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Changes in white matter microstructure predict lithium response in adolescents with bipolar disorder
Vivian Kafantaris1,2,3, Linda Spritzer3, Vishal Doshi1,2
1Division of Child and Adolescent Psychiatry, The Zucker Hillside Hospital of Northwell Health, Glen Oaks, NY, USA.
Bipolar Disorders
|October 10, 2017
Summary
Lithium treatment normalizes white matter in pediatric bipolar disorder patients, with improved brain structure predicting better clinical outcomes. This suggests white matter changes are key to treatment response.
Area of Science:
- Neuroscience
- Psychiatry
- Medical Imaging
Background:
- Pediatric bipolar disorder (PBD) is a complex condition impacting emotion regulation.
- White matter microstructure alterations are implicated in PBD.
- Lithium is a common treatment, but predictors of response are needed.
Purpose of the Study:
- To determine if changes in white matter microstructure predict lithium treatment response in pediatric bipolar disorder.
- To investigate the role of the cingulum hippocampus (CGH) white matter.
Main Methods:
- Diffusion Tensor Imaging (DTI) was used to assess white matter microstructure (fractional anisotropy - FA) in 18 lithium-naive PBD patients and 10 healthy controls.
- DTI scans were performed at baseline and after 4 weeks of lithium treatment.
- Clinical Global Impressions (CGI) scale assessed treatment response.
Main Results:
- Patients showed lower baseline FA in the left and right CGH compared to controls.
- Lithium responders exhibited a significant increase in left CGH FA after 4 weeks.
- Baseline left CGH FA predicted overall CGI severity at 8 weeks, including depression and mania symptoms.
Conclusions:
- White matter microstructure changes in the CGH are associated with lithium treatment response in pediatric bipolar disorder.
- Normalization of white matter in emotion-regulating regions may underlie treatment efficacy.