Right Orbitofrontal Corticolimbic and Left Corticocortical White Matter Connectivity Differentiate Bipolar and Unipolar Depression

Objectives The absence of pathophysiologically relevant diagnostic markers of bipolar disorder (BD) leads to its frequent misdiagnosis as unipolar depression (UD). We aimed to determine whether whole brain white matter connectivity differentiated BD from UD depression. Methods We employed a three-wa...

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Bibliographic Details
Published in:Biological psychiatry (1969) 2010-09, Vol.68 (6), p.560-567
Main Authors: Versace, Amelia, Almeida, Jorge R.C, Quevedo, Karina, Thompson, Wesley K, Terwilliger, Robert A, Hassel, Stefanie, Kupfer, David J, Phillips, Mary L
Format: Article
Language:English
Subjects:
Adolescent
Adult
Adult and adolescent clinical studies
Anisotropy
Biological and medical sciences
Bipolar Disorder - diagnosis
Bipolar Disorder - pathology
Bipolar disorders
Brain - pathology
Depression
Depressive Disorder - diagnosis
Depressive Disorder - pathology
Diagnosis, Differential
Diffusion Magnetic Resonance Imaging - methods
diffusion tensor imaging
Female
Humans
inferior longitudinal fasciculus
Male
Medical sciences
Middle Aged
Mood disorders
Nerve Fibers, Myelinated - pathology
Neural Pathways - pathology
Psychiatry
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
superior longitudinal fasciculus
uncinate fasciculus
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Summary:Objectives The absence of pathophysiologically relevant diagnostic markers of bipolar disorder (BD) leads to its frequent misdiagnosis as unipolar depression (UD). We aimed to determine whether whole brain white matter connectivity differentiated BD from UD depression. Methods We employed a three-way analysis of covariance, covarying for age, to examine whole brain fractional anisotropy (FA), and corresponding longitudinal and radial diffusivity, in currently depressed adults: 15 with BD-type I (mean age 36.3 years, SD 12.0 years), 16 with recurrent UD (mean age 32.3 years, SD 10.0 years), and 24 healthy control adults (HC) (mean age 29.5 years, SD 9.43 years). Depressed groups did not differ in depression severity, age of illness onset, and illness duration. Results There was a main effect of group in left superior and inferior longitudinal fasciculi (SLF and ILF) (all F ≥ 9.8; p ≤ .05, corrected). Whole brain post hoc analyses (all t ≥ 4.2; p ≤ .05, corrected) revealed decreased FA in left SLF in BD, versus UD adults in inferior temporal cortex and, versus HC, in primary sensory cortex (associated with increased radial and decreased longitudinal diffusivity, respectively); and decreased FA in left ILF in UD adults versus HC. A main effect of group in right uncinate fasciculus (in orbitofrontal cortex) just failed to meet significance in all participants but was present in women. Post hoc analyses revealed decreased right uncinate fasciculus FA in all and in women, BD versus HC. Conclusions White matter FA in left occipitotemporal and primary sensory regions supporting visuospatial and sensory processing differentiates BD from UD depression. Abnormally reduced FA in right fronto-temporal regions supporting mood regulation, might underlie predisposition to depression in BD. These measures might help differentiate pathophysiologic processes of BD versus UD depression.
ISSN:0006-3223
1873-2402
DOI:10.1016/j.biopsych.2010.04.036