interpositi (CVI) ve adhesio interthalamica (IA) orta hat gelişimsel varyantlarıdır; bunların psikiyatrik bozukluklarla ilişkisi belirsizdir. Çalışmamızın amacı, tek bir MRI protokolü altında bipolar bozukluk (BD), majör depresyon (MD) ve obsesif-kompulsif bozukluk (OKB) hastalarında bu dört yapının prevalansını ve CSP'nin boyutsal özelliklerini sağlıklı kontrol grubu (HC) ile karşılaştırmaktır. Retrospektif olarak, 1,5T beyin MRI'sı olan 454 yetişkin incelendi. CSP uzunluğu <6 mm “küçük”, ≥6 mm “büyük” olarak sınıflandırıldı; CV, CVI ve IA varlığı iki kör radyolog tarafından değerlendirildi. Tüm katılımcılar (hasta grupları ve sağlıklı kontroller) birlikte değerlendirildiğinde CSP prevalansı %61,5 idi (p<0,001). “Büyük” CSP sadece klinik gruplarda gözlendi (BD %23,8; MD %38,1; OKB %38,1). CVI, OKB hastalarının %37,4'ünde ve MD hastalarının %29,9'unda bulundu ve bu, HC'deki %10,5'e kıyasla önemli bir artış gösterdi (p<0,001). CV prevalansı HC'de %16,3; OCD'de %35,6; MD'de %28,8 idi (p<0,001). IA yokluğu hastaların %64,6'sında ve HC'nin %35,4'ünde saptandı, bu da gruplar arası bir fark olduğunu ortaya koydu (p<0,05). BD, MD ve özellikle OKB'de, CSP, CV ve CVI prevalansı ile IA yokluğu, HC'ye kıyasla önemli ölçüde artmıştır. Bulgular, bu varyantların psikotik bozukluklarla sınırlı olmadığını ve daha geniş bir duygu durumu/anksiyete spektrumunda nörogelişimsel biyobelirteç potansiyeline sahip olabileceğini göstermektedir, bu da prospektif doğrulama çalışmalarının gerekliliğini vurgulamaktadır.

Anahtar Kelimeler

• Cavum septum pellucidum
• Cavum vergae
• Cavum veli interpositi
• Adhesdio interthalamica
• Psikiyatri

Midline Cavum Variants and Adhesio Interthalamica in Psychiatric Disorders: Prevalence and MRI Morphometry

Öz

Cavum septum pellucidum (CSP), cavum vergae (CV), cavum veli interpositi (CVI), and interthalamic adhesion (IA) are midline developmental variants and their associations with psychiatric disorders are unclear. Our study aimed to compare the prevalence of these four structures and the dimensional features of CSP in bipolar disorder (BD), major depression (MD), and obsessive-compulsive disorder (OCD) with healthy controls (HC) under a single MRI protocol. A total of 454 adults with 1.5T brain MRI were examined retrospectively. CSP length ≤6 mm was classified as “small,” >6 mm as “large”; the presence of CV, CVI, and IA was evaluated by two blinded radiologists. When all participants (patients and healthy controls) were considered together, CSP prevalence was 61.5%. “Large” CSP was observed only in clinical groups (BD 23.8%; MD 38.1%; OCD 38.1%). CVI was found in 37.4% of OCD and 29.9% of MD patients, showing a significant increase compared to 10.5% in HC (p<0.001). CV prevalence was 16.3% in HC; 35.6% in OCD; 28.8% in MD (p<0.001). Absence of IA was found in 64.6% of patients and 35.4% of HC, revealing an intergroup difference (p<0.05). In BD, MD, and especially OCD, the prevalence of CSP, CV, and CVI, along with IA absence, was significantly increased compared to HC. The findings suggest that these variants are not limited to psychotic disorders and may have neurodevelopmental biomarker potential across a broader mood/anxiety spectrum, emphasizing the need for prospective validation studies.

Anahtar Kelimeler

• Cavum vergae
• cavum veli interpositi
• cavum septum pellucidum
• interthalamic adhesion
• psychiatry

Etik Beyan

Approval was obtained from the Ethics Committee of Bayındır Hospital (BTEDK-06/25). The procedures used in this study adhered to the tenets of the Declaration of 1964 Helsinki.

Kaynakça

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