Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, 00300 Helsinki, Finland; Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland.
HUS Medical Imaging Center, Helsinki University Central Hospital, Helsinki, Finland; Hyvinkää Hospital, Hyvinkää, Finland.
Eur Psychiatry. 2014 May;29(4):226-32. doi: 10.1016/j.eurpsy.2013.08.002. Epub 2013 Oct 28.
We evaluate for the first time the associations of brain white matter hyperintensities (WMHs) on magnetic resonance imaging (MRI) with neuropsychological variables among middle-aged bipolar I (BPI), II (BPII) and major depressive disorder (MDD) patients and controls using a path model.
Thirteen BPI, 15 BPII, 16 MDD patients, and 21 controls underwent brain MRI and a neuropsychological examination. Two experienced neuroradiologists evaluated WMHs on the MRI scans. We constructed structural equation models to test the strength of the associations between deep WMH (DWMH) grade, neuropsychological performance and diagnostic group.
Belonging in the BPI group as opposed to the control group predicted higher DWMH grade (coefficient estimate 1.13, P=0.012). The DWMH grade independently predicted worse performance on the Visual Span Forward test (coefficient estimate -0.48, P=0.002). Group effects of BPI and MDD were significant in predicting poorer performance on the Digit Symbol test (coefficient estimate -5.57, P=0.016 and coefficient estimate -5.66, P=0.034, respectively).
Because of the small number of study subjects in groups, the negative results must be considered with caution.
Only BPI patients had an increased risk for DWMHs. DWMHs were independently associated with deficits in visual attention.
我们首次使用路径模型评估中年双相情感障碍 I 型（BPI）、II 型（BPII）和重性抑郁障碍（MDD）患者和对照组大脑白质高信号（WMHs）与神经心理学变量之间的关联。
13 名 BPI、15 名 BPII、16 名 MDD 患者和 21 名对照者接受了脑部 MRI 和神经心理学检查。两名有经验的神经放射科医生对 MRI 扫描中的 WMH 进行了评估。我们构建了结构方程模型，以测试 DWMH 分级、神经心理学表现和诊断组之间关联的强度。
与对照组相比，属于 BPI 组预测 DWMH 分级更高（系数估计值 1.13，P=0.012）。DWMH 分级独立预测视觉跨度正向测试的表现更差（系数估计值 -0.48，P=0.002）。BPI 和 MDD 的组间效应在预测数字符号测试表现更差方面具有统计学意义（系数估计值分别为-5.57，P=0.016 和 -5.66，P=0.034）。
由于各组研究对象数量较少，必须谨慎考虑阴性结果。
只有 BPI 患者 DWMHs 风险增加。DWMHs 与视觉注意力缺陷独立相关。
