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White matter hyperintensities and cognitive performance in adult patients with bipolar I, bipolar II, and major depressive disorders

Published online by Cambridge University Press:  15 April 2020

T. Kieseppä ,
R. Mäntylä ,
A. Tuulio-Henriksson ,
K. Luoma ,
O. Mantere ,
M. Ketokivi ,
M. Holma ,
P. Jylhä ,
T. Melartin  and
K. Suominen
...Show all authors
T. Kieseppä*
Affiliation:
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, 00300Helsinki, Finland Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
R. Mäntylä
Affiliation:
HUS Medical Imaging Center, Helsinki University Central Hospital, Helsinki, Finland Hyvinkää Hospital, Hyvinkää, Finland
A. Tuulio-Henriksson
Affiliation:
Social Insurance Institution, Research Department, Helsinki, Finland Department of Behavioral Sciences, University of Helsinki, Helsinki, Finland
K. Luoma
Affiliation:
HUS Medical Imaging Center, Helsinki University Central Hospital, Helsinki, Finland
O. Mantere
Affiliation:
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, 00300Helsinki, Finland Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
M. Ketokivi
Affiliation:
Operations and Technology Department, IE Business School, Madrid, Spain
M. Holma
Affiliation:
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, 00300Helsinki, Finland Department of Psychiatry, City of Helsinki, Helsinki, Finland
P. Jylhä
Affiliation:
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, 00300Helsinki, Finland Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
T. Melartin
Affiliation:
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, 00300Helsinki, Finland Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
K. Suominen
Affiliation:
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, 00300Helsinki, Finland Department of Psychiatry, City of Helsinki, Helsinki, Finland
M. Vuorilehto
Affiliation:
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, 00300Helsinki, Finland
E. Isometsä
Affiliation:
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, 00300Helsinki, Finland Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland
*
*Corresponding author. Tel.: +358 44 5454291. E-mail addresses:[email protected], [email protected] (T. Kieseppä).
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Abstract

Purpose:

We evaluate for the first time the associations of brain white matter hyperintensities (WMHs) on magnetic resonance imaging (MRI) with neuropsychological variables among middle-aged bipolar I (BPI), II (BPII) and major depressive disorder (MDD) patients and controls using a path model.

Methods:

Thirteen BPI, 15 BPII, 16 MDD patients, and 21 controls underwent brain MRI and a neuropsychological examination. Two experienced neuroradiologists evaluated WMHs on the MRI scans. We constructed structural equation models to test the strength of the associations between deep WMH (DWMH) grade, neuropsychological performance and diagnostic group.

Results:

Belonging in the BPI group as opposed to the control group predicted higher DWMH grade (coefficient estimate 1.13, P = 0.012). The DWMH grade independently predicted worse performance on the Visual Span Forward test (coefficient estimate −0.48, P = 0.002). Group effects of BPI and MDD were significant in predicting poorer performance on the Digit Symbol test (coefficient estimate −5.57, P = 0.016 and coefficient estimate −5.66, P = 0.034, respectively).

Limitations:

Because of the small number of study subjects in groups, the negative results must be considered with caution.

Conclusions:

Only BPI patients had an increased risk for DWMHs. DWMHs were independently associated with deficits in visual attention.

Keywords

Unipolar depressionMania and bipolar disorderMRINeuroscience other (neuropsychology)
Type
Original articles
Information
European Psychiatry , Volume 29 , Issue 4 , May 2014 , pp. 226 - 232
Copyright
Copyright © European Psychiatric Association 2014

