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State-dependent microstructural white matter changes in bipolar I depression

Marcus V Zanetti1, Marcel P Jackowski, Amelia Versace

  • 1Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, University of São Paulo Medical School, Centro de Medicina Nuclear, São Paulo, SP 05403-010, Brazil. marcus_zanetti@yahoo.com.br

European Archives of Psychiatry and Clinical Neuroscience
|March 4, 2009
PubMed

Insights

Bipolar depression is linked to acute white matter changes, specifically in fronto-limbic-striatal tracts. These microstructural alterations in white matter tracts were not observed in remitted bipolar disorder patients.

Area of Science:

  • Neuroscience
  • Psychiatry
  • Neuroimaging

Background:

  • Fronto-limbic-striatal white matter (WM) abnormalities are implicated in bipolar disorder (BD), but findings are inconsistent.
  • Previous research has not detailed the impact of acute mood states on WM microstructure in BD.

Purpose of the Study:

  • To compare fiber density and structural integrity of WM tracts in bipolar I disorder (BD-I) depression versus remission.
  • To investigate microstructural WM changes associated with acute mood states in BD.

Main Methods:

  • Diffusion tensor imaging (DTI) was used to assess whole-brain fractional anisotropy (FA) and mean diffusivity (MD).
  • 37 BD-I patients (16 depressed, 21 remitted) and 26 healthy controls were included.

Main Results:

  • All BD-I patients showed decreased FA and increased MD in bilateral prefronto-limbic-striatal WM and specific fasciculi compared to controls.
  • Depressed BD-I patients exhibited decreased FA and increased MD compared to controls and remitted BD-I patients.
  • Depressed BD-I patients also showed increased FA in the ventromedial prefrontal cortex; remitted patients did not differ from controls.

Conclusions:

  • Acute depression in BD-I is associated with specific microstructural changes in WM tracts.
  • These WM changes may be reversible upon remission from depression.
  • DTI metrics like FA and MD can help differentiate between depressed and remitted states in BD-I.

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