A comparative study of white matter integrity in bipolar affective disorder and schizophrenia_West China Medical Journal

Authors：

ZHOU Yiting ¹ ,  LI Mingli ¹ , YU Hua ¹ , LI Yinfei ¹ , LI Tao ²

1. Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Neurobiology, Affiliated Mental Health Center & Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310013, P. R. China;

Corresponding author：

LI Mingli, Email: limingli@wchscu.cn

Keywords：

Schizophrenia; bipolar affective disorder; diffusion tensor imaging; white matter

DOI：

10.7507/1002-0179.202202024

Video：

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Objective To explore the difference of white matter changes between bipolar affective disorder and schizophrenia using diffusion tensor imaging (DTI). Methods Patients with bipolar affective disorder and schizophrenia were selected from the Mental Health Center of West China Hospital of Sichuan University between October 2014 and January 2017. Volunteers were recruited from October 2014 to January 2017. The included patients were divided into bipolar affective disorder group and schizophrenia group according to their diagnosis. Volunteers were divided into normal control group. The bipolar affective disorder group was divided into two subgroups: manic episode and depressive episode. DTI was performed on the included patients and volunteers. Tract based spatial statistics (TBSS) was used to study the differences in fractional anisotropy (FA) of white matter between patients and normal controls, and FA values of two subgroups of bipolar affective disorder and schizophrenia were compared. Results A total of 99 patients and 40 normal controls were included in this study. Among them, there were 40 cases in schizophrenia group and 59 cases in bipolar affective disorder group (31 cases of manic episode and 28 cases of depressive episode). Compared with the normal control group, FA values decreased in corpus callosum, fornix, occipital forceps and left inferior longitudinal fasciculus with bipolar affective disorder group and schizophrenia group (P<0.05). There was no significant difference in FA values between bipolar affective disorder group and schizophrenia group (P>0.05), but the FA value in left posterior thalamic radiation decreased in depressive episode of bipolar affective disorder group compared with schizophrenia group (P=0.001). Conclusions There are similarities between white matter changes in bipolar affective disorder and schizophrenia. However, the white matter change in posterior thalamic radiation may be the characteristic change in depressive episode of bipolar affective disorder.

Citation： ZHOU Yiting, LI Mingli, YU Hua, LI Yinfei, LI Tao. A comparative study of white matter integrity in bipolar affective disorder and schizophrenia. West China Medical Journal, 2022, 37(12): 1805-1811. doi: 10.7507/1002-0179.202202024 Copy