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References

Altshuler, L.L., Curran, J.G., Hauser, P., Mintz, J., Denicoff, K., Post, R.T2 hyperintensities in bipolar disorder: magnetic resonance imaging comparison and literature meta-analysis. Am J Psychiatry 1995;152(8):1139–1144.Google ScholarPubMed
Arts, B., Jabben, N., Krabbendam, L., van Os, J.Meta-analyses of cognitive functioning in euthymic bipolar patients and their first-degree relatives. Psychol Med 2008;38(6):771–785.CrossRefGoogle ScholarPubMed
Bearden, C.E., Hoffman, K.M., Cannon, T.D.The neuropsychology and neuroanatomy of bipolar affective disorder: a critical review. Bipolar Disord 2001;3(3):106–150.CrossRefGoogle ScholarPubMed
Boone, K.B., Miller, B.L., Lesser, I.M., Mehringer, C.M., Hill-Gutierrez, E., Goldberg, M.A.et al.Neuropsychological correlates of white-matter lesions in healthy elderly subjects. A threshold effect. Arch Neurol 1992;49(5):549–554.CrossRefGoogle ScholarPubMed
Bunce, D., Anstey, K.J., Cherbuin, N., Burns, R., Christensen, H., Wen, W.et al.Cognitive deficits are associated with frontal and temporal lobe white matter lesions in middle-aged adults living in the community. PLoS One 2010;5(10):e13567.CrossRefGoogle ScholarPubMed
Buschman, T.J., Miller, E.K.Top-down versus bottom-up control of attention in the prefrontal and posterior parietal cortices. Science 2007;315(5820):1860–1862.CrossRefGoogle ScholarPubMed
Coffey, C.E., Figiel, G.S., Djang, W.T., Weiner, R.D.Subcortical hyperintensity on magnetic resonance imaging: a comparison of normal and depressed elderly subjects. Am J Psychiatry 1990;147(2):187–189.Google ScholarPubMed
Dahabra, S., Ashton, C.H., Bahrainian, M., Britton, P.G., Ferrier, I.N., McAllister, V.A.et al.Structural and functional abnormalities in elderly patients clinically recovered from early- and late-onset depression. Biol Psychiatry 1998;44(1):34–46.CrossRefGoogle ScholarPubMed
Debette, S., Markus, H.S.The clinical importance of white matter hyperintensities on brain magnetic resonance imaging: systematic review and meta-analysis. BMJ 2010;341:c3666.CrossRefGoogle ScholarPubMed
Delis, D.C., Kramer, J.H., Kaplan, E., Ober, B.A.California verbal learning test. Manual. Research edition. Corporation TP (editor). San Antonio: Harcourt Brace & Company; 1987.Google Scholar
Dupont, R.M., Jernigan, T.L., Butters, N., Delis, D., Hesselink, J.R., Heindel, W.et al.Subcortical abnormalities detected in bipolar affective disorder using magnetic resonance imaging. Clinical and neuropsychological significance. Arch Gen Psychiatry 1990;47(1):55–59.CrossRefGoogle ScholarPubMed
Dupont, R.M., Jernigan, T.L., Heindel, W., Butters, N., Shafer, K., Wilson, T.et al.Magnetic resonance imaging and mood disorders. Localization of white matter and other subcortical abnormalities. Arch Gen Psychiatry 1995;52(9):747–755.CrossRefGoogle ScholarPubMed
Garde, E., Mortensen, E.L., Krabbe, K., Rostrup, E., Larsson, H.B.Relation between age-related decline in intelligence and cerebral white-matter hyperintensities in healthy octogenarians: a longitudinal study. Lancet 2000;356(9230):628–634.CrossRefGoogle ScholarPubMed
Goldstein, B.I., Fagiolini, A., Houck, P., Kupfer, D.J.Cardiovascular disease and hypertension among adults with bipolar I disorder in the United States. Bipolar Disord 2009;11(6):657–662.CrossRefGoogle ScholarPubMed
Gregoriou, G.G., Gotts, S.J., Zhou, H., Desimone, R.Long-range neural coupling through synchronization with attention. Prog Brain Res 2009;176:35–45.CrossRefGoogle ScholarPubMed
Gruber, S., Rathgeber, K., Braunig, P., Gauggel, S.Stability and course of neuropsychological deficits in manic and depressed bipolar patients compared to patients with major depression. J Affect Disord 2007;104(1–3):61–71.CrossRefGoogle ScholarPubMed
Ha, T.H., Her, J.Y., Kim, J.H., Chang, J.S., Cho, H.S., Ha, K.Similarities and differences of white matter connectivity and water diffusivity in bipolar I and II disorder. Neurosci Lett 2011;505(2):150–154.CrossRefGoogle ScholarPubMed
