Increased rates of white matter hyperintensities in late-onset bipolar disorder

Author(s)

Tamashiro, Jaqueline Hatsuko ^{[1, 2]} ; Zung, Stevin ^[1] ; Zanetti, Marcus Vinicius ^[1] ; de Castro, Claudio Campi ^[3] ; Vallada, Homero ^[1] ; Busatto, Geraldo F. ^[1] ; de Toledo Ferraz Alves, Tania Correa ^{[1, 2]}

Affiliation

^[1] Univ Sao Paulo, Dept Psychiat, Sch Med, Sao Paulo - Brazil

^[2] Fundacao ABC, ABC Reg Med Sch, Dept Psychiat, Santo Andre - Brazil

^[3] Univ Sao Paulo, Sch Med, Dept Radiol, Sao Paulo - Brazil

• Document type: Journal article
• Source: BIPOLAR DISORDERS; v. 10, n. 7, p. 765-775, 2008.
• Web of Science Citations: 40

Abstract

Objectives: Magnetic resonance imaging (MRI) studies have reported an increased frequency of white matter hyperintensities (WMH) in association with late-onset (LO) depression, and this has supported the notion that vascular-related mechanisms may be implicated in the pathophysiology of LO mood disorders. Recent clinical studies have also suggested a link between LO bipolar disorder (LO-BD) and cerebrovascular risk factors, but this has been little investigated with neuroimaging techniques. In order to ascertain whether there could be a specific association between WMH and LO-BD, we directly compared WMH rates between LO-BD subjects (illness onset 60 years), early-onset BD subjects (EO-BD, illness onset < 60 years), and elderly healthy volunteers. Methods: T2-weighted MRI data were acquired in LO-BD subjects (n = 10, age = 73.60 +/- 4.09), EO-BD patients (n = 49, age = 67.78 +/- 4.44), and healthy subjects (n = 24, age = 69.00 +/- 7.22). WMH rates were assessed using the Scheltens scale. Results: There was a greater prevalence of WMH in LO-BD patients relative to the two other groups in the deep parietal region (p = 0.018) and basal ganglia (p < 0.045). When between-group comparisons of mean WMH scores were conducted taking account of age differences (ANCOVA), there were more severe scores in LO-BD patients relative to the two other groups in deep frontal and parietal regions, as well as in the putamen (p < 0.05). Conclusions: Our results provide empirical support to the proposed link between vascular risk factors and LO-BD. If extended in future studies with larger samples, these. findings may help to clarify the pathophysiological distinctions between bipolar disorder emerging at early and late stages of life. (AU)

• FAPESP's process: 04/15336-5 - Brain abnormalities associated with cardiovascular risk factors: a population-based study using voxel-a-voxel morphometry by magnetic resonance and measures of glucose metabolism by positron-emission tomography
• Grantee: Geraldo Busatto Filho
• Support Opportunities: Regular Research Grants