Cognitive reserve lessens the burden of white matter lesions on executive functions in bipolar disorder

2016 ◽  
Vol 46 (15) ◽  
pp. 3095-3104 ◽  
Author(s):  
S. Rolstad ◽  
C. Abé ◽  
E. Olsson ◽  
C. Eckerström ◽  
M. Landén
Keyword(s):  
Bipolar Disorder ◽  
White Matter ◽  
Executive Functions ◽  
Cognitive Reserve ◽  
White Matter Lesions ◽  
Brain Pathology ◽  
Linear Regression Models ◽  
Brain Volumes ◽  
Interaction Terms ◽  
The Impact

BackgroundThe concept of cognitive reserve (CR) hypothesizes that intellectually stimulating activities provide resilience against brain pathology/disease. Whereas brain abnormalities and cognitive impairment are frequently reported in bipolar disorder (BD), it is unknown whether the impact of brain alterations can be lessened by higher CR in BD.MethodWe tested if higher CR would reduce the influence of total volumes of deep white matter hypointensities (WMH), ventricular cerebrospinal fluid (CSF), and prefrontal cortex on memory, executive, and attention/speed functions in patients with BD (n = 75). Linear regression models with interaction terms for CR and brain volumes were applied to directly test if CR reduces the influence of brain pathology on cognitive domains.ResultsCR reduced the influence of total volumes of deep WMH (β = −0.38, Q = 0.003) and ventricular CSF (β = −41, Q = 006) on executive functions.ConclusionsThe interactions between CR and total volumes of deep WMH/ventricular CSF appear to account for executive functioning in BD. The results suggest that the concept of CR is applicable in BD. Higher reserve capacity in BD alters the relationship between brain pathology and clinical presentation.

scholarly journals The impact of periventricular white matter lesions in patients with bipolar disorder type I

CNS Spectrums ◽  
2014 ◽  
Vol 21 (1) ◽  
pp. 23-34 ◽  
Author(s):  
Gianluca Serafini ◽  
Maurizio Pompili ◽  
Marco Innamorati ◽  
Nicoletta Girardi ◽  
Leonardo Strusi ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
White Matter ◽  
Rating Scale ◽  
Brain Magnetic Resonance Imaging ◽  
White Matter Lesions ◽  
Periventricular White Matter ◽  
Type I ◽  
Young Mania ◽  
Affective Symptoms ◽  
The Impact

IntroductionWhite matter hyperintensities (WMHs) are one the most common neuroimaging findings in patients with bipolar disorder (BD). It has been suggested that WMHs are associated with impaired insight in schizophrenia and schizoaffective patients; however, the relationship between insight and WMHs in BD type I has not been directly investigated.MethodsPatients with BD-I (148) were recruited and underwent brain magnetic resonance imaging (MRI). Affective symptoms were assessed using Young Mania Rating Scale (YMRS) and Hamilton Depression Rating Scale (HDRS17); the presence of impaired insight was based on the corresponding items of YMRS and HDRS17.ResultsMultiple punctate periventricular WMHs (PWMHs) and deep WMHs (DWMHs) were observed in 49.3% and 39.9% of the cases, respectively. Subjects with lower insight for mania had significantly more PWMHs (54.6% vs 22.2%; p < 0.05) when compared to BD-I patients with higher insight for mania. The presence of PWMHs was independently associated with lower insight for mania: patients who denied illness according to the YMRS were 4 times more likely to have PWMHs (95% CI: 1.21/13.42) than other patients.ConclusionsImpaired insight in BD-I is associated with periventricular WMHs. The early identification of BD-I subjects with PWMHs and impaired insight may be crucial for clinicians.

Abstract P191: Association Between Blood Pressure And Brain Volumes Vary By Sex And Age.

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Khawlah Alateeq ◽  
Erin Walsh ◽  
Walter Abhayaratna ◽  
Nicolas Cherbuin
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
White Matter ◽  
Body Mass ◽  
Antihypertensive Medication ◽  
Full Range ◽  
Age Groups ◽  
White Matter Lesions ◽  
Hippocampal Volume ◽  
Brain Volumes

Objective: To quantify the association between blood pressure (BP) across its full range and brain volumes and white matter lesions (WMLs) while investigating the effects of age, sex, body mass index (BMI), antihypertensive medication, and other risk factors. Methods: UK Biobank participants ( N =36,260) aged 40 to 70 years were included and stratified by sex and age into four groups (age ≤ 45, 46-55, 56-65 and > 65 years old). Multi-level regression analyses were used to assess the association between mean arterial (MAP), systolic (SBP), and diastolic (DBP) blood pressure, and brain volumes segmented using the FreeSufer software (gray matter [GMV], white matter [WMV], left [L] and right hippocampal volume [RHCV]) and WMLs. We also investigated the interaction effects between body mass index (BMI) and antihypertensive medication and BP in predicting brain volumes and WMLs. Results: Every 10-mmHg higher DBP was associated with lower brain volumes (GMV: -1300– -2800) [SE=34–90]; WMV: -903.44– -1171.7[SE=34.66–53.03]; LHCV: -7.7– -14.26 [SE=0.44–0.57]; RHCV: -6.25– -22.64[SE=0.32–0.95]) across all age groups. A similar pattern was detected in both sexes, although it was weaker, in men. Also, every 10-mmHg higher MAP was associated with larger WMLs across all age groups but peaked > 65 years (0.1 [SE=0.002]). Both lower BMI and anti-hypertensive medication appeared to afford a protective effect. Conclusion: Higher BP is associated with worse cerebral health across the full BP range from middle adulthood and across the life course. Therefore, it is important that prevention efforts be directed at younger adults with focus on achieving optimal BP to decrease future risk of developing dementia.

