Patients with chronic bipolar disorder exhibit widespread increases in extracellular free water

Tuozzo, Carissa; Lyall, Amanda E.; Pasternak, Ofer; James, Anthony; Crow, Timothy J.; Kubicki, Marek

doi:10.1111/bdi.12588

Cited by 26 publications

(15 citation statements)

References 50 publications

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Section: A Survey Of Advanced Microstructural Diffusion Mri Studies Imentioning

confidence: 99%

“…Interestingly, a study of 17 individuals with BD1 and 28 controls reported that individuals with chronic bipolar disorder look most similar to schizophrenia patients in their first episode, in that the chronic BD group showed global FW increases, but no significant FA T decreases, compared to controls (Tuozzo et al, 2017). Tuozzo et al (2017) interpreted these findings as indicative of a globalized acute response, possibly inflammation, in BD. No correlations were found between free-water measures and clinical scores, however, suggesting that changes in extracellular free-water do not impact clinical presentation, but rather reflect an up- or down-stream process related to the central neuropathology of the disorder.…”

Section: A Survey Of Advanced Microstructural Diffusion Mri Studies Imentioning

confidence: 99%

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Advances in microstructural diffusion neuroimaging for psychiatric disorders

et al. 2018

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Understanding the neuropathological underpinnings of mental disorders such as schizophrenia, major depression, and bipolar disorder is an essential step towards the development of targeted treatments. Diffusion MRI studies utilizing the diffusion tensor imaging (DTI) model have been extremely successful to date in identifying microstructural brain abnormalities in individuals suffering from mental illness, especially in regions of white matter, although identified abnormalities have been biologically non-specific. Building on DTI's success, in recent years more advanced diffusion MRI methods have been developed and applied to the study of psychiatric populations, with the aim of offering increased sensitivity to subtle neurological abnormalities, as well as improved specificity to candidate pathologies such as demyelination and neuroinflammation. These advanced methods, however, usually come at the cost of prolonged imaging sequences or reduced signal to noise, and they are more difficult to evaluate compared with the more simplified approach taken by the now common DTI model. To date, a limited number of advanced diffusion MRI methods have been employed to study schizophrenia, major depression and bipolar disorder populations. In this review we survey these studies, compare findings across diverse methods, discuss the main benefits and limitations of the different methods, and assess the extent to which the application of more advanced diffusion imaging approaches has led to novel and transformative information with regards to our ability to better understand the etiology and pathology of mental disorders.

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Section: A Survey Of Advanced Microstructural Diffusion Mri Studies Imentioning

confidence: 99%

Section: A Survey Of Advanced Microstructural Diffusion Mri Studies Imentioning

confidence: 99%

Advances in microstructural diffusion neuroimaging for psychiatric disorders

et al. 2018

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“…Additional studies using independent datasets have replicated this dual-mechanism underlying WM abnormalities in FEPs (Lyall et al, 2018). Tuozzo et al (2018) reported widespread higher FW in chronic BD but no significant FA-t changes compared to controls. FW DTI may also shed light on discrepant results of WM microstructural abnormalities previously reported in studies of FEPs using traditional FA.…”

Section: Introductionmentioning

confidence: 98%

Brain free water alterations in first-episode psychosis: a longitudinal analysis of diagnosis, course of illness, and medication effects

et al. 2020

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Background Multiple lines of evidence suggest the presence of altered neuroimmune processes in patients with schizophrenia (Sz) and severe mood disorders. Recent studies using a novel free water diffusion tensor imaging (FW DTI) approach, proposed as a putative biomarker of neuroinflammation, atrophy, or edema, have shown significantly increased FW in patients with Sz. However no studies to date have investigated the longitudinal stability of FW alterations during the early course of psychosis, nor have studies focused separately on FE psychosis patients with Sz or bipolar disorder (BD) with psychotic features. Methods The current study included 188 participants who underwent diffusion magnetic resonance imaging scanning at baseline. Sixty-four participants underwent follow-up rescanning after 12 months. DTI-based alterations in patients were calculated using voxelwise tract-based spatial statistics and region of interest analyses. Results Patients with FE psychosis, both Sz and BD, exhibited increased FW at illness onset which remained unchanged over the 12-month follow-up period. Preliminary analyses suggested that antipsychotic medication exposure was associated with higher FW in gray matter that reached significance in the BD group. Higher FW in white matter correlated with negative symptom severity. Conclusions Our results support the presence of elevated FW at the onset of psychosis in both Sz and BD, which remains stable during the early course of the illness, with no evidence of either progression or remission.

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“…Free water maps therefore seem promising for mapping degenerated spaces. FWE-DTI metrics have demonstrated significantly higher test-retest reliability than conventional DTI parameters (Albi et al, 2017), and have already provided insight on microstructural brain changes in conditions such as Alzheimer’s disease (Maier-Hein et al, 2015), depression (Bergamino et al, 2016), schizophrenia (Mandl et al, 2015), Parkinson’s disease (Ofori et al, 2015), Huntington’s disease (Steventon et al, 2016), and bipolar disorder (Tuozzo et al, 2017). Importantly, FWE-DTI does not require custom data acquisitions and can be applied post-acquisition to any DTI sequence.…”

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confidence: 99%

Re-examining age-related differences in white matter microstructure with free-water corrected diffusion tensor imaging

Chad

Pasternak

Salat

et al. 2018

Neurobiology of Aging

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Diffusion tensor imaging (DTI) has been used extensively to investigate white matter (WM) microstructural changes during healthy adult aging. However, WM fibers are known to shrink throughout the lifespan, leading to larger interstitial spaces with age. This could allow more extracellular free water molecules to bias DTI metrics, which are relied upon to provide WM microstructural information. Using a cohort of 212 participants, we demonstrate that WM microstructural changes in aging are potentially less pronounced than previously reported once the free water compartment is eliminated. After free water elimination, DTI parameters show age-related differences that match histological evidence of myelin degradation and debris accumulation. The fraction of free water is further shown to associate better with age than any of the conventional DTI parameters. Our findings suggest that DTI analyses involving free water are likely to yield novel insight into retrospective re-analysis of data and to answer new questions in ongoing DTI studies of brain aging.

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Patients with chronic bipolar disorder exhibit widespread increases in extracellular free water

Cited by 26 publications

References 50 publications

Advances in microstructural diffusion neuroimaging for psychiatric disorders

Advances in microstructural diffusion neuroimaging for psychiatric disorders

Brain free water alterations in first-episode psychosis: a longitudinal analysis of diagnosis, course of illness, and medication effects

Re-examining age-related differences in white matter microstructure with free-water corrected diffusion tensor imaging

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