White Matter Microstructural Abnormalities and Cognitive Functions Assessment in First versus Multiple episodes of Euthymic Bipolar Cases

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Abstract Background Recently, several studies have detected cognitive impairment and microstructural deficits of white matter in bipolar disorder type. It is still unclear if these structural and cognitive abnormalities in bipolar disorder are progressive or static. Results The study was conducted on 40 cases with bipolar disorder I during euthymic state (20 cases with single episodes and 20 cases with multiple episodes) and 20 healthy participants. Assessment of white matter integrity of selected regions and tracts using diffusion tensor imaging technique and correlated the findings with cognitive functions results. Cases with BD I both with a single episode or multiple episodes showed deficits than the control group in all the selected regions for Diffusion Tensor Imaging study in comparison to controls. Also, more deficits were found as regards cognitive functions include (memory, executive functions, and sustained attention). On the other hand, cases with multiple episodes had more deficit than those with a single episode regarding seven regions of interest (left and right inferior longitudinal fasciculus, left and right superior longitudinal fasciculus, left uncinate fasciculus, right cingulum, and right inferior frontal area) as well as more impairment in executive functions and sustained attention which correlated with these white matter deficits. Conclusion The present findings indicate that white matter microstructural abnormalities and cognitive functions deficits could serve as state and trait markers in cases with bipolar disorder I. The detected abnormalities could affect the future in early diagnosis and intervention, thus facilitating functional recovery in cases with bipolar disorder I.

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