Increased rates of white matter hyperintensities in late-onset bipolar disorder |
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Authors: | Jaqueline Hatsuko Tamashiro Stevin Zung Marcus Vinicius Zanetti Cláudio Campi De Castro Homero Vallada Geraldo F Busatto Tânia Correa De Toledo Ferraz Alves |
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Affiliation: | 1. Department of Psychiatry, University of São Paulo Medical School, São Paulo Department of Psychiatry, ABC Region Medical School, Fundação ABC, Santo André;2. Department of Psychiatry, University of São Paulo Medical School, São Paulo;3. Department of Radiology, University of São Paulo Medical School, São Paulo, Brazil |
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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. |
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Keywords: | bipolar disorder late-onset mood disorders magnetic resonance imaging vascular risk factors white matter hyperintensities |
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