Data from: Cerebral white matter lesions and affective episodes correlate in male individuals with bipolar disorder

Background: Cerebral white matter lesions (WML) have been found in normal aging, vascular disease and several neuropsychiatric conditions. Correlations of WML with clinical parameters in BD have been described, but not with the number of affective episodes, illness duration, age of onset and Body Mass Index in a well characterized group of euthymic bipolar adults. Herein, we aimed to evaluate the associations between bipolar course of illness parameters and WML measured with volumetric analysis. Methods: In a cross-sectional study 100 euthymic individuals with BD as well as 54 healthy controls (HC) were enrolled to undergo brain magnetic resonance imaging using 3T including a FLAIR sequence for volumetric assessment of WML-load using FSL-software. Additionally, clinical characteristics and psychometric measures including Structured Clinical Interview according to DSM-IV, Hamilton-Depression, Young Mania Rating Scale and Beck’s Depression Inventory were evaluated. Results: Individuals with BD had significantly more (F = 3.968, p < .05) WML (Mdn = 3710mm3; IQR = 2961mm3) than HC (Mdn = 2185mm3; IQR = 1665mm3). BD men (Mdn = 4095mm3; IQR = 3295mm3) and BD women (Mdn = 3032mm3; IQR = 2816mm3) did not significantly differ as to the WML-load or the number and type of risk factors for WML. However, in men only, the number of manic/hypomanic episodes (r = 0.72; p < .001) as well as depressive episodes (r = 0.51; p < .001) correlated positively with WML-load. Conclusions: WML-load strongly correlated with the number of manic episodes in male BD patients, suggesting that men might be more vulnerable to mania in the context of cerebral white matter changes.

背景：研究已在正常衰老、血管疾病及多种神经精神疾病中发现脑白质病变（White Matter Lesions，WML）。现有研究已报道双相障碍（Bipolar Disorder，BD）患者的WML与临床参数存在相关性，但针对特征明确的心境正常双相成人群体，尚未明确其WML与情感发作次数、病程、发病年龄及身体质量指数（Body Mass Index，BMI）之间的关联。本研究旨在探讨双相障碍疾病进程相关参数与通过体积分析法测得的WML负荷之间的关联。
方法：本项横断面研究纳入100名心境正常的双相障碍患者及54名健康对照（Healthy Controls，HC），所有受试者均接受3T颅脑磁共振成像扫描，包含液体衰减反转恢复序列（Fluid-Attenuated Inversion Recovery，FLAIR），采用FSL软件完成WML负荷的体积定量评估。此外，本研究还对受试者的临床特征及多项心理测评结果进行了评估，包括符合DSM-IV标准的结构化临床访谈、汉密尔顿抑郁量表、杨氏躁狂评定量表以及贝克抑郁量表。
结果：心境正常的双相障碍患者的WML负荷（中位数Mdn=3710mm³；四分位距IQR=2961mm³）显著高于健康对照（Mdn=2185mm³；IQR=1665mm³；F=3.968，p<0.05）。男性双相障碍患者（Mdn=4095mm³；IQR=3295mm³）与女性双相障碍患者（Mdn=3032mm³；IQR=2816mm³）的WML负荷，以及WML相关危险因素的数量与类型均无显著差异。但仅在男性患者中，躁狂/轻躁狂发作次数（r=0.72；p<0.001）与抑郁发作次数（r=0.51；p<0.001）均与WML负荷呈显著正相关。
结论：男性双相障碍患者的WML负荷与躁狂发作次数呈强相关，提示在脑白质病变的背景下，男性可能对躁狂发作更为易感。