Abnormal anterior cingulum integrity in bipolar disorder determined through diffusion tensor imaging

Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA.
The British Journal of Psychiatry (Impact Factor: 7.34). 09/2008; 193(2):126-9. DOI: 10.1192/bjp.bp.107.048793
Source: PubMed

ABSTRACT Convergent evidence implicates white matter abnormalities in bipolar disorder. The cingulum is an important candidate structure for study in bipolar disorder as it provides substantial white matter connections within the corticolimbic neural system that subserves emotional regulation involved in the disorder.
To test the hypothesis that bipolar disorder is associated with abnormal white matter integrity in the cingulum.
Fractional anisotropy in the anterior and posterior cingulum was compared between 42 participants with bipolar disorder and 42 healthy participants using diffusion tensor imaging.
Fractional anisotropy was significantly decreased in the anterior cingulum in the bipolar disorder group compared with the healthy group (P=0.003); however, fractional anisotropy in the posterior cingulum did not differ significantly between groups.
Our findings demonstrate abnormalities in the structural integrity of the anterior cingulum in bipolar disorder. They extend evidence that supports involvement of the neural system comprising the anterior cingulate cortex and its corticolimbic gray matter connection sites in bipolar disorder to implicate abnormalities in the white matter connections within the system provided by the cingulum.

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Available from: Gaolang Gong, Mar 26, 2015
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    • "To date most investigations of microstructural white matter changes in patients with BD have been conducted in patients who are in mid-life or who have persistent or recurrent disorders [1], [5]–[8]. These studies have identified a wide range of abnormalities including structural changes within the CC, cingulate as well as the inferior and superior longitudinal fasciculi [1],[5],[7],[8]. Moreover, a recent meta-analysis of diffusion tension studies [9] suggests two clusters of abnormality (on the right parahippocampal gyrus and subgenual cingulate cortex). "
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    ABSTRACT: To date, most studies of white matter changes in Bipolar Disorder (BD) have been conducted in older subjects and with well-established disorders. Studies of young people who are closer to their illness onset may help to identify core neurobiological characteristics and separate these from consequences of repeated illness episodes or prolonged treatment. Diffusion tensor imaging (DTI) was used to examine white matter microstructural changes in 58 young patients with BD (mean age 23 years; range 16-30 years) and 40 controls. Whole brain voxelwise measures of fractional anisotropy (FA), parallel diffusivity (λ//) and radial diffusivity (λ⊥) were calculated for all subjects. White matter microstructure differences (decreased FA corrected p<.05) were found between the patients with BD and controls in the genu, body and splenium of the corpus callosum as well as the superior and anterior corona radiata. In addition, significantly increased radial diffusivity (p<.01) was found in the BD group. Neuroimaging studies of young patients with BD may help to clarify neurodevelopmental aspects of the illness and for identifying biomarkers of disease onset and progression. Our findings provide evidence of microstructural white matter changes early in the course of illness within the corpus callosum and the nature of these changes suggest they are associated with abnormalities in the myelination of axons.
    PLoS ONE 03/2013; 8(3):e59108. DOI:10.1371/journal.pone.0059108 · 3.23 Impact Factor
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    • "Various methods of analyzing DTI data have been developed based on this technique. DTI studies using the region of interest (ROI) approach have reported reduced FA within adult patients in prefrontal WM, corpus callosum (Macritchie et al., 2010; Wang et al., 2008b), anterior cingulum (Wang et al., 2008a), anterior limb of the internal capsule (Sussmann et al., 2009), anterior thalamic radiation, and uncinate fasciculus (McIntosh et al., 2008). First-episode (FE) BD adolescents showed significantly decreased FA in superior-frontal WM tracts in one study (Adler et al., 2006), but another study showed increased FA in anterior frontal regions and corpus callosum and normal FA in several other regions (Heng et al., 2010). "
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    ABSTRACT: Structural abnormality of both gray and white matter has been detected in patients with bipolar disorder (BD). But results were greatly inconsistent across studies which were most likely attributed to heterogeneous populations as well as processing techniques. The present study aimed to investigate brain structural and microstructural alterations in a relative homogenous sample of bipolar mania. 3D T1-weighted magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) were conducted in 18 patients with BD and 27 healthy volunteers. Gray matter (GM) and white matter (WM) differences were evaluated using voxel-based morphometry (VBM) and voxel-based analysis of fractional anisotropy (FA) maps derived from DTI, respectively. Patients with BD had a larger volume of GM in the left thalamus and bilateral basal ganglia, including the bilateral putamen and extending to the left claustrum, as well as reduced FA values in the left posterior corona radiata. By combined analysis, alterations in subcortical GM areas and part of the corresponding association fiber area were detected. Compared with observations in homogeneous samples, our findings indicate that disruption of the limbic network may be intrinsic to BD.
    Progress in Neuro-Psychopharmacology and Biological Psychiatry 11/2011; 36(2):231-8. DOI:10.1016/j.pnpbp.2011.11.002 · 4.03 Impact Factor
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    • "To date, there are several DTI studies that have investigated white matter microstructure in bipolar disorder. Abnormalities in white matter integrity in frontal regions, callosal regions, and regions within the anterior limbic network have been demonstrated in bipolar disorder by region-of-interest (ROI) based analyses (Adler et al., 2004, 2006; Beyer et al., 2005; Frazier et al., 2007; Haznedar et al., 2005; Macritchie et al., 2010; Yurgelun-Todd et al., 2007; Wang et al., 2008a, 2008b), voxel-based analyses (Bruno et al., 2008; Chaddock et al., 2009; Kafantaris et al., 2009; Mahon et al., 2009; Sussmann et al., 2009; Wessa et al., 2009; Zanetti et al., 2009), tract-based spatial statistics analyses (Barnea-Goraly et al., 2009; Versace et al., 2008), and tractography-based analyses (Houenou et al., 2007; McIntosh et al., 2008). These studies suggested that mood dysregulation in bipolar disorder may result from deficient frontal modulation of subcortical and limbic structures. "
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    ABSTRACT: In bipolar disorder, white matter abnormalities have been reported with region-of-interest and voxel-based methods; however, deficits in specific white matter tracts cannot be localized by these methods. Therefore, in this study, we aimed to investigate the white matter tracts that mediate connectivity of the frontal cortex using diffusion tensor imaging (DTI) tractography. Eighteen patients with bipolar disorder and sixteen age- and gender-matched healthy subjects underwent DTI examinations. Frontal cortex white matter tracts, including the anterior thalamic radiation (ATR), uncinate fasciculus (UF), superior longitudinal fasciculus (SLF), cingulum, and inferior fronto-occipital fasciculus (IFO) were reconstructed by DTI tractography, and we calculated the mean fractional anisotropy (FA) for each fiber tract. The values were compared between groups by repeated measures analysis of variance with age and gender as covariates, which allowed us to investigate significant differences between the tracts. When compared with healthy controls, the patients with bipolar disorder showed significantly decreased FA in the ATR and UF, and a trend towards lower FA in the SLF and cingulum. However, there were no FA differences between groups in the IFO. Our study indicates that bipolar patients show abnormalities within white matter tracts connecting the frontal cortex with the temporal and parietal cortices and the fronto-subcortical circuits. These findings suggest that alterations in the connectivity of white matter tracts in the frontal cortex might contribute to the neuropathology of bipolar disorder.
    Journal of Affective Disorders 06/2011; 131(1-3):299-306. DOI:10.1016/j.jad.2010.12.018 · 3.71 Impact Factor
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