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Altered cerebral perfusion in bipolar disorder: A pCASL MRI study
Author(s) -
Zeng Victor,
Lizano Paulo,
Bolo Nicolas R.,
Lutz Olivia,
Brady Roscoe,
Ivleva Elena I.,
Dai Weiying,
Clementz Brett,
Tamminga Carol,
Pearlson Godfrey,
Keshavan Matcheri
Publication year - 2021
Publication title -
bipolar disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.285
H-Index - 129
eISSN - 1399-5618
pISSN - 1398-5647
DOI - 10.1111/bdi.12966
Subject(s) - cerebral blood flow , voxel , cardiology , statistical parametric mapping , thalamus , medicine , cerebellum , neuroscience , magnetic resonance imaging , psychology , radiology
Background Neurovascular abnormalities are relevant to the pathophysiology of bipolar disorder (BD), which can be assessed using cerebral blood flow (CBF) imaging. CBF alterations have been identified in BD, but studies to date have been small and inconclusive. We aimed to determine cortical gray matter CBF (GM‐CBF) differences between BD and healthy controls (HC) and to identify relationships between CBF and clinical or cognitive measures. Methods Cortical GM‐CBF maps were generated using Pseudo‐Continuous Arterial Spin Labeling (pCASL) for 109 participants (BD, n = 61; HC, n = 48). We used SnPM13 to perform non‐parametric voxel‐wise two‐sample t‐tests comparing CBF between groups. We performed multiple linear regression to relate GM‐CBF with clinical and cognitive measures. Analysis was adjusted for multiple comparisons with 10,000 permutations. Significance was set at a voxel level threshold of P < .001 followed by AlphaSim cluster‐wise correction of P < .05. Results Compared to HCs, BD patients had greater GM‐CBF in the left lateral occipital cortex, superior division and lower CBF in the right lateral occipital, angular and middle temporal gyrus. Greater GM‐CBF in the left lateral occipital cortex correlated with worse working memory, verbal memory, attention and speed of processing. We found using voxel‐wise regression that decreased gray matter CBF in the bilateral thalamus and cerebellum, and increased right fronto‐limbic CBF were associated with worse working memory. No clusters were associated with clinical variables after FDR correction. Conclusions Cortical GM‐CBF alterations are seen in BD and may be related to cognitive function, which suggest neurovascular unit dysfunction as a possible pathophysiologic mechanism.