Effects of illness duration on cognitive performances in bipolar depression are mediated by white matter microstructure
Abstract
Background Cognitive deficits are a core feature of bipolar disorder (BD), and persist during the euthymic phase. White matter (WM) microstructural abnormalities are widely considered a structural marker of BD. Features of illness chronicity, such as illness duration and number of mood episodes, have been associated with worsening of both clinical profile and brain structural alterations. This study examined the role of WM integrity as a possible mediator between illness duration and cognitive performances in a sample of BD patients.Methods We assessed 88 inpatients affected by a depressive episode in course of type I BD for verbal memory, visual memory, working memory, visuospatial constructional abilities, psychomotor coordination, executive functions, processing speed, and verbal fluency. White matter integrity was evaluated through FA measurements derived using the Enhancing Neuro Imaging Genetics Through Meta-Analysis (ENIGMA)-DTI protocol.Results The effect of illness duration on processing speed, verbal memory, and visual memory was mediated by the FA values of bilateral anterior corona radiata, bilateral corona radiata, genu of corpus callosum, and fornix, adjusting for age, sex, education and lithium treatment (p < 0.05).Limitations Potential interaction factors were not examined in this study.Conclusions This is the first study to show the role of WM integrity as a mediator of the negative effect of illness duration on cognitive performances. Our data provide new insight into the neuroprogressive hypothesis of BD.
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The effect on neurocognitive dysfunctions is proportional to illness duration.
“an effect proportional to illness duration (Melloni et al., 2019)”
From Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: effect of inflammatory biomarkers at three-month follow-up (2021) · cites this paper as Melloni et al., 2019
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- Authors
- Melloni, E. M. T., Poletti, S., Vai, B., Bollettini, I., Colombo, C., & Benedetti, F.
- Affiliations
- Vita-Salute San Raffaele University (IT)
- IRCCS Ospedale San Raffaele (IT)
- Corresponding author
- Melloni, Elisa M.T.
- ORCID
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2019-04
- Volume
- 249
- Pages
- 175-182
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2912016006
- Cited by
- 34
- References
- 124
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 3 · 2023: 5 · 2022: 6 · 2021: 8 · 2020: 4 · 2019: 1
- FWCI
- 3.78
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion)
- Funders
- Ministry of Health
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- bipolar depression, disease duration, cognitive impairment, white matter microstructure, fractional anisotropy, mediation analysis, processing speed, verbal memory, visual memory, corpus callosum, fornix, executive function, lithium therapy
- MeSH terms
- Adult, Bipolar Disorder, Cognition, Corpus Callosum, Depression, Female, Humans, Male, Memory, Short-Term, Middle Aged, Case-Control Studies, Executive Function, Cognitive Dysfunction, White Matter
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