White matter abnormalities: Insights into the pathophysiology of major affective disorders

Gianluca Serafini1, Xenia Gonda1, Zoltan Rihmer1

  • 1Gianluca Serafini, Paolo Girardi, Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy.

Insights

White matter hyperintensities (WMHs) in major affective disorders may indicate higher suicidal risk. The severity of these brain changes could serve as a neurobiological marker for disease vulnerability and clinical presentation.

Area of Science:

  • Neuroscience
  • Psychiatry
  • Neuroimaging

Background:

  • White matter hyperintensities (WMHs) are linked to poor outcomes in major affective disorders.
  • Confounding factors like medication and illness duration complicate WMH interpretation.
  • Existing literature on WMHs in affective disorders presents conflicting findings.

Purpose of the Study:

  • To investigate the association between WMHs and suicidal risk in major affective disorders.
  • To explore the potential of WMH severity as a trait marker for these disorders.

Main Methods:

  • Utilized the modified Fazekas scale to assess WMH severity.
  • Compared suicidal risk in subjects with and without WMHs.

Main Results:

  • Subjects with WMHs showed a higher risk of suicide compared to those without.
  • WMH severity, assessed by the Fazekas scale, may act as a disease trait marker.

Conclusions:

  • WMHs may represent a neurobiological marker in major affective disorders.
  • WMH presence and severity are associated with increased suicidal risk.
  • WMHs could bridge underlying vulnerability and clinical manifestations.

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