Prevalence of white matter hyperintensities is not elevated in a large sample of adolescents and young adults with bipolar disorder

Mehrhof, Sara Z; Popel, Najla; Mio, Megan; Lu, Weicong; Heyn, Chinthaka; Fiksenbaum, Lisa; MacIntosh, Bradley J.; Goldstein, Benjamin I.

doi:10.1590/1516-4446-2020-0886

Cited by 4 publications

(2 citation statements)

References 41 publications

(91 reference statements)

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“…Compared to the BD participants, the HC participants generally expressed more surprise and distress upon receiving a call regarding an incidental finding. Relatedly, while we expected higher rates of WMH in youth with BD vs. HCs, we did not observe such a difference, as articulated in detail in a prior publication focused on WMH specifically (25).…”

Section: Discussioncontrasting

confidence: 44%

Incidental Findings Among Youth Participating in Multimodal Imaging Research: Characteristics of Findings and Description of a Management Approach

et al. 2022

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Research imaging in healthy and clinical youth populations yields incidental findings that require a management strategy. Our primary objective was to document the frequency and nature of incidental findings within a research group integrating multiple imaging modalities. A second objective was to describe the evolution of an approach to handling incidental findings. A case example was included to display the intricacies of some of these scenarios. Youth, ages 13–20 years, with bipolar disorder, familial risk for bipolar disorder, or healthy controls, obtained one or a combination of neuroimaging, cardio-thoracic imaging, retinal imaging, and carotid imaging. All images were systematically reviewed for incidental findings. Overall, of 223 participants (n = 102 healthy controls), 59% (n = 131) had a brain magnetic resonance imaging (MRI) incidental finding and 27% (n = 60) had at least one incidental brain finding requiring non-urgent follow-up. In addition, of 109 participants with chest/cardiac MRI and carotid ultrasound, 3% (n = 3) had chest findings, 2% (n = 2) had cardiac findings, and 1% (n = 1) had a carotid finding. Of 165 youth with retinal imaging, 1% (n = 2) had incidental findings. While the vast majority of these incidental findings were of a non-serious, non-urgent nature, there were noteworthy exceptions. Imaging research groups need a system that emphasizes the value of clinical review of research images and one that is collaborative and responsive in order to inform follow-up plans. Rating systems that have been developed and used in neuroimaging for the classification of incidental findings can be adapted for use in areas other than the brain. Regardless of severity, incidental findings may raise anxiety in youth participants and their parents. The optimal threshold is one that balances transparency with utility.

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Section: Discussioncontrasting

confidence: 44%

Incidental Findings Among Youth Participating in Multimodal Imaging Research: Characteristics of Findings and Description of a Management Approach

et al. 2022

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“…Five healthy controls found to have SCIs were excluded from analysis: these five individuals represented a subpopulation too small to adequately analyze but did not otherwise differ from the remaining healthy controls. White matter alterations are expected in a small portion of healthy children and young adults (17,18). Full exclusion logic is shown in Figure 1.…”

Section: Methodsmentioning

confidence: 99%

Silent infarction in sickle cell disease is associated with brain volume loss in excess of infarct volume

et al. 2023

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IntroductionSickle cell disease (SCD) increases cerebral infarct risk, but reported effects on brain volume have varied. More detailed information using larger cohorts and contemporary methods could motivate the use of longitudinal brain volume assessment in SCD as an automated marker of disease stability or future progression. The purpose of this study was to rigorously evaluate whether children and young adults with SCD have reduced gray matter volume (GMV) and white matter volume (WMV) compared to healthy controls using high-resolution MRI. We tested the hypotheses that (i) elevated CBF, a marker of cerebral hemodynamic compensation in SCD, is associated with global and regional brain atrophy, and (ii) silent cerebral infarct burden is associated with brain atrophy in excess of infarct volume.MethodsHealthy controls (n = 49) and SCD participants without overt stroke (n = 88) aged 7–32 years completed 3 T brain MRI; pseudocontinuous arterial spin labeling measured CBF. Multivariable linear regressions assessed associations of independent variables with GMV, WMV, and volumes of cortical/subcortical regions.ResultsReduced hemoglobin was associated with reductions in both GMV (p = 0.032) and WMV (p = 0.005); reduced arterial oxygen content (CaO2) was also associated with reductions in GMV (p = 0.035) and WMV (p = 0.006). Elevated gray matter CBF was associated with reduced WMV (p = 0.018). Infarct burden was associated with reductions in WMV 30-fold greater than the infarct volume itself (p = 0.005). Increased GM CBF correlated with volumetric reductions of the insula and left and right caudate nuclei (p = 0.017, 0.017, 0.036, respectively). Infarct burden was associated with reduced left and right nucleus accumbens, right thalamus, and anterior corpus callosum volumes (p = 0.002, 0.002, 0.009, 0.002, respectively).DiscussionWe demonstrate that anemia and decreased CaO2 are associated with reductions in GMV and WMV in SCD. Increased CBF and infarct burden were also associated with reduced volume in subcortical structures. Global WMV deficits associated with infarct burden far exceed infarct volume itself. Hemodynamic compensation via increased cerebral blood flow in SCD seems inadequate to prevent brain volume loss. Our work highlights that silent cerebral infarcts are just a portion of the brain injury that occurs in SCD; brain volume is another potential biomarker of brain injury in SCD.

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Neuroimaging studies of bipolar disorder in youth

Singh¹,

DelBello²

2022

The Bipolar Brain

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Bipolar disorder is defined by the onset of the first manic episode, which typically occurs in late adolescence or early adulthood. However, it is increasingly recognized that many people with bipolar disorder experience significant premorbid symptoms, prior to an initial disorder-defining onset of mania. Combined with the heritability of bipolar disorder, it is likely that the underlying biological basis of the disorder produces premorbid and early-course neurophysiological abnormalities that might help to identify at-risk cases and herald an early onset and progression of illness course. This chapter will focus on neuroimaging in bipolar disorder in youth, as well as in at-risk individuals (unaffected and subthreshold affected children of parents with bipolar disorder), to inform models of early bipolar development. This edition’s chapter adds more emphasis on at-risk individuals and progression of neurobiological changes at illness onset, as well as the potential implications for early intervention in an effort to interrupt illness progression.

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Prevalence of white matter hyperintensities is not elevated in a large sample of adolescents and young adults with bipolar disorder

Cited by 4 publications

References 41 publications

Incidental Findings Among Youth Participating in Multimodal Imaging Research: Characteristics of Findings and Description of a Management Approach

Incidental Findings Among Youth Participating in Multimodal Imaging Research: Characteristics of Findings and Description of a Management Approach

Silent infarction in sickle cell disease is associated with brain volume loss in excess of infarct volume

Neuroimaging studies of bipolar disorder in youth

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