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Title: Patterns of microstructural white matter abnormalities and their impact on cognitive dysfunction in the various phases of type I bipolar disorder
Authors: Magioncalda, Paola
Martino, Matteo
Conio, Benedetta
Piaggio, Niccolò
Teodorescu, Roxana Oana
Escelsior, Andrea
Marozzi, Valentina
Northoff, Georg
Contributors: 心智、大腦與學習研究中心
Keywords: anticonvulsive agent;atypical antipsychotic agent;benzodiazepine derivative;chlorpromazine;diazepam;lithium;neuroleptic agent;serotonin noradrenalin reuptake inhibitor;tricyclic antidepressant agent;valproic acid;adult;Article;bipolar depression;bipolar I disorder;bipolar mania;cingulate gyrus;cognitive defect;continuous performance test;controlled study;correlation analysis;diffusion tensor imaging;female;fractional anisotropy;human;inferior longitudinal fasciculus;major clinical study;male;multicenter study;nuclear magnetic resonance scanner;occipitofrontal fasciculus;priority journal;pyramidal tract;statistical significance;superior longitudinal fasciculus;thalamus anterior nucleus;uncinate fasciculus;white matter injury;anisotropy;bipolar disorder;case control study;cognitive defect;diffusion tensor imaging;middle aged;pathology;pathophysiology;white matter;Adult;Anisotropy;Bipolar Disorder;Case-Control Studies;Cognition Disorders;Diffusion Tensor Imaging;Female;Humans;Male;Middle Aged;White Matter
Date: 2016-03
Issue Date: 2017-08-23 10:41:07 (UTC+8)
Abstract: Background In recent years, diffusion tensor imaging (DTI) studies have detected subtle microstructural abnormalities of white matter (WM) in type I bipolar disorder (BD). However, WM alterations in the different phases of BD remain to be explored. The aims of this study is to investigate the WM alterations in the various phases of illness and their correlations with clinical and neurocognitive features. Methods We investigated the DTI-derived fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD) and axial diffusivity (AD) in patients with type I BD (n=61) subdivided in manic (n=21), depressive (n=20) and euthymic phases (n=20) vs. healthy controls (n=42), using a tract-based spatial statistics (TBSS) approach. Then, we investigated whether the subgroups of patients in the various phases of illness present different patterns of WM abnormalities. Finally we studied the correlations between WM alterations and clinical-cognitive parameters. Results We found a widespread alteration in WM microstructure (decrease in FA and increase in MD and RD) in BD when compared to controls. The various subgroups of BD showed different spatial patterns of WM alterations. A gradient of increasing WM abnormalities from the euthymic (low degree and localized WM alterations mainly in the midline structures) to the manic (more diffuse WM alterations affecting both midline and lateral structures) and, finally, to the depressive phase (high degree and widespread WM alterations), was found. Furthermore, the WM diffuse alterations correlated with cognitive deficits in BD, such as decreased fluency prompted by letter and decreased hits and increased omission errors at the continuous performance test. Limitations Patients under treatment. Conclusions The WM alterations in type I BD showed different spatial patterns in the various phases of illness, mainly affecting the active phases, and correlated with some cognitive deficits. This suggests a complex trait- and state-dependent pathogenesis of WM abnormalities in BD.
Relation: Journal of Affective Disorders, 193, 39-50
Data Type: article
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Appears in Collections:[心智‧大腦與學習研究中心 ] 期刊論文

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