Cerebral white matter lesions in bipolar affective disorder: relationship to outcome

Moore, P. A.; Shepherd, DJ; Eccleston, D.; MacMillan, Ian C.; Goswami, Utpal; McAllister, VL; Ferrier, IN

doi:10.1192/bjp.178.2.172

Cited by 126 publications

(90 citation statements)

References 24 publications

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“…Studies examining white matter lesions in non-diabetic, asymptomatic volunteers aged 20 to 83 years found that 11 to 73% of participants had white matter hyperintensities ranging from grade 1 to grade 3 [29][30][31][32][33][34] with more white matter hyperintensities occurring among older participants [29,32]; for those under 50 years of age, 11 to 42% of participants had either deep white matter or periventricular hyperintensities [29,31,33,34]. This prevalence of white matter hyperintensities in non-diabetic controls suggests that some white matter hyperintensities, particularly grades 1 and 2, may not be clinically significant and emphasises the importance of including a non-diabetic control group when assessing the effect of diabetes on brain structure.…”

Section: Discussionmentioning

confidence: 99%

The effects of type 1 diabetes on cerebral white matter

et al. 2007

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Aim/hypothesis Studies investigating the structure, neurophysiology and functional outcomes of white matter among type 1 diabetes patients have given conflicting results. Our aim was to investigate the relationship between type 1 diabetes and white matter hyperintensities. Method We assessed white matter integrity (using magnetic resonance imaging), depressive symptoms and neuropsychological function in 114 type 1 diabetes patients and 58 age-matched non-diabetic controls.Results Only Fazekas grade 1 and 2 white matter hyperintensities were found among 114 long-duration, relatively young diabetes patients; the severity of lesions did not differ substantially from 58 healthy controls. White matter hyperintensities were not associated with depressive history or with clinical characteristics of diabetes, including retinopathy, severe hypoglycaemia or glycaemia control. Conclusions/interpretation Our data do not support an association between diabetes characteristics and white matter hyperintensities among relatively young type 1 diabetes participants.

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Section: Discussionmentioning

confidence: 99%

The effects of type 1 diabetes on cerebral white matter

et al. 2007

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“…Periventricular lesions have been reported, but deep WMH occur most frequently (Ahn et al, 2004;Moore et al, 2001;Silverstone et al, 2003). Interestingly, no studies report the most severe grades on the scales for assessing these lesions, which were developed to rate demyelinating disease, indicating that these white matter changes are subtle.…”

Section: White Mattermentioning

confidence: 99%

The structural neuroimaging of bipolar disorder

Emsell

McDonald

2009

International Review of Psychiatry

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There is an increasing body of literature fuelled by advances in high-resolution structural MRI acquisition and image processing techniques which implicates subtle neuroanatomical abnormalities in the aetiopathogenesis of bipolar disorder. This account reviews the main findings from structural neuroimaging research into regional brain abnormalities, the impact of genetic liability and mood stabilizing medication on brain structure in bipolar disorder, and the overlapping structural deviations found in the allied disorders of schizophrenia and depression. The manifold challenges extant within neuroimaging research are highlighted with accompanying recommendations for future studies. The most consistent findings include preservation of total cerebral volume with regional grey and white matter structural changes in prefrontal, midline and anterior limbic networks, non-contingent ventriculomegaly and increased rates of white matter hyperintensities, with more pronounced deficits in juveniles suffering from the illness. There is increasing evidence that medication has observable effects on brain structure, whereby lithium status is associated with volumetric increase in the medial temporal lobe and anterior cingulate gyrus. However, research continues to be confounded by the use of highly heterogeneous methodology and clinical populations, in studies employing small scale, low-powered, cross-sectional designs. Future work should investigate larger, clinically homogenous groups of patients and unaffected relatives, combining both categorical and dimensional approaches to illness classification in cross-sectional and longitudinal designs in order to elucidate trait versus state mechanisms, genetic effects and medication/illness progression effects over time.

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“…Neuroimaging research in BD has already produced several data documenting the involvement of different cortical and subcortical regions in different phases of the illness. In particular, published studies explored structural and functional abnormalities present in BD and tried to establish specific correlations with outcome (Moore et al, 2001;Wingo et al, 2009) as well as difficult-to-treat conditions such as treatment resistant forms (Regenold et al, 2008). The possibility to study cognitive function in BD through fMRI represents another major acquisition of neuroimaging in psychiatric research.…”

Section: Discussionmentioning

confidence: 99%