Heiden, A., Kettenbach, J., Fischer, P., Schein, B., Ba-Ssalamah, A., Frey, R.et al.White matter hyperintensities and chronicity of depression. J Psychiatr Res 2005;39(3):285–293.CrossRefGoogle ScholarPubMed
Hickie, I., Scott, E., Mitchell, P., Wilhelm, K., Austin, M.P., Bennett, B.Subcortical hyperintensities on magnetic resonance imaging: clinical correlates and prognostic significance in patients with severe depression. Biol Psychiatry 1995;37(3):151–160.CrossRefGoogle ScholarPubMed
Holma, K.M., Holma, I.A.K., Melartin, T.K., Rytsälä, H.J., Isometsä, E.T.Long-term outcome of major depressive disorder in psychiatric patients is variable. J Clin Psychiatry 2008;69(2):196–205.CrossRefGoogle ScholarPubMed
Johannessen, L., Strudsholm, U., Foldager, L., Munk-Jorgensen, P.Increased risk of hypertension in patients with bipolar disorder and patients with anxiety compared to background population and patients with schizophrenia. J Affect Disord 2006;95(1–3):13–17.CrossRefGoogle ScholarPubMed
Jylha, P., Isometsa, E.The relationship of neuroticism and extraversion to symptoms of anxiety and depression in the general population. Depress Anxiety 2006;23(5):281–289.CrossRefGoogle ScholarPubMed
Kempton, M.J., Salvador, Z., Munafo, M.R., Geddes, J.R., Simmons, A., Frangou, S.et al.Structural neuroimaging studies in major depressive disorder. Meta-analysis and comparison with bipolar disorder. Arch Gen Psychiatry 2011;68(7):675–690.CrossRefGoogle ScholarPubMed
Krabbendam, L., Honig, A., Wiersma, J., Vuurman, E.F.P.M., Hofman, P.A.M., Derix, M.M.A.et al.Cognitive dysfunctions and white matter lesions in patients with bipolar disorder in remission. Acta Psychiatr Scand 2000;101:274–280.Google ScholarPubMed
Lezak, M.D., Howieson, D.B., Loring, D.W.Neuropsychological assessment, 4th ed., New York: Oxford University Press; 2004.Google Scholar
Liao, D., Cooper, L., Cai, J., Toole, J., Bryan, N., Burke, G.et al.The prevalence and severity of white matter lesions, their relationship with age, ethnicity, gender, and cardiovascular disease risk factors: the ARIC Study. Neuroepidemiology 1997;16(3):149–162.CrossRefGoogle ScholarPubMed
Liu, J.X., Chen, Y.S., Hsieh, J.C., Su, T.P., Yeh, T.C., Chen, L.F.Differences in white matter abnormalities between bipolar I and II disorders. J Affect Disord 2010;127(1–3):309–315.CrossRefGoogle ScholarPubMed
Lyoo, I.K., Lee, H.K., Jung, J.H., Noam, G.G., Renshaw, P.F.White matter hyperintensities on magnetic resonance imaging of the brain in children with psychiatric disorders. Compr Psychiatry 2002;43(5):361–368.CrossRefGoogle ScholarPubMed
Mahon, K., Burdick, K.E., Szeszko, P.R.A role for white matter abnormalities in the pathophysiology of bipolar disorder. Neurosci Biobehav Rev 2010;34(4):533–554.CrossRefGoogle ScholarPubMed
Mantere, O., Suominen, K., Leppamaki, S., Valtonen, H., Arvilommi, P., Isometsa, E.The clinical characteristics of DSM-IV bipolar I and II disorders: baseline findings from the Jorvi Bipolar Study (JoBS). Bipolar Disord 2004;6(5):395–405.CrossRefGoogle Scholar
Martinez-Aran, A., Vieta, E., Reinares, M., Colom, F., Torrent, C., Sanchez-Moreno, J.et al.Cognitive function across manic or hypomanic, depressed, and euthymic states in bipolar disorder. Am J Psychiatry 2004;161(2):262–270.CrossRefGoogle ScholarPubMed
Melartin, T.K., Rytsala, H.J., Leskela, U.S., Lestela-Mielonen, P.S., Sokero, T.P., Isometsa, E.T.Current comorbidity of psychiatric disorders among DSM-IV major depressive disorder patients in psychiatric care in the Vantaa Depression Study. J Clin Psychiatry 2002;63(2):126–134.CrossRefGoogle ScholarPubMed
Moore, P.B., Shepherd, D.J., Eccleston, D., Macmillan, I.C., Goswami, U., McAllister, V.L.et al.Cerebral white matter lesions in bipolar affective disorder: relationship to outcome. Br J Psychiatry 2001;178:172–176.CrossRefGoogle Scholar
Muthén, L.K., Muthén, B.O.Mplus user's guide, 5th ed., Los Angeles, CA: Muthén & Muthén; 2007.Google Scholar
