White Matter Integrity Alterations in First Episode Euthymic Bipolar I Patients and their Impact on Cognitive Functions

Abstract

Bipolar disorder (BD) is a serious affective illness that affects approximately 1.5% of the population. A recurrent and episodic course characterizes the disease, involving disturbances of mood, sleep behavior, and perception. The disease is associated with high rates of non-recovery, psychiatric and medical comorbidity, and progressive cognitive deterioration (Quraishi and Frangou, 2002). Patients of bipolar disorder seem to be the most expensive in terms of overall medical and psychological care in comparison to other mental patients and one of the most categories of patients in the whole field of medicine (Fountoulakis, 2015). Although the neuropathology linked to bipolar symptomatology remains poorly understood morphologic and functional neuroimaging studies implicate dysfunction in the anterior limbic network (ALN), a group of structures hypothesized to be involved in emotional regulation and modulation (Strakowski et al., 2000). The ALN includes the ventrolateral prefrontal cortex (VLPFC), amygdala, and hippocampal complex, as well as subcortical structures such as the striatum and thalamus, which appear to modulate activity in portions of the prefrontal cortex.