scholarly journals APOE ε4, white matter hyperintensities, and cognition in Alzheimer and Lewy body dementia

Neurology ◽  
2019 ◽  
Vol 93 (19) ◽  
pp. e1807-e1819 ◽  
Author(s):  
Saira Saeed Mirza ◽  
Usman Saeed ◽  
Jo Knight ◽  
Joel Ramirez ◽  
Donald T. Stuss ◽  
...  
Keyword(s):  
White Matter ◽  
Executive Functions ◽  
White Matter Hyperintensities ◽  
Neuropsychological Test ◽  
Neuropsychological Testing ◽  
Lewy Bodies ◽  
Lewy Body Dementia ◽  
Factor Scores ◽  
Linear Regression Models ◽  
Cognitive Domains

ObjectiveTo determine if APOE ε4 influences the association between white matter hyperintensities (WMH) and cognitive impairment in Alzheimer disease (AD) and dementia with Lewy bodies (DLB).MethodsA total of 289 patients (AD = 239; DLB = 50) underwent volumetric MRI, neuropsychological testing, and APOE ε4 genotyping. Total WMH volumes were quantified. Neuropsychological test scores were included in a confirmatory factor analysis to identify cognitive domains encompassing attention/executive functions, learning/memory, and language, and factor scores for each domain were calculated per participant. After testing interactions between WMH and APOE ε4 in the full sample, we tested associations of WMH with factor scores using linear regression models in APOE ε4 carriers (n = 167) and noncarriers (n = 122). We hypothesized that greater WMH volume would relate to worse cognition more strongly in APOE ε4 carriers. Findings were replicated in 198 patients with AD from the Alzheimer's Disease Neuroimaging Initiative (ADNI-I), and estimates from both samples were meta-analyzed.ResultsA significant interaction was observed between WMH and APOE ε4 for language, but not for memory or executive functions. Separate analyses in APOE ε4 carriers and noncarriers showed that greater WMH volume was associated with worse attention/executive functions, learning/memory, and language in APOE ε4 carriers only. In ADNI-I, greater WMH burden was associated with worse attention/executive functions and language in APOE ε4 carriers only. No significant associations were observed in noncarriers. Meta-analyses showed that greater WMH volume was associated with worse performance on all cognitive domains in APOE ε4 carriers only.ConclusionAPOE ε4 may influence the association between WMH and cognitive performance in AD and DLB.

scholarly journals Education Modulates the Impact of White Matter Lesions on the Risk of Mild Cognitive Impairment and Dementia

2014 ◽  
Vol 22 (11) ◽  
pp. 1336-1345 ◽  
Author(s):  
Marion Mortamais ◽  
Florence Portet ◽  
Adam M. Brickman ◽  
Frank A. Provenzano ◽  
Jordan Muraskin ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
White Matter ◽  
White Matter Lesions ◽  
The Impact

scholarly journals PP029 Hospitalizations And Costs In Bipolar Disorder Patients Initiating Long-acting Injectable Antipsychotics

2017 ◽  
Vol 33 (S1) ◽  
pp. 83-83
Author(s):  
Mallik Greene ◽  
Tingjian Yan ◽  
Eunice Chang ◽  
Ann Hartry ◽  
Michael Broder
Keyword(s):  
Bipolar Disorder ◽  
Reference Group ◽  
Cohort Analysis ◽  
Linear Regression Models ◽  
Inpatient Hospitalization ◽  
Inpatient Hospitalizations ◽  
Long Acting ◽  
Bipolar Patients ◽  
The Impact

