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White matter hyperintensities in bipolar and unipolar patients with relatively mild-to-moderate illness severity
Roberto B Sassi1, Paolo Brambilla, Mark Nicoletti
1Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. soares@uthscsa.edu
Background:
Increased rates of white matter hyperintense lesions have been reported in mood disorder patients. However, the potential effects of age and illness severity on reported findings are not fully established. We examined the rates of hyperintense lesions in adult, non-elderly bipolar and unipolar patients, with a relatively mild-to-moderate illness severity, and in matched healthy controls.
Method:
We examined brain MRI images in 24 bipolar (19-56 years, mean+/-S.D.=34.2+/-9.9 years) and 17 unipolar patients (24-59 years, 42.8+/-9.2 years), and 38 healthy controls (21-59 years, 36.8+/-9.7 years). T2-weighted and proton-density axial MRI images were obtained at 1.5 Tesla. The lesions were rated by two independent raters, using a semi-quantitative rating scale.
Results:
There were no significant differences in the frequency of hyperintensities between bipolar or unipolar patients and healthy controls. Age was related to the presence of subcortical gray matter hyperintensities for the whole sample. Among the unipolar patients, length of illness and presence of mood disorder in a first-degree relative were related to deep and periventricular white matter lesions, respectively.
Limitations:
The methodology utilized for measurement of the white matter hyperintensities was semi-quantitative.
Conclusions:
Increased rates of white matter hyperintensities do not appear to be present in a group of relatively young mood disorder patients, with relatively mild to moderate illness severity. These brain lesions may be more directly related to late-life and more severe cases of these illnesses.
Insights
Young mood disorder patients with mild-to-moderate illness do not show increased white matter lesions. These brain lesions may be more common in older individuals and those with severe mood disorders.
Area of Science:
- Neuroimaging
- Psychiatry
- Neurology
Background:
- White matter hyperintensities are frequently reported in mood disorder patients.
- The influence of age and illness severity on these findings requires further investigation.
- This study focuses on adult, non-elderly individuals with mild-to-moderate bipolar or unipolar disorder.
Purpose of the Study:
- To investigate the prevalence of white matter hyperintensities in young to middle-aged adults with bipolar and unipolar mood disorders.
- To compare lesion rates between mood disorder patients and healthy controls.
- To explore the relationship between age, illness duration, family history, and white matter lesions.
Main Methods:
- Brain MRI scans (T2-weighted, proton-density axial) were analyzed from 24 bipolar patients, 17 unipolar patients, and 38 healthy controls.
- Participants' ages ranged from 19 to 59 years.
- Lesions were assessed using a semi-quantitative rating scale by two independent raters.
Main Results:
- No significant differences in white matter hyperintensity frequency were observed between mood disorder patients and healthy controls.
- Age correlated with subcortical gray matter hyperintensities across all participants.
- In unipolar patients, illness duration was linked to deep white matter lesions, and family history of mood disorder to periventricular lesions.
Conclusions:
- Increased white matter hyperintensities are not evident in younger mood disorder patients with mild-to-moderate illness severity.
- These brain lesions might be more associated with late-life onset or more severe presentations of mood disorders.
- The study employed a semi-quantitative methodology for lesion measurement.
