Widespread intra-axonal signal fraction abnormalities in bipolar disorder from multicompartment diffusion : Sensitivity to diagnosis, association with clinical features and pharmacologic treatment
Canales-Rodriguez, Erick Jorge (Germanes Hospitalàries Research Foundation (Barcelona, Catalunya))
Verdolini, Norma (Universitat de Barcelona)
Alonso-Lana, Silvia (Universitat Internacional de Catalunya)
Torres, María Llanos (Hospital Mare de Déu de la Mercè (Barcelona, Catalunya))
Panicalli, Francesco (Benito Menni CASM (Sant Boi de Llobregat, Barcelona))
Argila-Plaza, Isabel (Germanes Hospitalàries Research Foundation (Barcelona, Catalunya))
Rodriguez-Cano, Elena (Germanes Hospitalàries (Sant Boi de Llobregat, Barcelona))
Montoro, Irene (Universitat Rovira i Virgili)
Garcia-Ruiz, Beatriz (Universitat Rovira i Virgili)
Jimenez, Esther (Universitat de Barcelona)
Varo, Cristina (Universitat de Barcelona)
Lluch, Anna (Universitat Rovira i Virgili)
del Mar Bonnin, Caterina (Universitat Autònoma de Barcelona)
Maluf, Silvana (Hospital Sagrat Cor (Martorell))
Pujol, Marc (Hospital de Sant Rafael)
Jaurrieta Guarner, Núria (Hospital Sagrat Cor (Martorell))
Sarró, Salvador (Germanes Hospitalàries Research Foundation (Barcelona, Catalunya))
Vieta, Eduard (Universitat Autònoma de Barcelona)
Vilella, Elisabet (Universitat Rovira i Virgili)
Salvador, Raymond (Germanes Hospitalàries Research Foundation (Barcelona, Catalunya))
Pomarol-Clotet, Edith (Germanes Hospitalàries Research Foundation (Barcelona, Catalunya))

Fecha:	2023
Resumen:	Despite diffusion tensor imaging (DTI) evidence for widespread fractional anisotropy (FA) reductions in the brain white matter of patients with bipolar disorder, questions remain regarding the specificity and sensitivity of FA abnormalities as opposed to other diffusion metrics in the disorder. We conducted a whole-brain voxel-based multicompartment diffusion MRI study on 316 participants (i. e. , 158 patients and 158 matched healthy controls) employing four diffusion metrics: the mean diffusivity (MD) and FA estimated from DTI, and the intra-axonal signal fraction (IASF) and microscopic axonal parallel diffusivity (Dpar) derived from the spherical mean technique. Our findings provide novel evidence about widespread abnormalities in other diffusion metrics in BD. An extensive overlap between the FA and IASF results suggests that the lower FA in patients may be caused by a reduced intra-axonal volume fraction or a higher macromolecular content in the intra-axonal water. We also found a diffuse alteration in MD involving white and grey matter tissue and more localised changes in Dpar. A Machine Learning analysis revealed that FA, followed by IASF, were the most helpful metric for the automatic diagnosis of BD patients, reaching an accuracy of 72%. Number of mood episodes, age of onset/duration of illness, psychotic symptoms, and current treatment with lithium, antipsychotics, antidepressants, and antiepileptics were all significantly associated with microstructure abnormalities. Lithium treatment was associated with less microstructure abnormality. A whole-brain voxel-based approach combining DTI and SMT diffusion-derived metrics to reveal specific brain tissue microstructure abnormalities in bipolar disorder (BD) was carried out. We also evaluate the sensitivity of various diffusion metrics for the automatic diagnosis of BD through machine learning algorithms and cross-validation. Finally, we look for differences between BD subtypes and the possible effect of duration of illness, age at onset, history of psychosis, and pharmacological treatment with lithium, antidepressant, antipsychotic, and antiepileptic drugs.
Ayudas:	"la Caixa" Foundation 100010434 "la Caixa" Foundation LCF/PR/GN18/50310006 Agència de Gestió d'Ajuts Universitaris i de Recerca 2014/SGR-1573 Agència de Gestió d'Ajuts Universitaris i de Recerca 2014/SGR-398 Agència de Gestió d'Ajuts Universitaris i de Recerca 2017/SGR-1365 European Commission 754550 Ministerio de Economía y Competitividad CPII13/00018 Ministerio de Economía y Competitividad CPII16/00018 Ministerio de Economía y Competitividad PI14/01148 Ministerio de Economía y Competitividad PI15/00277 Ministerio de Economía y Competitividad PI15/00283 Ministerio de Economía y Competitividad PI15/00852 Instituto de Salud Carlos III PI18/00805 Instituto de Salud Carlos III PI18/00810 Instituto de Salud Carlos III PI18/00877 Instituto de Salud Carlos III PI21/00525
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Bipolar disorder ; Brain ; Diffusion tensor imaging ; Spherical mean technique ; Tissue microstructure
Publicado en:	Human brain mapping, Vol. 44 (june 2023) , p. 4605-4622, ISSN 1097-0193

DOI: 10.1002/hbm.26405
PMID: 37357976

18 p, 3.2 MB

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