Ovbiagele, B., Saver, J.L.Cerebral white matter hyperintensities on MRI: current concepts and therapeutic implications. Cerebrovasc Dis 2006;22(2–3):83–90.CrossRefGoogle ScholarPubMed
Pantoni, L., Poggesi, A., Inzitari, D.The relation between white-matter lesions and cognition. Curr Opin Neurol 2007;20(4):390–397.CrossRefGoogle ScholarPubMed
Porter, R.J., Bourke, C., Gallagher, P.Neuropsychological impairment in major depression: its nature, origin and clinical significance. Aust N Z J Psychiatry 2007;41(2):115–128.CrossRefGoogle ScholarPubMed
Reitan, R., Wolfson, D.The Halstead-Reitan neuropsychological test. Battery: theory and clinical interpretation. Tucson, AZ: Neuropsychology Press; 1993.Google Scholar
Robinson, L.J., Thompson, J.M., Gallagher, P., Goswami, U., Young, A.H., Ferrier, I.N.et al.A meta-analysis of cognitive deficits in euthymic patients with bipolar disorder. J Affect Disord 2006;93(1–3):105–115.CrossRefGoogle ScholarPubMed
Sachdev, P., Chen, X., Wen, W.White matter hyperintensities in mid-adult life. Curr Opin Psychiatry 2008;21(3):268–274.CrossRefGoogle ScholarPubMed
Salonen, O., Autti, T., Raininko, R., Ylikoski, A., Erkinjuntti, T.MRI of the brain in neurologically healthy middle-aged and elderly individuals. Neuroradiology 1997;39(8):537–545.CrossRefGoogle ScholarPubMed
Schmidt, R., Fazekas, F., Offenbacher, H., Dusek, T., Zach, E., Reinhart, B.et al.Neuropsychologic correlates of MRI white matter hyperintensities: a study of 150 normal volunteers. Neurology 1993;43(12):2490–2494.CrossRefGoogle ScholarPubMed
Simonsen, C., Sundet, K., Vaskinn, A., Birkenaes, A.B., Engh, J.A., Hansen, C.F.et al.Neurocognitive profiles in bipolar I and bipolar II disorder: differences in pattern and magnitude of dysfunction. Bipolar Disord 2008;10(2):245–255.CrossRefGoogle ScholarPubMed
Spitzer, R.L., Gibbon, M., Williams, J.B.W.The structured clinical interview for DSM-IV axis I and II disorders (SCID I-II). Washington, DC: American Psychiatric Press; 1997.Google Scholar
Summers, M., Papadopoulou, K., Bruno, S., Cipolotti, L., Ron, M.A.Bipolar I and bipolar II disorder: cognition and emotion processing. Psychol Med 2006;36(12):1799–1809.CrossRefGoogle ScholarPubMed
Tighe, S.K., Reading, S.A., Rivkin, P., Caffo, B., Schweizer, B., Pearlson, G.et al.Total white matter hyperintensity volume in bipolar disorder patients and their healthy relatives. Bipolar Disord 2012;14(8):888–893.CrossRefGoogle ScholarPubMed
Wechsler, D.Wechsler Adult Intelligence Scale - revised (WAIS-R), manual. Corporation P (editor). Cleveland: Harcourt Brace Jovanovich, Inc; 1981.Google Scholar
Wechsler, D.Wechsler Memory Scale - revised (WMS-R), manual. Corporation P (editor). San Antonio: Harcourt Brace Jovanovich, Inc; 1987.Google Scholar
Versace, A., Almeida, J.R., Quevedo, K., Thompson, W.K., Terwilliger, R.A., Hassel, S.et al.Right orbitofrontal corticolimbic and left corticocortical white matter connectivity differentiate bipolar and unipolar depression. Biol Psychiatry 2010;68(6):560–567.CrossRefGoogle ScholarPubMed
Vuorilehto, M., Melartin, T., Isometsa, E.Depressive disorders in primary care: recurrent, chronic, and co-morbid. Psychol Med 2005;35(5):673–682.CrossRefGoogle ScholarPubMed
Ylikoski, A., Erkinjuntti, T., Raininko, R., Sarna, S., Sulkava, R., Tilvis, R.White matter hyperintensities on MRI in the neurologically nondiseased elderly. Analysis of cohorts of consecutive subjects aged 55 to 85 years living at home. Stroke 1995;26(7):1171–1177.CrossRefGoogle ScholarPubMed
Ylikoski, R., Ylikoski, A., Erkinjuntti, T., Sulkava, R., Raininko, R., Tilvis, R.White matter changes in healthy elderly persons correlate with attention and speed of mental processing. Arch Neurol 1993;50(8):818–824.CrossRefGoogle ScholarPubMed
Zanetti, M.V., Schaufelberger, M.S., de Castro, C.C., Menezes, P.R., Scazufca, M., McGuire, P.K.et al.White-matter hyperintensities in first-episode psychosis. Br J Psychiatry 2008;193(1):25–30.CrossRefGoogle ScholarPubMed
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