title: Cerebral White Matter Lesions and Affective Episodes Correlate in Male Individuals with Bipolar Disorder.
abstract: BACKGROUND
  Cerebral white matter lesions (WML) have been found in normal aging, vascular disease and several neuropsychiatric conditions. Correlations of WML with clinical parameters in BD have been described, but not with the number of affective episodes, illness duration, age of onset and Body Mass Index in a well characterized group of euthymic bipolar adults. Herein, we aimed to evaluate the associations between bipolar course of illness parameters and WML measured with volumetric analysis.
  
  
  METHODS
  In a cross-sectional study 100 euthymic individuals with BD as well as 54 healthy controls (HC) were enrolled to undergo brain magnetic resonance imaging using 3T including a FLAIR sequence for volumetric assessment of WML-load using FSL-software. Additionally, clinical characteristics and psychometric measures including Structured Clinical Interview according to DSM-IV, Hamilton-Depression, Young Mania Rating Scale and Beck's Depression Inventory were evaluated.
  
  
  RESULTS
  Individuals with BD had significantly more (F = 3.968, p < .05) WML (Mdn = 3710 mm3; IQR = 2961 mm3) than HC (Mdn = 2185 mm3; IQR = 1665 mm3). BD men (Mdn = 4095 mm3; IQR = 3295 mm3) and BD women (Mdn = 3032 mm3; IQR = 2816 mm3) did not significantly differ as to the WML-load or the number and type of risk factors for WML. However, in men only, the number of manic/hypomanic episodes (r = 0.72; p < .001) as well as depressive episodes (r = 0.51; p < .001) correlated positively with WML-load.
  
  
  CONCLUSIONS
  WML-load strongly correlated with the number of manic episodes in male BD patients, suggesting that men might be more vulnerable to mania in the context of cerebral white matter changes.
authors.affiliation: Department of Psychiatry, Medical University of Graz, Graz, Austria.
authors.forename: Armin
authors.initials: A
authors.lastname: Birner
authors.affiliation: Department of Neurology, Medical University of Graz, Graz, Austria.
authors.forename: Stephan
authors.initials: S
authors.lastname: Seiler
authors.affiliation: Department of Psychiatry, Medical University of Graz, Graz, Austria.
authors.forename: Nina
authors.initials: N
authors.lastname: Lackner
authors.affiliation: Department of Psychiatry, Medical University of Graz, Graz, Austria.
authors.forename: Susanne A
authors.initials: SA
authors.lastname: Bengesser
authors.affiliation: Department of Psychiatry, Medical University of Graz, Graz, Austria.
authors.forename: Robert
authors.initials: R
authors.lastname: Queissner
authors.affiliation: Department of Psychiatry, Medical University of Graz, Graz, Austria.
authors.forename: Frederike T
authors.initials: FT
authors.lastname: Fellendorf
authors.affiliation: Department of Psychiatry, Medical University of Graz, Graz, Austria.
authors.forename: Martina
authors.initials: M
authors.lastname: Platzer
authors.affiliation: Department of Neurology, Medical University of Graz, Graz, Austria.
authors.forename: Stefan
authors.initials: S
authors.lastname: Ropele
authors.affiliation: Department of Neurology, Medical University of Graz, Graz, Austria; Division of Neuroradiology, Department of Radiology, Medical University of Graz, Graz, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Enzinger
authors.affiliation: Department of Neurology, Medical University of Graz, Graz, Austria; Division of Neuroradiology, Department of Radiology, Medical University of Graz, Graz, Austria.
authors.forename: Petra
authors.initials: P
authors.lastname: Schwingenschuh
authors.affiliation: Research Unit on Lifestyle and Inflammation-associated Risk Biomarkers, Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University Graz, Graz, Austria.
authors.forename: Harald
authors.initials: H
authors.lastname: Mangge
authors.affiliation: Department of Neurology, Medical University of Graz, Graz, Austria.
authors.forename: Lukas
authors.initials: L
authors.lastname: Pirpamer
authors.affiliation: Division of Neuroradiology, Department of Radiology, Medical University of Graz, Graz, Austria.
authors.forename: Hannes
authors.initials: H
authors.lastname: Deutschmann
authors.affiliation: Mood Disorders Psychopharmacology Unit at the University Health Network, University of Toronto, Toronto, Canada.
authors.forename: Roger S
authors.initials: RS
authors.lastname: McIntyre
authors.affiliation: Department of Psychiatry, Medical University of Graz, Graz, Austria.
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Kapfhammer
authors.affiliation: Department of Psychiatry, Medical University of Graz, Graz, Austria.
authors.forename: Bernd
authors.initials: B
authors.lastname: Reininghaus
authors.affiliation: Department of Psychiatry, Medical University of Graz, Graz, Austria.
authors.forename: Eva Z
authors.initials: EZ
authors.lastname: Reininghaus
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000503:physiopathology*; D015992:Body Mass Index; D001921:Brain / Q000473:pathology*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003863:Depression; D005260:Female; D006801:Humans; D008019:Life Style; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D012737:Sex Factors; D012984:Software; D011795:Surveys and Questionnaires; D066127:White Matter / Q000002:abnormalities*