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. 2018 Oct:73:192-204.
doi: 10.1016/j.bbi.2018.04.017. Epub 2018 May 1.

White matter microstructure alterations correlate with terminally differentiated CD8+ effector T cell depletion in the peripheral blood in mania: Combined DTI and immunological investigation in the different phases of bipolar disorder

Paola Magioncalda  1 , Matteo Martino  2 , Samuele Tardito  3 , Bruno Sterlini  4 , Benedetta Conio  5 , Valentina Marozzi  6 , Giulia Adavastro  7 , Laura Capobianco  8 , Daniel Russo  9 , Alessia Parodi  10 , Francesca Kalli  11 , Giorgia Nasi  12 , Tiziana Altosole  13 , Niccolò Piaggio  14 , Georg Northoff  15 , Daniela Fenoglio  16 , Matilde Inglese  17 , Gilberto Filaci  18 , Mario Amore  19
Affiliations

White matter microstructure alterations correlate with terminally differentiated CD8+ effector T cell depletion in the peripheral blood in mania: Combined DTI and immunological investigation in the different phases of bipolar disorder

Paola Magioncalda et al. Brain Behav Immun. 2018 Oct.

Abstract

Background: White matter (WM) microstructural abnormalities and, independently, signs of immunological activation were consistently demonstrated in bipolar disorder (BD). However, the relationship between WM and immunological alterations as well as their occurrence in the various phases of BD remain unclear.

Method: In 60 type I BD patients - 20 in manic, 20 in depressive, 20 in euthymic phases - and 20 controls we investigated: (i) diffusion tensor imaging (DTI)-derived fractional anisotropy (FA), radial diffusivity (RD) and axial diffusivity (AD) using a tract-based spatial statistics (TBSS) approach; (ii) circulating T cell subpopulations frequencies, as well as plasma levels of different cytokines; (iii) potential relationships between WM and immunological data.

Results: We found: (i) a significant widespread combined FA-RD alteration mainly in mania, with involvement of the body of corpus callosum (BCC) and superior corona radiata (SCR); (ii) significant increase in CD4+ T cells as well as significant decrease in CD8+ T cells and their subpopulations effector memory (CD8+ CD28-CD45RA-), terminal effector memory (CD8+ CD28-CD45RA+) and CD8+ IFNγ+ in mania; (iii) a significant relationship between WM and immunological alterations in the whole cohort, and a significant correlation of FA-RD abnormalities in the BCC and SCR with reduced frequencies of CD8+ terminal effector memory and CD8+ IFNγ+ T cells in mania only.

Conclusions: Our data show a combined occurrence of WM and immunological alterations in mania. WM abnormalities highly correlated with reduction in circulating CD8+ T cell subpopulations that are terminally differentiated effector cells prone to tissue migration, suggesting that these T cells could play a role in WM alteration in BD.

Keywords: Bipolar disorder; Immunological alterations; Mania; T cells; TBSS; White matter abnormalities.

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