scholarly journals Cerebral white matter lesions in bipolar affective disorder: relationship to outcome

2001 ◽  
Vol 178 (2) ◽  
pp. 172-176 ◽  
Author(s):  
P. Brian Moore ◽  
Debra J. Shepherd ◽  
Donald Eccleston ◽  
Iain C. Macmillan ◽  
Uptal Goswami ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
White Matter ◽  
Affective Disorder ◽  
Bipolar Affective Disorder ◽  
White Matter Lesions ◽  
Periventricular White Matter ◽  
White Matter Abnormalities ◽  
Good Outcome ◽  
Poor Outcome ◽  
Outcome Group

BackgroundTwenty per cent of patients with bipolar affective disorder suffer an illness that responds inadequately to treatment and has a poor outcome. Many patients, but not all, with bipolar disorder show white matter abnormalities on T2-weighted magnetic resonance imaging (MRI).AimsTo explore the hypothesis that white matter abnormalities on MRI are seen more frequently in subjects whose illness has a poor outcome compared with those with a good outcome or controls.MethodTwo groups of age- and gender-matched patients with bipolar disorder (14 with a good outcome and 15 with a poor outcome) and 15 controls, aged 20–65 years, were studied. Axial T2-weighted MRI scans were examined for the presence and severity of white matter abnormalities.ResultsSignificantly more poor outcome group members had deep subcortical punctate, but not periventricular, white matter hyperintensities than the good outcome group (P=0.035) or controls (P=0.003) and these abnormalities were of greater severity (P=0.030 and P < 0.014, respectively).ConclusionsSubcortical white matter lesions are associated with poor outcome bipolar disorder.

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.

scholarly journals Magnetic resonance imaging abnormalities in young euthymic patients with bipolar affective disorder

2006 ◽  
Vol 189 (1) ◽  
pp. 81-82 ◽  
Author(s):  
Selim M. El-Badri ◽  
David A. Cousins ◽  
Sean Parker ◽  
Heather C. Ashton ◽  
Victor L. McAllister ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bipolar Disorder ◽  
White Matter ◽  
Magnetic Resonance ◽  
Temporal Lobe ◽  
Bipolar Affective Disorder ◽  
White Matter Lesions ◽  
Resonance Imaging ◽  
Deep White Matter ◽  
Mri Scans

SummaryTemporal lobe and limbic structures may be abnormal in bipolar disorder. T2-weighted magnetic resonance imaging (MRI) scans frequently show deep white matter lesions. MRI was performed on 50 young (19–39 years) euthymic patients with bipolar disorder and 26 controls. Mean temporal lobe volumes were reduced in patients (right, 9.42 cm3; left, 6.33 cm3) but this could not be ascribed to a specific structure. Deep white matter lesions were present in 5 patients but no controls raising questions of their aetiological significance.

Comparative Neuropsychiatry: White Matter Abnormalities in Children and Adolescents with Schizophrenia, Bipolar Affective Disorder, and Obsessive-Compulsive Disorder

2015 ◽  
Vol 30 (2) ◽  
pp. 205-213 ◽  
Author(s):  
T. White ◽  
C. Langen ◽  
M. Schmidt ◽  
M. Hough ◽  
A. James
Keyword(s):  
White Matter ◽  
Children And Adolescents ◽  
Affective Disorder ◽  
Obsessive Compulsive Disorder ◽  
Early Onset ◽  
Bipolar Affective Disorder ◽  
Early Onset Schizophrenia ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
White Matter Abnormalities

AbstractBackground:There is considerable evidence that white matter abnormalities play a key role in the pathogenesis of a number of major psychiatric disorders, including schizophrenia, bipolar affective disorder, and obsessive-compulsive disorder. Few studies, however, have compared white matter abnormalities early in the course of the illness.Methods:A total of 102 children and adolescents participated in the study, including 43 with early-onset schizophrenia, 13 with early-onset bipolar affective disorder, 17 with obsessive-compulsive disorder, and 29 healthy controls. Diffusion tensor imaging scans were obtained on all children and the images were assessed for the presence of non-spatially overlapping regions of white matter differences, a novel algorithm known as the pothole approach.Results:Patients with early-onset schizophrenia and early-onset bipolar affective disorder had a significantly greater number of white matter potholes compared to controls, but the total number of potholes did not differ between the two groups. The volumes of the potholes were significantly larger in patients with early-onset bipolar affective disorder compared to the early-onset schizophrenia group. Children and adolescents with obsessive-compulsive disorder showed no differences in the total number of white matter potholes compared to controls.Conclusions:White matter abnormalities in early-onset schizophrenia and bipolar affective disorder are more global in nature, whereas children and adolescents with obsessive-compulsive disorder do not show widespread differences in FA.

