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. 2018 Jun;28(6):743-751.
doi: 10.1016/j.euroneuro.2018.01.001. Epub 2018 May 18.

White matter disruptions in patients with bipolar disorder

Lucija Abramovic  1 , Marco P M Boks  1 , Annabel Vreeker  1 , Sanne Verkooijen  1 , Annet H van Bergen  1 , Roel A Ophoff  2 , René S Kahn  3 , Neeltje E M van Haren  4
Affiliations

White matter disruptions in patients with bipolar disorder

Lucija Abramovic et al. Eur Neuropsychopharmacol. 2018 Jun.

Abstract

Bipolar disorder (BD) patients show aberrant white matter microstructure compared to healthy controls but little is known about the relation with clinical characteristics. We therefore investigated the relation of white matter microstructure with the main pharmacological treatments as well its relation with IQ. Patients with BD (N = 257) and controls (N = 167) underwent diffusion tensor imaging (DTI) and comprehensive clinically assessments including IQ estimates. DTI images were analyzed using tract-based spatial statistics. Fractional anisotropy (FA) and Mean Diffusivity (MD) were determined. Patients had significantly lower FA and higher MD values throughout the white matter skeleton compared to controls. Within the BD patients, lithium use was associated with higher FA and lower MD. Antipsychotic medication use in the BD patients was not associated with FA but, in contrast to lithium, was associated with higher MD. IQ was significantly positively correlated with FA and negatively with MD in patients as well as in controls. In this large DTI study we found evidence for marked differences in FA and MD particularly in (but not restricted to) corpus callosum, between BD patients and controls. This effect was most pronounced in lithium-free patients, implicating that lithium affects white matter microstructure and attenuates differences associated with bipolar disorder. Effects of antipsychotic medication intake were absent in FA and only subtle in MD relative to those of lithium. The abnormal white matter microstructure was associated with IQ but not specifically for either group.

Keywords: Antipsychotic medication; Bipolar disorder; Diffusion-weighted imaging; IQ; Lithium; TBSS.

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Conflict of interest statement

Conflict of Interest

The authors confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome

Figures

Figure 1
Figure 1
Comparison of mean FA and mean MD in Li- (N=88) and Li+ (N=169) patients with bipolar disorder versus controls (N=107). and AP− (N=132) and AP+ (N=108) patients with bipolar disorder versus controls. Corrected means are shown.
Figure 2
Figure 2
A) Lower FA in patients with BP (N=257) compared with controls (N=167). B) Lower MD in controls than in patients with BP. Age and gender have been added to the analyses as covariates. C) Lower FA in Li− patients compared with Li+ patients. D) Lower MD in Li+ patients compared with Li- patients. E) Higher MD in AP+ patients compared with AP− patients. Age and gender have been added to the analyses as covariates. Results are FWE-corrected and projected on a red-yellow color scale for which the range is shown for (red) p<0.05.
Figure 3
Figure 3
The correlation between mean FA and mean MD, and IQ in the combined group of patients and controls.
See this image and copyright information in PMC

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