Abstract

BackgroundThe presence of microstructural white matter (WM) abnormalities in individuals with bipolar disorder (BD) has previously been reported. However, the interpretation of data is challenging because pharmacological treatment has a potential effect on WM integrity. To date, no study has compared the differences in WM structure among drug-naïve BD patients, drug-naïve major depression disorder (MDD) patients, and healthy controls (HC) using the visual evaluation method of diffusion tensor tractography (DTT).MethodsThis retrospective study included 12 drug-naïve patients with BD, 15 drug-naïve patients with MDD, and 27 age- and sex-matched HC individuals. Visual evaluation, fractional anisotropy (FA), and apparent diffusion coefficient (ADC) were analysed in the anterior thalamic radiation (ATR) as a tract of interest using the optimal follow-up truncation threshold. They were also analysed in the cingulate fasciculus, superior longitudinal fasciculus, inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, uncinate fasciculus, and fornix.ResultsNo significant differences were found in the FA or ADC of any tract. However, visual evaluation revealed poorer depiction of ATR in patients with BD than in patients with MDD and HC individuals (p = 0.004). Our post-hoc analysis showed a significant difference between BD and HC patients (p = 0.018).ConclusionsThe visual evaluation method of DTT revealed poor depiction of ATR in patients with BD compared with HC individuals and MDD patients, suggesting microstructural WM abnormalities of ATR in BD.

Highlights

  • The difficulty of diagnosing bipolar disorder (BD) in clinical practise resides in the need to identify a specific brain abnormality

  • Our previous diffusion tensor tractography (DTT) study has indicated the potential usefulness of the visual evaluation of white matter (WM) integrity for the distinction of BD patients from healthy controls (HC), which revealed poor depiction of the anterior thalamic radiation (ATR) in BD [9]

  • In the present study, we investigated the effectiveness of several DTT evaluation methods among drug-naïve BD patients, drug-naïve major depressive disorder (MDD) patients, and HC

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Summary

Introduction

The difficulty of diagnosing bipolar disorder (BD) in clinical practise resides in the need to identify a specific brain abnormality. Disruptions in the cerebral white matter (WM) integrity are considered a biological indicator of BD. Previous studies have investigated the effectiveness of diffusion tensor imaging (DTI) in the identification of this abnormality [1–3]. Our previous DTT study has indicated the potential usefulness of the visual evaluation of WM integrity for the distinction of BD patients from healthy controls (HC), which revealed poor depiction of the anterior thalamic radiation (ATR) in BD [9]. The presence of microstructural white matter (WM) abnormalities in individuals with bipolar disorder (BD) has previously been reported. No study has compared the differences in WM structure among drug-naïve BD patients, drug-naïve major depression disorder (MDD) patients, and healthy controls (HC) using the visual evaluation method of diffusion tensor tractography (DTT)

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