Psychiatry Investig.  2017 Jul;14(4):471-482. 10.4306/pi.2017.14.4.471.

Microstructural Abnormalities of Basal Ganglia and Thalamus in Bipolar and Unipolar Disorders: A Diffusion Kurtosis and Perfusion Imaging Study

• Zhao L
• Wang Y
• Jia Y
• Zhong S
• Sun Y
• Zhou Z
• Zhang Z
• Huang L

• KMID: 2387139
• DOI: http://doi.org/10.4306/pi.2017.14.4.471

Abstract

OBJECTIVE
Bipolar disorder (BD) is often misdiagnosed as unipolar depression (UD), leading to mistreatment and poor clinical outcomes. However, little is known about the similarities and differences in subcorticalgray matter regions between BD and UD.
METHODS
Thirty-five BD patients, 30 UD patients and 40 healthy controls underwent diffusional kurtosis imaging (DKI) and three dimensional arterial spin labeling (3D ASL). The parameters including mean kurtosis (MK), axial kurtosis (Ka), radial kurtosis (Kr), fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (Da), radial diffusivity (Dr) and cerebral blood flow (CBF) were measured by using regions-of-interest analysis in the caudate, putamen and thalamus of the subcortical gray matter regions.
RESULTS
UD exhibited differences from controls for DKI measures and CBF in the left putamen and caudate. BD showed differences from controls for DKI measures in the left caudate. Additionally, BD showed lower Ka in right putamen, higher MD in right caudate compared with UD. Receiver operating characteristic analysis revealed the Kr of left caudate had the highest predictive power for distinguishing UD from controls.
CONCLUSION
The two disorders may have overlaps in microstructural abnormality in basal ganglia. The change of caudate may serve as a potential biomarker for UD.

Keyword

Bipolar disorder; Depressive disorder; Major; Brain imaging/neuroimaging; Diffusion; Perfusion imaging

MeSH Terms

Anisotropy
Basal Ganglia*
Bipolar Disorder
Cerebrovascular Circulation
Depressive Disorder
Diffusion*
Gray Matter
Humans
Perfusion Imaging*
Perfusion*
Putamen
ROC Curve
Thalamus*