4.6 Article

Relationship between age at onset and magnetic resonance image-defined hyperintensities in mood disorders

Journal

JOURNAL OF PSYCHIATRIC RESEARCH
Volume 42, Issue 6, Pages 443-450

Publisher

PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.jpsychires.2007.05.003

Keywords

cerebrovascular lesion; bipolar disorder; major depressive disorder; illness vulnerability; risk factors; hypertension

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Objectives: To examine in patients with mood disorders the relationship of age at onset with the location and degree of MRI-defined brain hyperintensities. Method: Fifty-two patients diagnosed as having mood disorders and 14 controls participated in the study. Brain MR images were analyzed according to semiquantitative ratings for the anatomical distribution and severity of T2-weighted hyperintensities. We compared these hyperintensities among the three age- and sex-matched groups of late-onset mood disorder patients (LOM), early-onset mood disorder patients (EOM), and controls. The time since the onset of disorder was significantly longer in the EOM than in the LOM group. We also conducted linear multiple regression analysis using the severity of hyperintensities as dependent variable to determine whether the clinical features correlate with vascular pathology. Results: As for deep white matter hyperintensity (DWMH), LOM exhibited higher ratings than EOM; as for brain areas, significant between-group differences were detected in the bilateral frontal areas and in the left parieto-occipital area. No significant difference was observed between EOM and controls. As for periventricular hyperintensity, there was no difference among the three groups. We obtained a significant regression model to predict DWMH ratings; age, number of ECTs, and LOM were selected as significant variables. Conclusion: The present study suggests that the time since the onset of disorder does not affect the development of white matter lesions, but that white matter lesions are associated with late-onset mood disorders. The frontal areas and the left parieto-occipital area would be important for the development of late-onset mood disorders. (c) 2007 Elsevier Ltd. All rights reserved.

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