Du Hui, Yang Bing, Wang Hui, Zeng Yaqing, Xin Jianpin, Li Xiaoqiang
Department of Blood Transfusion, Affiliated Xiaolan Hospital, Southern Medical University, Zhongshan, Guangdong, China.
Neurological Department and Stroke Center, the First Affiliated Hospital of Jinan University and Clinical Neuroscience Institute, Jinan University, Guangzhou, Guangdong, China.
Front Psychiatry. 2023 Mar 16;14:1149663. doi: 10.3389/fpsyt.2023.1149663. eCollection 2023.
Cerebral white matter lesions (WML) are major risk factors for bipolar disorder (BD). However, studies on the association between cerebral WML volume and BD risk are limited. This study aimed to investigate the relationship between cerebral WML volume and BD incidence. This is a secondary retrospective analysis of patients ( = 146, 72 males, 74 females, mean age = 41.77 years) who have previously undergone magnetic resonance imaging examinations. Information was obtained from the Dryad database. Univariate analysis, piecewise linear regression model, and multivariable logistic regression model were used for statistical analysis. A non-linear relationship was recognized between the cerebral WML volume and BD incidence, in which the inflection point of the WML volume was 6,200 mm. The effect sizes and confidence intervals on the left and right sides of the emphasis point were 1.0009 (1.0003, 1.0015) and 0.9988 (0.9974, 1.0003), respectively. Subgroup analysis (WML volume < 6,200 mm) showed that the cerebral WML volume (for 0.1 mm increase) was positively related to the BD incidence (OR = 1.11, 95% confidence interval [CI] (1.03, 1.21)). Here we show that the cerebral WML volume is positively and non-linearly correlated to the BD risk. Volumetric analysis of WML provide a better understanding of the association between WML and the BD risk, and thereby the pathophysiological mechanisms of BD.
A non-linear relationship between the volume of cerebral white matter lesions (WML) and bipolar disorder (BD) incidence is shown. The cerebral WML volume is positively and non-linearly correlated to the BD risk. The correlation is stronger when the cerebral WML volume was <6,200 mm.Graphical AbstractA non-linear relationship between the volume of cerebral white matter lesions and bipolar disorder incidence is shown after adjusting for age; sex; lithium, atypical antipsychotic, antiepileptic, and antidepressant drug use; BMI; migraine; smoking; hypertension; diabetes mellitus; substance and alcohol dependency; and anxiety disorder.
脑白质病变（WML）是双相情感障碍（BD）的主要危险因素。然而，关于脑WML体积与BD风险之间关联的研究有限。本研究旨在探讨脑WML体积与BD发病率之间的关系。这是一项对先前接受过磁共振成像检查的患者（n = 146，男性72例，女性74例，平均年龄 = 41.77岁）进行的二次回顾性分析。信息来自Dryad数据库。采用单因素分析、分段线性回归模型和多变量逻辑回归模型进行统计分析。发现脑WML体积与BD发病率之间存在非线性关系，其中WML体积的拐点为6200 mm³。重点值左右两侧的效应大小和置信区间分别为1.0009（1.0003，1.0015）和0.9988（0.9974，1.0003）。亚组分析（WML体积 < 6200 mm³）显示，脑WML体积（每增加0.1 mm³）与BD发病率呈正相关（OR = 1.11，95%置信区间[CI]（1.03，1.21））。在此我们表明，脑WML体积与BD风险呈正相关且为非线性关系。WML的体积分析有助于更好地理解WML与BD风险之间的关联，从而了解BD的病理生理机制。
显示了脑白质病变（WML）体积与双相情感障碍（BD）发病率之间的非线性关系。脑WML体积与BD风险呈正相关且为非线性关系。当脑WML体积 < 6200 mm³时，这种相关性更强。
在调整年龄、性别、锂盐、非典型抗精神病药物、抗癫痫药物和抗抑郁药物使用、BMI、偏头痛、吸烟、高血压、糖尿病、物质和酒精依赖以及焦虑症后，显示了脑白质病变体积与双相情感障碍发病率之间的非线性关系。