INTRODUCTION:Existing studies have not investigated the effectiveness of one long-acting injectable antipsychotic (LAI) versus another in preventing hospitalizations among patients with bipolar disorder (BD). This study was conducted to compare all-cause inpatient healthcare utilization and associated costs among BD patients who initiated LAIs.METHODS:This retrospective cohort analysis used the Truven Health Analytics MarketScan® Commercial and Medicaid claims database. Bipolar patients >18 years with at least one claim for one of the following LAIs were identified between 1 January 2013 and 30 June 2014 (identification period): aripiprazole, haloperidol, paliperidone, and risperidone. The first day of initiating an LAI was considered the index date. Logistic regression and generalized linear regression models were conducted to estimate risk of inpatient hospitalization and associated costs during the 1-year follow up.RESULTS:A total of 1,540 BD patients initiated an LAI: 14.5 percent aripiprazole, 16.3 percent risperidone, 21.0 percent haloperidol, and 48.1 percent paliperidone. With the aripiprazole cohort as the reference group, the odds of having any inpatient hospitalizations were significantly higher in haloperidol [Odds Ratio, OR (95 percent Confidence Interval, CI): 1.49 (1.01 - 2.19)] and risperidone [1.78 (1.19 - 2.66)] cohorts. The paliperidone cohort also had a higher risk of having a hospitalization than aripiprazole, but the difference was not statistically significant (p>.05). Among LAI initiators having any inpatient hospitalizations, the adjusted mean all-cause inpatient costs were lowest in the aripiprazole cohort (USD26,002), followed by risperidone (USD27,937), haloperidol (USD30,411), and paliperidone (USD33,240). However, the cost difference was not statistically significant.CONCLUSIONS:Our study findings highlight the value of aripiprazole in reducing all-cause inpatient hospitalizations and associated costs among patients with BD during the 1-year follow-up. It is worthwhile to note that bipolar diagnoses were identified from healthcare claims coded for reimbursement purposes, thus misclassification was possible. Future studies are warranted to understand the impact of LAI use in a longer period of time.

scholarly journals Genetic Risk Factors for Longitudinal Changes in Structural MRI in Former Organolead Workers

2011 ◽  
Vol 2011 ◽  
pp. 1-11 ◽  
Author(s):  
Bryan D. James ◽  
Brian Caffo ◽  
Walter F. Stewart ◽  
David Yousem ◽  
Christos Davatzikos ◽  
...  
Keyword(s):  
Risk Factors ◽  
White Matter ◽  
Brain Volume ◽  
Density Lipoprotein ◽  
White Matter Lesions ◽  
Structural Mri ◽  
Population Based ◽  
Effect Modification ◽  
Longitudinal Change ◽  
Brain Volumes

This study examined associations between polymorphisms in three genes, apolipoprotein E (APOE), angiotensin converting enzyme (ACE), and vitamin D receptor (VDR), and longitudinal change in brain volumes and white matter lesions (WML) as well as effect modification by cardiovascular factors and tibia lead concentrations. Two MRIs, an average of 5 years apart, were obtained for 317 former organolead workers and 45 population-based controls. Both regions-of-interest and voxel-wise analyses were conducted.APOEε3/ε4andε4/ε4genotypes were associated with less decline in white matter volumes. There was some evidence of interaction between genetic polymorphisms and cardiovascular risk factors (ACEand high-density lipoprotein;VDRand diabetes) on brain volume decline. TheVDR FokIff genotype was associated with an increase in WML (no association forAPOEorACE). This study expands our understanding of how genetic precursors of dementia and cardiovascular diseases are related to changes in brain structure.

Head size may modify the impact of white matter lesions on dementia

2012 ◽  
Vol 33 (7) ◽  
pp. 1186-1193 ◽  
Author(s):  
Ingmar Skoog ◽  
Pernille J. Olesen ◽  
Kaj Blennow ◽  
Bo Palmertz ◽  
Sterling C. Johnson ◽  
...  
Keyword(s):  
White Matter ◽  
White Matter Lesions ◽  
Head Size ◽  
The Impact

The Relationship Between Isolated Hypertension with Brain Volumes in UK Biobank

2021 ◽  
Author(s):  
Danielle Newby ◽  
Laura Winchester ◽  
William Sproviero ◽  
Marco Fernandes ◽  
Upamanyu Ghose ◽  
...  
Keyword(s):  
White Matter ◽  
Grey Matter ◽  
Brain Mri ◽  
Uk Biobank ◽  
Brain Health ◽  
Brain Volumes ◽  
Dementia Risk ◽  
Diastolic Hypertension ◽  
The Impact ◽  
The Relationship

Hypertension is a well-established risk factor for cognitive impairment, brain atrophy, and dementia. However, the relationship of other types of hypertension, such as, isolated hypertension on brain health and its comparison to systolic-diastolic hypertension (where systolic and diastolic measures are high), is still relatively unknown. Due to its increased prevalence, it is important to investigate the impact of isolated hypertension to help understand its potential impact on cognitive decline and future dementia risk. In this study, we compared a variety of global brain measures between participants with isolated hypertension to those with normal blood pressure or systolic-diastolic hypertension using the largest cohort of healthy individuals. Using the UK Biobank cohort, we carried out a cross-sectional study using 29775 participants [mean age 63 years, 53% female] with BP measurements and brain MRI data. We used linear regression models adjusted for multiple confounders to compare a variety of global, sub cortical and white matter brain measures. We compared participants with either isolated systolic or diastolic hypertension with normotensives and then with participants with systolic-diastolic hypertension. The results showed that participants with isolated systolic or diastolic hypertension taking BP medications had smaller grey matter but larger white matter microstructures and macrostructures compared to normotensives. However, isolated hypertensives had larger total grey matter and smaller white matter traits when comparing these regions with participants with systolic-diastolic hypertension.These results provide support to investigate possible preventative strategies that target isolated hypertension as well as systolic-diastolic hypertension to maintain brain health and/or reduce dementia risk earlier in life particularly in white matter regions.

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