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Effects of illness duration on cognitive performances in bipolar depression are mediated by white matter

Elisa M T Melloni1, Sara Poletti1, Benedetta Vai2

  • 1University Vita-Salute San Raffaele, Milano, Italy.

Journal of Affective Disorders
|February 18, 2019
PubMed
Abstract

Insights

Illness duration in bipolar disorder (BD) negatively impacts cognitive functions, with white matter (WM) integrity acting as a key mediator. This finding supports the neuroprogressive nature of BD.

Area of Science:

  • Neuroscience
  • Psychiatry
  • Neuroimaging

Background:

  • Cognitive deficits are a hallmark of bipolar disorder (BD), persisting even during remission.
  • White matter (WM) abnormalities are recognized structural markers in BD.
  • Illness chronicity, including duration and episode frequency, correlates with clinical and structural brain changes.

Purpose of the Study:

  • To investigate if white matter (WM) integrity mediates the relationship between illness duration and cognitive performance in bipolar disorder (BD) patients.
  • To explore the neurobiological underpinnings of cognitive decline in BD.

Main Methods:

  • Assessed 88 inpatients with type I BD during a depressive episode.
  • Evaluated cognitive functions including memory, processing speed, and executive functions.
  • Measured white matter integrity using fractional anisotropy (FA) values via the ENIGMA-DTI protocol.

Main Results:

  • Illness duration significantly affected processing speed, verbal memory, and visual memory.
  • Fractional anisotropy (FA) values in specific WM tracts (anterior corona radiata, corpus callosum genu, fornix) mediated these effects.
  • Results were adjusted for age, sex, education, and lithium treatment.

Conclusions:

  • This study demonstrates WM integrity as a mediator between illness duration and cognitive deficits in BD.
  • Findings provide evidence for the neuroprogressive hypothesis of bipolar disorder.
  • Highlights the role of WM microstructural changes in the cognitive profile of BD.

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