White Matter Lesions and Season of Birth of Patients With Bipolar Affective Disorder

2001 ◽  
Vol 158 (9) ◽  
pp. 1521-1524 ◽  
Author(s):  
P. Brian Moore ◽  
Selim M. El-Badri ◽  
David Cousins ◽  
Debra J. Shepherd ◽  
Allan H. Young ◽  
...  
Keyword(s):  
White Matter ◽  
Affective Disorder ◽  
Bipolar Affective Disorder ◽  
White Matter Lesions ◽  
Season Of Birth

scholarly journals Influence of white matter lesions on the prognosis of acute cardioembolic stroke without reperfusion therapy

2021 ◽  
Author(s):  
yikun Guo ◽  
Wenying Zou ◽  
Zhuoyou Chen ◽  
Min Zhang ◽  
Qian Wang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
White Matter ◽  
White Matter Lesions ◽  
Binary Logistic Regression ◽  
Reperfusion Therapy ◽  
Favorable Outcome ◽  
Nihss Score ◽  
Poor Outcome ◽  
Poor Outcome Group ◽  
Outcome Group

Abstract Background Few studies have investigated the influence of white matter lesions (WMLs) on the prognosis of acute cardioembolic stroke (CES). We aimed to explore the role of WMLs in predicting 3-month prognosis of CES without reperfusion therapy. Methods A number of 251 acute CES patients without reperfusion therapy at a single center were retrospectively recruited. The severity of WMLs was evaluated by Fazekas scale and patients were divided into mild WMLs group (188 cases, Fazekas ≤ 2 points) and moderate to severe WMLs group (63 cases, Fazekas ≥ 3 points) accordingly. General data and clinical features of the two groups were compared. Functional outcomes of patients were followed up for 3 months using the modified Rankin scale (mRS) and patients were divided into poor outcome group (mRS ≥ 3) and favorable outcome group (mRS ≤ 2). The effect of WMLs on the prognosis was identified by binary logistic regression. Results Patients in moderate to severe WMLs group were older (P < 0.001). Also, they had higher baseline NIHSS score (P < 0.001) and elevated incidence of asymptomatic cerebral hemorrhage (P = 0.040) and stroke associated pneumonia (P = 0.001) than those in mild WMLs group. At 3 months, there were 100 cases in the poor outcome group. Patients in poor outcome group had higher baseline NIHSS score, increased proportion of moderate to severe WMLs, and elevated incidence of stroke associated pneumonia than those in favorable outcome group (P < 0.001). Binary logistic regression analysis showed that moderate to severe WMLs (odds ratio [OR] = 4.105, 95% confidence interval [CI] = 1.447–11.646), baseline NIHSS score (OR = 1.368, 95% CI = 1.240–1.511), and stroke-associated pneumonia (OR = 4.840, 95%CI = 1.889–12.400) were independent risk factors for poor outcome. Conclusion Moderate to severe WMLs is an independent risk factor for prognosis of CES patients without reperfusion therapy.

scholarly journals Influence of white matter lesions on the prognosis of acute cardioembolic stroke without reperfusion therapy

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yikun Guo ◽  
Zhuoyou Chen ◽  
Qian Wang ◽  
Min Zhang ◽  
Guanzhong Dong ◽  
...  
Keyword(s):  
Logistic Regression ◽  
White Matter ◽  
White Matter Lesions ◽  
Binary Logistic Regression ◽  
Reperfusion Therapy ◽  
Favorable Outcome ◽  
Nihss Score ◽  
Poor Outcome ◽  
Poor Outcome Group ◽  
Outcome Group

Abstract Background Few studies have investigated the influence of white matter lesions (WMLs) on the prognosis of acute cardioembolic stroke (CES). We aimed to explore the role of WMLs in predicting 3-month prognosis of CES without reperfusion therapy. Methods A number of 251 acute CES patients without reperfusion therapy at a single center were retrospectively recruited. The severity of WMLs was evaluated by Fazekas scale and patients were divided into mild WMLs group (188 cases, Fazekas ≤ 2 points) and moderate to severe WMLs group (63 cases, Fazekas ≥ 3 points) accordingly. General data and clinical features of the two groups were compared. Functional outcomes of patients were followed up for 3 months using the modified Rankin scale (mRS) and patients were divided into poor outcome group (mRS ≥ 3) and favorable outcome group (mRS ≤ 2). The effect of WMLs on the prognosis was identified by binary logistic regression. Results Patients in moderate to severe WMLs group were older (P < 0.001). Also, they had higher baseline National Institutes of Health Stroke Scale (NIHSS) score (P < 0.001) and elevated incidence of asymptomatic cerebral hemorrhage (P = 0.040) and stroke associated pneumonia (P = 0.001) than those in mild WMLs group. At 3 months, there were 100 cases in the poor outcome group. Patients in poor outcome group had higher baseline NIHSS score, increased proportion of moderate to severe WMLs, and elevated incidence of stroke associated pneumonia than those in favorable outcome group (P < 0.001). Binary logistic regression analysis showed that moderate to severe WMLs (odds ratio [OR] = 4.105, 95 % confidence interval [CI] = 1.447–11.646), baseline NIHSS score (OR = 1.368, 95 % CI = 1.240–1.511), and stroke-associated pneumonia (OR = 4.840, 95 %CI = 1.889–12.400) were independent risk factors for poor outcome. Conclusions Moderate to severe WMLs is an independent risk factor for prognosis of CES patients without reperfusion therapy.

