title: White matter hyperintensities and cognitive performance in adult patients with bipolar I, bipolar II, and major depressive disorders.
abstract: OBJECTIVE
  We evaluate for the first time the associations of brain white matter hyperintensities (WMHs) on magnetic resonance imaging (MRI) with neuropsychological variables among middle-aged bipolar I (BPI), II (BPII) and major depressive disorder (MDD) patients and controls using a path model.
  
  
  METHODS
  Thirteen BPI, 15 BPII, 16 MDD patients, and 21 controls underwent brain MRI and a neuropsychological examination. Two experienced neuroradiologists evaluated WMHs on the MRI scans. We constructed structural equation models to test the strength of the associations between deep WMH (DWMH) grade, neuropsychological performance and diagnostic group.
  
  
  RESULTS
  Belonging in the BPI group as opposed to the control group predicted higher DWMH grade (coefficient estimate 1.13, P=0.012). The DWMH grade independently predicted worse performance on the Visual Span Forward test (coefficient estimate -0.48, P=0.002). Group effects of BPI and MDD were significant in predicting poorer performance on the Digit Symbol test (coefficient estimate -5.57, P=0.016 and coefficient estimate -5.66, P=0.034, respectively).
  
  
  CONCLUSIONS
  Because of the small number of study subjects in groups, the negative results must be considered with caution.
  
  
  CONCLUSIONS
  Only BPI patients had an increased risk for DWMHs. DWMHs were independently associated with deficits in visual attention.
authors.affiliation: Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, 00300 Helsinki, Finland; Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland. Electronic address: tuula.kieseppa@thl.fi.
authors.forename: T
authors.initials: T
authors.lastname: Kieseppä
authors.affiliation: HUS Medical Imaging Center, Helsinki University Central Hospital, Helsinki, Finland; Hyvinkää Hospital, Hyvinkää, Finland.
authors.forename: R
authors.initials: R
authors.lastname: Mäntylä
authors.affiliation: Social Insurance Institution, Research Department, Helsinki, Finland; Department of Behavioral Sciences, University of Helsinki, Helsinki, Finland.
authors.forename: A
authors.initials: A
authors.lastname: Tuulio-Henriksson
authors.affiliation: HUS Medical Imaging Center, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: K
authors.initials: K
authors.lastname: Luoma
authors.affiliation: Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, 00300 Helsinki, Finland; Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: O
authors.initials: O
authors.lastname: Mantere
authors.affiliation: Operations and Technology Department, IE Business School, Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Ketokivi
authors.affiliation: Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, 00300 Helsinki, Finland; Department of Psychiatry, City of Helsinki, Helsinki, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Holma
authors.affiliation: Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, 00300 Helsinki, Finland; Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: P
authors.initials: P
authors.lastname: Jylhä
authors.affiliation: Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, 00300 Helsinki, Finland; Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: T
authors.initials: T
authors.lastname: Melartin
authors.affiliation: Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, 00300 Helsinki, Finland; Department of Psychiatry, City of Helsinki, Helsinki, Finland.
authors.forename: K
authors.initials: K
authors.lastname: Suominen
authors.affiliation: Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, 00300 Helsinki, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Vuorilehto
authors.affiliation: Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, 00300 Helsinki, Finland; Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland; Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland.
authors.forename: E
authors.initials: E
authors.lastname: Isometsä
mesh_terms: D000328:Adult; D001288:Attention; D001714:Bipolar Disorder / Q000473:pathology* / Q000503:physiopathology / Q000523:psychology; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000473:pathology*; D003865:Major Depressive Disorder / Q000473:pathology* / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging; D009483:Neuropsychological Tests
keywords: MRI; Mania and bipolar disorder; Neuroscience other (neuropsychology); Unipolar depression