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Adverse childhood experiences influence white matter microstructure in patients with bipolar disorder

Published online by Cambridge University Press:  27 March 2014

F. Benedetti ,
I. Bollettini ,
D. Radaelli ,
S. Poletti ,
C. Locatelli ,
A. Falini ,
E. Smeraldi  and
C. Colombo
F. Benedetti*
Affiliation:
Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milan, Italy C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
I. Bollettini
Affiliation:
Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milan, Italy C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
D. Radaelli
Affiliation:
Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milan, Italy C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
S. Poletti
Affiliation:
Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milan, Italy C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
C. Locatelli
Affiliation:
Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milan, Italy C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
A. Falini
Affiliation:
C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy Department of Neuroradiology, Scientific Institute Ospedale San Raffaele, Milan, Italy
E. Smeraldi
Affiliation:
Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milan, Italy C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
C. Colombo
Affiliation:
Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milan, Italy
*
* Address for correspondence: F. Benedetti, M.D., Istituto Scientifico Ospedale San Raffaele, Department of Clinical Neurosciences, San Raffaele Turro, Via Stamira d'Ancona 20, Milano, Italy. (Email: benedetti.francesco@hsr.it)
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Abstract

Background

Bipolar disorder (BD) is associated with adverse childhood experiences (ACE), which worsen the lifetime course of illness, and with signs of widespread disruption of white matter (WM) integrity in adult life. ACE are associated with changes in WM microstructure in healthy humans.

Method

We tested the effects of ACE on diffusion-tensor imaging (DTI) measures of WM integrity in 80 in-patients affected by a major depressive episode in the course of BD. We used whole-brain tract-based spatial statistics in the WM skeleton with threshold-free cluster enhancement of DTI measures of WM microstructure: axial, radial and mean diffusivity, and fractional anisotropy.

Results

ACE hastened the onset of illness. We observed an inverse correlation between the severity of ACE and DTI measures of axial diffusivity in several WM fibre tracts contributing to the functional integrity of the brain and including the corona radiata, thalamic radiations, corpus callosum, cingulum bundle, superior longitudinal fasciculus, inferior fronto-occipital fasciculus and uncinate fasciculus.

Conclusions

Axial diffusivity reflects the integrity of axons and myelin sheaths, and correlates with functional connectivity and with higher-order abilities such as reasoning and experience of emotions. In patients with BD axial diffusivity is increased by lithium treatment. ACE might contribute to BD pathophysiology by hampering structural connectivity in critical cortico-limbic networks.

Keywords

Bipolar disorderchildhoodstresstraumawhite matter
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 14 , October 2014 , pp. 3069 - 3082
Copyright
Copyright © Cambridge University Press 2014 

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