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White Matter Hyperintensities after Five-Year Follow-Up and a Cross-Sectional FA Decrease in Bipolar I and Major

Tuula Kieseppä1,2, Riitta Mäntylä3, Katariina Luoma4

  • 1Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Neuropsychobiology
|June 15, 2021
PubMed
Abstract

Insights

Brain white matter changes like hyperintensities and reduced fractional anisotropy (FA) are seen in bipolar disorder and major depressive disorder. Illness duration and substance use correlate with white matter hyperintensities in bipolar I patients.

Area of Science:

  • Neuroimaging
  • Psychiatry
  • Neurology

Background:

  • White matter hyperintensities (WMHs) and decreased fractional anisotropy (FA) are observed in Bipolar I (BPI), Bipolar II (BPII), and Major Depressive Disorder (MDD).
  • The relationship between WMHs and FA, and their differences across diagnostic groups, remain unclear.
  • Longitudinal studies investigating these changes are scarce.

Purpose of the Study:

  • To longitudinally evaluate WMHs and FA in BPI, BPII, and MDD patients compared to controls over a 5-year period.
  • To investigate the influence of clinical variables on WMHs and FA.
  • To explore associations between clinical variables and cross-sectional whole-brain FA.

Main Methods:

  • Magnetic resonance imaging (MRI) was performed at baseline and follow-up in 8 BPI, 8 BPII, 6 MDD patients, and 19 controls.
  • Diffusion-weighted imaging was utilized at follow-up.
  • WMHs were assessed using the Coffey scale; tract-based spatial statistics analyzed diffusion data. Statistical analyses included general linear model, ANOVA, Fisher's exact, Wilcoxon sign, and Kruskal-Wallis tests.

Main Results:

  • Periventricular WMHs increased in BPI patients (p = 0.047), correlating with illness duration and substance use disorder history (p = 0.018).
  • FA decreased in the corpus callosum of BPI patients (p < 0.01) and in the right cerebellar middle peduncle (RCMP) of MDD patients (p < 0.01).
  • In BPI patients, illness duration correlated with FA increase in RCMP (p < 0.05). No association was found between FA decrease and WMHs.

Conclusions:

  • Illness burden modestly correlates with WMHs and FA increase in RCMP in BPI patients.
  • MDD patients exhibit FA decrease in RCMP.
  • No association was identified between FA decrease and WMHs across the studied groups.
Keywords:
Bipolar disorderDiffusion tensor imagingMajor depressive disorderWhite matterWhite matter hyperintensities

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