Homogeneous magnetic resonance imaging of brain abnormalities in bipolar spectrum disorders comorbid with Wilson's disease

Screening for bipolar disorders: A public health issue

“…From a neurobiological perspective, a preliminary study of a sample consisting entirely of patients with a rare neurologic disease, Wilson's Disease, at high risk for developing Bipolar Disorder found specific alterations in the brain imaging of patients screening positive on the MDQ, compared with those without mood disorders, and those with Major Depressive Episode who screened negative, (Carta et al 2015a). These data are coherent with the hypothesis that positivity at screening identifies a bipolar spectrum of clinical and public health interest, including subthreshold cases.…”

Psychiatric comorbidity in Wilson’s disease

“…People with hepatic, neurological, and psychiatric involvement displayed early abnormal patterns of brain perfusion in the temporal cortex and basal ganglia at 99Tcm-ethyl cysteinate dimer (ECD) single photon emission computer tomography (SPECT) compared with healthy age-gender matched controls, with an individual with depression and anxiety also showing pathological magnetic resonance imaging (MRI) findings on images of putamen, midbrain, and pons (Piga, et al, 2008). This hypothesis was further confirmed by the evidence of a higher frequency of brain damage (detected using MRI), particularly in the basal ganglia (p < .001), and in the overall brain (p < .003), and total brain damage (p ¼ .003) in patients with comorbid WD and BD compared to both comorbid WD and MDD, and WD without mood disorders (Carta et al, 2015).…”

“…MRI abnormalities, specially described in basal ganglia, pons, and subcortical area, have been shown in neuropsychiatric forms of WD in almost 90-100% of cases and hypothesized to be correlated with copper deposits (Dusek, Litwin, & Czlonkowska, 2015). Such typical WD MRI brain abnormalities in basal ganglia and white matter were shown, with a higher frequency in subjects with co-morbid BD compared with both co-morbid MDD and WD without mood disorders (Carta et al, 2015). Moreover, irritability and aggression, previously described as 'personality changes' or 'behavioural disturbances' (Akil et al, 1991;Dening & Berrios, 1989a;Oder et al, 1991;Walshe & Yealland, 1992), were associated with neurological signs of WD, such as dyskinesia and dysarthria, and with the presence of lesions of putamen and pallidum (Lang et al, 1990;Oder et al, 1993).…”

“…Given the rarity of WD, samples in case-control and cross-sectional studies were generally small. However, a number of studies assessed psychiatric comorbidity by means of standardized interviews (Carta, et al, 2015;Lang, M€ uller, Claus, & Druschky, 1990;Shanmugiah et al, 2008;Svetel et al, 2009), thus conferring on results greater validity.…”

Dream Recall Frequencies and Dream Content in Wilson’s Disease with and without REM Sleep Behaviour Disorder: A Neurooneirologic Study

“…The main manifestations of Wilson's disease (WD) are hepatic dysfunction and a broad spectrum of movement disorders with parkinsonian, dystonic, ataxic, and choreatic characteristics. Cognitive limitations, especially in the executive domain [ 10 ], as well as depression are frequent in WD [ 11 ] and might contribute to altered dreaming. On the other hand, in some movement disorder conditions, physical motor disability has been shown to affect dream content very little [ 12 , 13 ], as these patients generally dream of themselves without limitations of their movement abilities.…”