scholarly journals White Matter Lesions as Possible Predictors of Audiological Performance in Adults after Cochlear Implantation

2021 ◽  
Vol 11 (5) ◽  
pp. 600
Author(s):  
Steffen Knopke ◽  
Hans-Christian Bauknecht ◽  
Stefan Gräbel ◽  
Sophia Marie Häußler ◽  
Agnieszka J. Szczepek ◽  
...  
Keyword(s):  
Speech Perception ◽  
White Matter ◽  
Cochlear Implantation ◽  
Age Groups ◽  
White Matter Lesions ◽  
Periventricular White Matter ◽  
Rehabilitation Outcomes ◽  
Hearing Ability ◽  
Structural Brain Damage ◽  
Oldenburg Sentence Test

The presented prospective study investigated whether structural brain damage, measured with the Fazekas score, could predict hearing rehabilitation outcomes with cochlear implantation (CI). With a follow-up period of 24 months, this study included 49 bilaterally, postlingually hearing impaired CI candidates for unilateral CI (67.3 ± 8.7 years; 20 men, 29 women) older than 50 at the time of implantation. The differences in the predictive value between two age groups, 50–70 year-olds (mid-age; n = 26) and over 70-year-olds (elderly; n = 23), were analyzed. The patients were evaluated using speech perception (SP) measured in quiet (Freiburg monosyllabic test; FMT) and noise (Oldenburg sentence test; OLSA). The subjective hearing ability was assessed using Oldenburg inventory (OI). The Fazekas PVWM score predicted postoperative speech perception two years after CI in the mid-age population. The periventricular white matter lesions (PVWM) could explain 27.4% of the speech perception (FMT) variance. Our findings support the hypothesis about the influence of pre-existing WMLs on CI outcome. We recommend the evaluation of Fazekas score as a predictive factor for post-implantation hearing ability.

White matter lesions and poor outcome after intracerebral hemorrhage: A nationwide cohort study

Neurology ◽  
2010 ◽  
Vol 74 (19) ◽  
pp. 1502-1510 ◽  
Author(s):  
S. H. Lee ◽  
B. J. Kim ◽  
W. S. Ryu ◽  
C. K. Kim ◽  
N. Kim ◽  
...  
Keyword(s):  
Cohort Study ◽  
White Matter ◽  
Intracerebral Hemorrhage ◽  
White Matter Lesions ◽  
Poor Outcome

Abstract TP195: Pre-Stroke Cognitive Impairment is Associated With Poor Outcome in Acute Ischemic Stroke Patients Treated With Mechanical Thrombectomy

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Takuya Kanamaru ◽  
Satoshi Suda ◽  
Junya Aoki ◽  
Kentaro Suzuki ◽  
Yuki Sakamoto ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cognitive Impairment ◽  
Acute Ischemic Stroke ◽  
Mechanical Thrombectomy ◽  
Modified Rankin Scale ◽  
Good Outcome ◽  
Poor Outcome ◽  
Poor Outcome Group ◽  
Outcome Group ◽  
Significant Difference

Background: It is reported that pre-stroke cognitive impairment is associated with poor functional outcome after stroke associated with small vessel disease. However, it is not clear that pre-stroke cognitive impairment is associated with poor outcome in patients treated with mechanical thrombectomy. Method: We enrolled 127 consecutive patients treated with mechanical thrombectomy for acute ischemic stroke from December 2016 to November 2018. Pre-stroke cognitive function was evaluated using the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). We retrospectively compared poor outcome (a score of 3 to 6 on the modified Rankin Scale at 90 days) group (n=75) with good outcome (a score of 0, 1, or 2 on the modified Rankin Scale at 90 days) group (n=52) and examined that IQCODE could be the predictor of PO. Result: IQCODE was significantly higher in poor outcome group than in good outcome group (89 vs. 82, P=0.0012). Moreover, age (77.2 years old vs. 71.6 years old, P= 0.0009), the percentage of female (42.7% vs. 17.3%, P= 0.0021), complication of hypertension (HT, 68.0% vs. 44.2%, P=0.0076), National Institutes of Health Stroke Scale (NIHSS) at admission (20 vs. 11, P<0.0001), the percentage of postoperative intracerebral hemorrhage (ICH, 33.3% vs. 15.4%, P=0.0233) were higher in poor outcome group than in good outcome group, too. However, there was no significant difference between poor outcome and good outcome groups in occlusion site (P= 0.1229), DWI-ASPECTS (P= 0.2839), the duration from onset to recanalization (P=0.4871) and other risk factors. Multivariable logistic regression analysis demonstrated that IQCODE, HT and NIHSS at admission were associated with poor outcome (P= 0.0128, P=0.0061 and P<0.0001, respectively). Conclusion: Cognitive impairment could be associated with poor outcome in patients treated with mechanical thrombectomy.

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