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[Hyperintensive intramedullary lesions in psychiatric patients. Spatial distribution and psychopathologic symptoms]
T Becker1, A Schmidtke, G Stöber
1Psychiatrische Klinik und Poliklinik, Universität Würzburg.
Abstract:
In a sample of 130 patients who had undergone MRI (transverse T2-weighted SE sequence) patchy white matter lesions (WML) were documented according to number and spatial distribution in the brain. Ventricle-to-Brain Ratio (VBR) was determined. Configural frequency analysis led to delineation of four patient groups on the basis of WML location: 1. no WML (n = 35), 2. right frontal-temporal WML (n = 23), 3. bifrontal WML (n = 12), 4. WML in all/all but one brain region (n = 16). Psychopathological symptoms reported in the course of a maximum of 3 years were documented by chart review. In the 'pervasive WML' group psychopathological items characteristic of organic brain syndromes prevailed, mean VBR exceeded values in all other groups (ANOVA, p < 0.001). WML spatial distribution accounted for 10.2% of total psychopathological variance. Patient age, but not VBR, had a significant impact on symptom profile (MANCO-VA). When the 'pervasive WML' group was excluded, the finding of a significant effect of WML location on psychopathological symptom profiles was robust. Bifrontal WML were associated with thought incoherence, right frontal-temporal WML with affective symptoms. Findings support an impact of spatial distribution of unspecific WML on psychopathological symptoms in psychiatric patients.
Insights
The spatial distribution of white matter lesions (WML) significantly impacts psychopathological symptoms in psychiatric patients. Specific lesion locations, like bifrontal, correlate with distinct symptom profiles, influencing patient outcomes.
Area of Science:
- Neuroimaging
- Neuropathology
- Psychiatry
Context:
- White matter lesions (WML) are frequently observed in psychiatric patients.
- The relationship between the spatial distribution of WML and psychopathological symptoms requires further elucidation.
- Magnetic Resonance Imaging (MRI) is crucial for identifying and characterizing WML.
Purpose:
- To investigate the association between the spatial distribution of white matter lesions (WML) and psychopathological symptoms in a cohort of psychiatric patients.
- To determine if WML location, number, or Ventricle-to-Brain Ratio (VBR) correlates with specific psychiatric symptom profiles.
- To explore the impact of WML spatial distribution on the variance of psychopathological symptoms.
Summary:
- A study analyzed 130 patients with MRI-detected WML, categorizing them by lesion location.
- Configural frequency analysis revealed distinct psychopathological profiles associated with specific WML distributions, particularly bifrontal and right frontal-temporal.
- Pervasive WML were linked to organic brain syndromes and higher VBR, while lesion location significantly predicted symptom profiles, independent of VBR.
Impact:
- Findings suggest that the spatial distribution of unspecific WML is a significant factor in the manifestation of psychopathological symptoms.
- This research supports a more nuanced understanding of how brain structural changes relate to psychiatric conditions.
- The results may inform diagnostic and therapeutic strategies by considering the topographical impact of WML.