1.	GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet, 2017, 390(10100): 1211-1259.
2.	Dunayevich E, Keck PE Jr. Prevalence and description of psychotic features in bipolar mania. Curr Psychiatry Rep, 2000, 2(4): 286-290.
3.	Keshavan MS, Morris DW, Sweeney JA, et al. A dimensional approach to the psychosis spectrum between bipolar disorder and schizophrenia: the Schizo-Bipolar Scale. Schizophr Res, 2011, 133(1/2/3): 250-254.
4.	Schretlen DJ, Cascella NG, Meyer SM, et al. Neuropsychological functioning in bipolar disorder and schizophrenia. Biol Psychiatry, 2007, 62(2): 179-186.
5.	d'Albis MA, Houenou J. The Kraepelinian dichotomy viewed by neuroimaging. Schizophr Bull, 2015, 41(2): 330-335.
6.	Chang M, Womer FY, Edmiston EK, et al. Neurobiological commonalities and distinctions among three major psychiatric diagnostic categories: a structural MRI study. Schizophr Bull, 2018, 44(1): 65-74.
7.	Calhoun VD, Sui J, Kiehl K, et al. Exploring the psychosis functional connectome: aberrant intrinsic networks in schizophrenia and bipolar disorder. Front Psychiatry, 2012, 2: 75.
8.	Emsell L, Leemans A, Langan C, et al. Limbic and callosal white matter changes in euthymic bipolarⅠdisorder: an advanced diffusion magnetic resonance imaging tractography study. Biol Psychiatry, 2013, 73(2): 194-201.
9.	Ellison-Wright I, Bullmore E. Anatomy of bipolar disorder and schizophrenia: a meta-analysis. Schizophr Res, 2010, 117(1): 1-12.
10.	Nortje G, Stein DJ, Radua J, et al. Systematic review and voxel-based meta-analysis of diffusion tensor imaging studies in bipolar disorder. J Affect Disord, 2013, 150(2): 192-200.
11.	Beaulieu C. The basis of anisotropic water diffusion in the nervous system-a technical review. NMR Biomed, 2002, 15(7/8): 435-455.
12.	Shizukuishi T, Abe O, Aoki S. Diffusion tensor imaging analysis for psychiatric disorders. Magn Reson Med Sci, 2013, 12(3): 153-159.
13.	Knöchel C, Schmied C, Linden DE, et al. White matter abnormalities in the fornix are linked to cognitive performance in SZ but not in BD disorder: an exploratory analysis with DTI deterministic tractography. J Affect Disord, 2016, 201: 64-78.
14.	Koshiyama D, Fukunaga M, Okada N, et al. White matter microstructural alterations across four major psychiatric disorders: mega-analysis study in 2937 individuals. Mol Psychiatry, 2020, 25(4): 883-895.
15.	Nenadić I, Hoof A, Dietzek M, et al. Diffusion tensor imaging of cingulum bundle and corpus callosum in schizophrenia vs bipolar disorder. Psychiatry Res Neuroimaging, 2017, 266: 96-100.
16.	Lu LH, Zhou XJ, Keedy SK, et al. White matter microstructure in untreated first episode bipolar disorder with psychosis: comparison with schizophrenia. Bipolar Disord, 2011, 13(7/8): 604-613.
17.	Squarcina L, Bellani M, Rossetti MG, et al. Similar white matter changes in schizophrenia and bipolar disorder: a tract-based spatial statistics study. PLoS One, 2017, 12(6): e0178089.
18.	Yang C, Li L, Hu X, et al. Psychoradiologic abnormalities of white matter in patients with bipolar disorder: diffusion tensor imaging studies using tract-based spatial statistics. J Psychiatry Neurosci, 2019, 44(1): 32-44.
19.	Favre P, Pauling M, Stout J, et al. Widespread white matter microstructural abnormalities in bipolar disorder: evidence from mega- and meta-analyses across 3033 individuals. Neuropsychopharmacology, 2019, 44(13): 2285-2293.
20.	Kumar J, Iwabuchi S, Oowise S, et al. Shared white-matter dysconnectivity in schizophrenia and bipolar disorder with psychosis. Psychol Med, 2015, 45(4): 759-770.
21.	Li J, Kale Edmiston E, Chen K, et al. A comparative diffusion tensor imaging study of corpus callosum subregion integrity in bipolar disorder and schizophrenia. Psychiatry Res, 2014, 221(1): 58-62.
22.	Knöchel C, Stäblein M, Storchak H, et al. Multimodal assessments of the hippocampal formation in schizophrenia and bipolar disorder: evidences from neurobehavioral measures and functional and structural MRI. Neuroimage Clin, 2014, 6: 134-144.
23.	Sui J, Pearlson G, Caprihan A, et al. Discriminating schizophrenia and bipolar disorder by fusing fMRI and DTI in a multimodal CCA+ joint ICA model. Neuroimage, 2011, 57(3): 839-855.
24.	Anderson D, Ardekani BA, Burdick KE, et al. Overlapping and distinct gray and white matter abnormalities in schizophrenia and bipolar I disorder. Bipolar Disord, 2013, 15(6): 680-693.
25.	Dong D, Wang Y, Chang X, et al. Shared abnormality of white matter integrity in schizophrenia and bipolar disorder: a comparative voxel-based meta-analysis. Schizophr Res, 2017, 185: 41-50.
26.	Benedetti F, Yeh PH, Bellani M, et al. Disruption of white matter integrity in bipolar depression as a possible structural marker of illness. Biol Psychiatry, 2011, 69(4): 309-317.
27.	Lan MJ, Rubin-Falcone H, Sublette ME, et al. Deficits of white matter axial diffusivity in bipolar disorder relative to major depressive disorder: no relationship to cerebral perfusion or body mass index. Bipolar Disord, 2020, 22(3): 296-302.
28.	White T, Langen C, Schmidt M, et al. Comparative neuropsychiatry: white matter abnormalities in children and adolescents with schizophrenia, bipolar affective disorder, and obsessive-compulsive disorder. Eur Psychiatry, 2015, 30(2): 205-213.
29.	McIntosh AM, Muñoz Maniega S, Lymer GK, et al. White matter tractography in bipolar disorder and schizophrenia. Biol Psychiatry, 2008, 64(12): 1088-1092.
30.	Hoptman MJ, Nierenberg J, Bertisch HC, et al. A DTI study of white matter microstructure in individuals at high genetic risk for schizophrenia. Schizophr Res, 2008, 106(2/3): 115-124.
31.	Katagiri N, Pantelis C, Nemoto T, et al. A longitudinal study investigating sub-threshold symptoms and white matter changes in individuals with an ‘at risk mental state’ (ARMS). Schizophr Res, 2015, 162(1/2/3): 7-13.
32.	Wang Q, Cheung C, Deng W, et al. White-matter microstructure in previously drug-naive patients with schizophrenia after 6 weeks of treatment. Psychol Med, 2013, 43(11): 2301-2309.

1. GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet, 2017, 390(10100): 1211-1259.
2. Dunayevich E, Keck PE Jr. Prevalence and description of psychotic features in bipolar mania. Curr Psychiatry Rep, 2000, 2(4): 286-290.
3. Keshavan MS, Morris DW, Sweeney JA, et al. A dimensional approach to the psychosis spectrum between bipolar disorder and schizophrenia: the Schizo-Bipolar Scale. Schizophr Res, 2011, 133(1/2/3): 250-254.
4. Schretlen DJ, Cascella NG, Meyer SM, et al. Neuropsychological functioning in bipolar disorder and schizophrenia. Biol Psychiatry, 2007, 62(2): 179-186.
5. d'Albis MA, Houenou J. The Kraepelinian dichotomy viewed by neuroimaging. Schizophr Bull, 2015, 41(2): 330-335.
6. Chang M, Womer FY, Edmiston EK, et al. Neurobiological commonalities and distinctions among three major psychiatric diagnostic categories: a structural MRI study. Schizophr Bull, 2018, 44(1): 65-74.
7. Calhoun VD, Sui J, Kiehl K, et al. Exploring the psychosis functional connectome: aberrant intrinsic networks in schizophrenia and bipolar disorder. Front Psychiatry, 2012, 2: 75.
8. Emsell L, Leemans A, Langan C, et al. Limbic and callosal white matter changes in euthymic bipolarⅠdisorder: an advanced diffusion magnetic resonance imaging tractography study. Biol Psychiatry, 2013, 73(2): 194-201.
9. Ellison-Wright I, Bullmore E. Anatomy of bipolar disorder and schizophrenia: a meta-analysis. Schizophr Res, 2010, 117(1): 1-12.
10. Nortje G, Stein DJ, Radua J, et al. Systematic review and voxel-based meta-analysis of diffusion tensor imaging studies in bipolar disorder. J Affect Disord, 2013, 150(2): 192-200.
11. Beaulieu C. The basis of anisotropic water diffusion in the nervous system-a technical review. NMR Biomed, 2002, 15(7/8): 435-455.
12. Shizukuishi T, Abe O, Aoki S. Diffusion tensor imaging analysis for psychiatric disorders. Magn Reson Med Sci, 2013, 12(3): 153-159.
13. Knöchel C, Schmied C, Linden DE, et al. White matter abnormalities in the fornix are linked to cognitive performance in SZ but not in BD disorder: an exploratory analysis with DTI deterministic tractography. J Affect Disord, 2016, 201: 64-78.
14. Koshiyama D, Fukunaga M, Okada N, et al. White matter microstructural alterations across four major psychiatric disorders: mega-analysis study in 2937 individuals. Mol Psychiatry, 2020, 25(4): 883-895.
15. Nenadić I, Hoof A, Dietzek M, et al. Diffusion tensor imaging of cingulum bundle and corpus callosum in schizophrenia vs bipolar disorder. Psychiatry Res Neuroimaging, 2017, 266: 96-100.
16. Lu LH, Zhou XJ, Keedy SK, et al. White matter microstructure in untreated first episode bipolar disorder with psychosis: comparison with schizophrenia. Bipolar Disord, 2011, 13(7/8): 604-613.
17. Squarcina L, Bellani M, Rossetti MG, et al. Similar white matter changes in schizophrenia and bipolar disorder: a tract-based spatial statistics study. PLoS One, 2017, 12(6): e0178089.
18. Yang C, Li L, Hu X, et al. Psychoradiologic abnormalities of white matter in patients with bipolar disorder: diffusion tensor imaging studies using tract-based spatial statistics. J Psychiatry Neurosci, 2019, 44(1): 32-44.
