Altered Magnetic Resonance White-Matter T₁ Values in Patients with Affective Disorder

Abstract

The MRI T1 proton relaxation values were assessedin 14 patients with bipolar affective disorder and 10 with a unipolar disorder and a matched normal control group. The T1values in the frontal white matter of patients significantlyexceeded those of the controls. This difference was accounted for by an increase in T1 values in the frontal white matter of unipolarpatients:the valuesfor bipolarpatientsalonedid not differ from those for controls. These preliminary findings support a hypothesis of frontal lobe dysfunction mediating pathologicalchangesin mood. (Braftos & Sagedal, 1960; Haug, 1962; Nagy, 1963) (Jacoby & Levy, 1980; Pearlson & Veroff, 1981; Dolan et a!, 1985 Dolan et a!, , 1986. Using a CT index of brain tissue density (Hounsfield units), patients suffering affective disorders were found to differ from both controls and patients with dementia (Jacoby et a!, 1983). Magnetic resonance imaging (MRI) represents a further technological advance in the study of brain structure. It is sensitive to pathological changes (Bydder eta!, 1984)and has the potential to examine physiochemical changes. The proton relaxation parameters, T1 and T2, are sensitive to patho physiological change, particularly shifts in water distribution. As yet, this potential of MRI has been little used in the study of so-called functional psychoses. However, in one study of patients with bipolar affective disorder an increase in T1 values in frontal and temporal white matter, which normal ised following lithium therapy, was reported (Rangel Guerra et a!, 1983). The present study was under taken to explore further the relationship between regional brain T1 values of patients with affective disorders by comparison with an age-and sex matched control group. MethodPatients were selected from the acute in-patient population of a teaching hospital, the Royal Free Hospital, and a large mental hospital, Friern Barnet Psychiatric Hospital. A further sample was recruited from patients undergoing evaluation for psychosurgery at the Geoffrey Knight Unit for Affective Disorders. All patients fulfilled Research Diagnostic Criteria (RDC) for current major depressive disorder (Spitzer et al, 1978). Exclusion criteria included a history of significantpast or concurrent medicalillness or of alcohol abuse. Normal control subjects, matched with the patients for age and sex, wererecruited from hospital staff and from the general public by advertisement. None of the controls had a past or present history of significant physical illness, alcohol abuse, or a family history of psychiatric disorder. All patients and controls gave written informed consent.Iwenty-four patients (12 men, 12women) and 13control subjects (6 men, 7 women) were included in the study. Fourteen patients had a bipolar illness (8 men, 6 women) while the remainder had a unipolar disorder. Three of the bipolar and four of the unipolar women were menopausal.Sixpatients wererecruited fromtheGeoffrey Knight Unit for Affective Disorders.A detailedpsychiatrichistoryobtained by interviewwas supplem...

Abnormalities of the NMDA Receptor and Associated Intracellular Molecules in the Thalamus in Schizophrenia and Bipolar Disorder

“…More recent in vivo imaging studies in patients with affective disorder have rendered mixed results. Some studies reported increased thalamic density (Dewan et al, 1988) and volume (Dupont et al, 1995;Strakowski et al, 1999) in bipolar patients, but other work has found that thalamic volume is either unchanged (Dolan et al, 1990;Krishnan et al, 1991Krishnan et al, , 1993Sax et al, 1999;Strakowski et al, 1993) or even decreased (Dasari et al, 1999;Dupont et al, 1995) in bipolar and unipolar depression.…”

Emotional and Motivational Processes in Bipolar Disorder: A Neural Network Perspective

“…Studies have reported larger caudate volumes in males [105] and in both affected and unaffected monozygotic bipolar twins [106] compared to controls. However, other studies have found no differences in the caudate of bipolar disorder patients [107][108][109][110][111][112][113] or decreased caudate volume [114]. Similarly, putamen enlargement was reported [112,115,116], but other studies found no differences in the putamen [105,107,113] or decreased volume [117].…”

Lobar Distribution of Lesion Volumes in Late-Life Depression: The Biomedical Informatics Research Network (BIRN)

“…Numerous other reports have also found greater total WML volumes in elderly depressed subjects (Krishnan et al, 1988;Dolan et al, 1990;Fujikawa et al, 1993;Krishnan, 1993;Greenwald et al, 1996;Steffens et al, 1999;Kumar et al, 2000;Tupler et al, 2002), but few of these studies examined the location of WMLs. Using an objective method of quantifying WML volume within each lobe, we have confirmed reports (Greenwald et al, 1998;MacFall et al, 2001;Taylor et al, 2003b;Firbank et al, 2004) that the preponderance of WMLs that are different between depressed and control populations occur in the frontal lobe.…”

“…Many reports associate hyperintense lesions with late-life depression. White and gray matter hyperintense lesions are more severe in older depressed subjects than nondepressed subjects (Krishnan et al, 1988;Dolan et al, 1990;Fujikawa et al, 1993;Krishnan, 1993;Greenwald et al, 1996;Steffens et al, 1999;Kumar et al, 2000;Tupler et al, 2002;Taylor et al, 2005), and are more severe in late-onset than early-onset elderly depressed subjects (Figiel et al, 1991;Hickie et al, 1995;Salloway et al, 1996;Krishnan et al, 1997;Lavretsky et al, 1998;de Groot et al, 2000;Tupler et al, 2002). Increases in WML severity over time are additionally associated with new onset of depression (Lavretsky et al, 1999;Nebes et al, 2002) and poorer outcomes to antidepressant therapy (Simpson et al, 1997;O'Brien et al, 1998;Taylor et al, 2003c), although some have not found a relationship between WML severity and treatment outcomes (Salloway et al, 2002).…”