White matter integrity in young medication-naïve bipolar II depressed adults
Open Access
- 19 January 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Scientific Reports
- Vol. 11 (1), 1-10
- https://doi.org/10.1038/s41598-021-81355-9
Abstract
It is unknown if young medication-naïve bipolar II (BPII) depressed patients have increased white matter (WM) disruptions. 27 each of young (average 23 years) and treatment-naïve BPII depressed, unipolar depressed (UD) patients and age–sex–education matched healthy controls (HC) underwent 3 T MRIs with diffusion tensor imaging. Diagnostic ratings included Structured Clinical Interview for DSM Disorders (SCID), Montgomery-Åsberg Depression Rating Scale (MADRS), Young Mania Rating Scale (YMRS) and Hamilton Anxiety Rating Scale (HAM-A). Patients were clinically depressed (MADRS-BPII: 26.15 [SD9.25], UD: 25.56 [5.24], p = 0.86). Compared to UD, BPII had increased family bipolarity (BPII 13.6% vs UD 2.5%, p = 0.01, φc = 0.28), hypomanic symptoms (YMRS-BPII: 4.22 [4.24], UD: 1.33 [2], p = 0.02, d = 0.87), lifetime number of depressive episodes (BPII: 2.37 [1.23], UD: 1.44 [0.75], p = 0.02, d = 0.91), lifetime and current-year number of episodes (lifetime BPII: 50.85 [95.47], UD: 1.7 [1.03]; current-year BPII: 9.93 [16.29], UD: 1.11 [0.32], ps = 0.04, ds = 0.73–0.77) and longer illness duration (BPII: 4.96 years [3.96], UD: 2.99 [3.33], p = 0.15, d = 0.54). BPII showed no increased WM disruptions vs UD or HC in any of the 15 a priori WM tracts. UD had lower right superior longitudinal fasciculus (SLF) (temporal) axial diffusivity (AD) (1.14 vs 1.17 (BPII), 1.16 (HC); F = 6.93, 95% CI of \({F}_{B}\): 0.00073, 5.22, ηp2 = 0.15). Principal component analysis followed by exploratory linear discriminant analysis showed that increased R-SLF (temporal) AD, YMRS and family bipolarity distinguished BPII from UD (81.5% sensitivity, 85.2% specificity) independent of episode number and frequency. Young, medication-naïve adults with BPII depression did not show the WM disruptions distinguishing more chronically ill BP patients from UD. These WM disruptions may therefore be partly attributable to illness chronicity. Longitudinal studies should examine the trajectory of WM changes in BPII and UD and predictive validity of these baseline clinical and imaging parameters.
Funding Information
- Research Grants Council, University Grants Committee (24100114)
This publication has 60 references indexed in Scilit:
- Widespread white matter microstructural abnormalities in bipolar disorder: evidence from mega- and meta-analyses across 3033 individualsNeuropsychopharmacology, 2019
- Understanding the Physiopathology Behind Axial and Radial Diffusivity Changes—What Do We Know?Frontiers in Neurology, 2018
- Bipolar I and II versus unipolar depression: Clinical differences and impulsivity/aggression traitsEuropean Psychiatry, 2015
- Diffusion tensor MRI as a biomarker in axonal and myelin damageImaging in Medicine, 2013
- Pushing spatial and temporal resolution for functional and diffusion MRI in the Human Connectome ProjectNeuroImage, 2013
- White matter pathology – an endophenotype for bipolar disorder?BMC Psychiatry, 2012
- White matter hyperintensities: from medical comorbidities to bipolar disorders and back.Annals of Medicine, 2011
- Improvement of brain segmentation accuracy by optimizing non-uniformity correction using N3NeuroImage, 2009
- Corpus callosum areas in first-episode patients with bipolar disorderPsychological Medicine, 2007
- The SF-36 summary scales were valid, reliable, and equivalent in a Chinese populationJournal of Clinical Epidemiology, 2005