title: Differences in white matter abnormalities between bipolar I and II disorders.
abstract: BACKGROUND
  Although patients with bipolar I and II disorders exhibit heterogeneous clinical presentations and cognitive functions, it remains unclear whether these two subtypes have distinct neural substrates. This study aimed to differentiate the fiber abnormalities between bipolar I and II patients using diffusion tensor images.
  
  
  METHODS
  Fourteen bipolar I patients, thirteen bipolar II patients, and twenty-one healthy subjects were recruited. Fractional anisotropy (FA) values calculated from diffusion tensor images were compared among groups using two-sample t-test analysis in a voxel-wise manner. Correlations between the mean FA value of each survived area and the clinical characteristics as well as the scores of neuropsychological tests were further analyzed.
  
  
  RESULTS
  Patients of both subtypes manifested fiber impairments in the thalamus, anterior cingulate, and inferior frontal areas, whereas the bipolar II patients showed more fiber alterations in the temporal and inferior prefrontal regions. The FA values of the subgenual anterior cingulate cortices for both subtypes correlated with the performance of working memory. The FA values of the right inferior frontal area of bipolar I and the left middle temporal area of bipolar II both correlated with executive function. For bipolar II patients, the left middle temporal and inferior prefrontal FA values correlated with the scores of YMRS and hypomanic episodes, respectively.
  
  
  CONCLUSIONS
  Our findings suggest distinct neuropathological substrates between bipolar I and II subtypes. The fiber alterations observed in the bipolar I patients were majorly associated with cognitive dysfunction, whereas those in the bipolar II patients were related to both cognitive and emotional processing.
authors.affiliation: Department of Computer Science, National Chiao Tung University, Hsinchu, Taiwan.
authors.forename: Jia-Xiu
authors.initials: JX
authors.lastname: Liu
authors.forename: Yong-Sheng
authors.initials: YS
authors.lastname: Chen
authors.forename: Jen-Chuen
authors.initials: JC
authors.lastname: Hsieh
authors.forename: Tung-Ping
authors.initials: TP
authors.lastname: Su
authors.forename: Tzu-Chen
authors.initials: TC
authors.lastname: Yeh
authors.forename: Li-Fen
authors.initials: LF
authors.lastname: Chen
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000145:classification / Q000175:diagnosis* / Q000473:pathology* / Q000523:psychology; D001931:Brain Mapping; D003072:Cognition Disorders / Q000175:diagnosis / Q000523:psychology; D038524:Diffusion Magnetic Resonance Imaging; D004292:Dominance, Cerebral / Q000502:physiology; D005260:Female; D005625:Frontal Lobe / Q000473:pathology; D006179:Gyrus Cinguli / Q000473:pathology; D006801:Humans; D056784:Leukoencephalopathies / Q000175:diagnosis* / Q000473:pathology* / Q000523:psychology; D008297:Male; D008570:Memory, Short-Term / Q000502:physiology; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology; D017397:Prefrontal Cortex / Q000473:pathology; D013702:Temporal Lobe / Q000473:pathology; D013788:Thalamus / Q000473:pathology