19. Favre P, Pauling M, Stout J, et al. Widespread white matter microstructural abnormalities in bipolar disorder: evidence from mega- and meta-analyses across 3033 individuals. Neuropsychopharmacology, 2019, 44(13): 2285-2293.
20. Kumar J, Iwabuchi S, Oowise S, et al. Shared white-matter dysconnectivity in schizophrenia and bipolar disorder with psychosis. Psychol Med, 2015, 45(4): 759-770.
21. Li J, Kale Edmiston E, Chen K, et al. A comparative diffusion tensor imaging study of corpus callosum subregion integrity in bipolar disorder and schizophrenia. Psychiatry Res, 2014, 221(1): 58-62.
22. Knöchel C, Stäblein M, Storchak H, et al. Multimodal assessments of the hippocampal formation in schizophrenia and bipolar disorder: evidences from neurobehavioral measures and functional and structural MRI. Neuroimage Clin, 2014, 6: 134-144.
23. Sui J, Pearlson G, Caprihan A, et al. Discriminating schizophrenia and bipolar disorder by fusing fMRI and DTI in a multimodal CCA+ joint ICA model. Neuroimage, 2011, 57(3): 839-855.
24. Anderson D, Ardekani BA, Burdick KE, et al. Overlapping and distinct gray and white matter abnormalities in schizophrenia and bipolar I disorder. Bipolar Disord, 2013, 15(6): 680-693.
25. Dong D, Wang Y, Chang X, et al. Shared abnormality of white matter integrity in schizophrenia and bipolar disorder: a comparative voxel-based meta-analysis. Schizophr Res, 2017, 185: 41-50.
26. Benedetti F, Yeh PH, Bellani M, et al. Disruption of white matter integrity in bipolar depression as a possible structural marker of illness. Biol Psychiatry, 2011, 69(4): 309-317.
27. Lan MJ, Rubin-Falcone H, Sublette ME, et al. Deficits of white matter axial diffusivity in bipolar disorder relative to major depressive disorder: no relationship to cerebral perfusion or body mass index. Bipolar Disord, 2020, 22(3): 296-302.
28. White T, Langen C, Schmidt M, et al. Comparative neuropsychiatry: white matter abnormalities in children and adolescents with schizophrenia, bipolar affective disorder, and obsessive-compulsive disorder. Eur Psychiatry, 2015, 30(2): 205-213.
29. McIntosh AM, Muñoz Maniega S, Lymer GK, et al. White matter tractography in bipolar disorder and schizophrenia. Biol Psychiatry, 2008, 64(12): 1088-1092.
30. Hoptman MJ, Nierenberg J, Bertisch HC, et al. A DTI study of white matter microstructure in individuals at high genetic risk for schizophrenia. Schizophr Res, 2008, 106(2/3): 115-124.
31. Katagiri N, Pantelis C, Nemoto T, et al. A longitudinal study investigating sub-threshold symptoms and white matter changes in individuals with an ‘at risk mental state’ (ARMS). Schizophr Res, 2015, 162(1/2/3): 7-13.
32. Wang Q, Cheung C, Deng W, et al. White-matter microstructure in previously drug-naive patients with schizophrenia after 6 weeks of treatment. Psychol Med, 2013, 43(11): 2301-2309.

West China Medical Journal

A comparative study of white matter integrity in bipolar affective disorder and schizophrenia

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