Sex Effects Of White Matter Integrity In Adolescents And Young Adults With Bipolar Disorder

Objective: Sex differences were observed in both epidemiological and clinical aspects of bipolar disorder(BD).However,there was lack of study to confirm the significant differences in the brain structure changes between different gender patients.Using diffusion tensor imaging(DTI)technology to explore sex differences of white matter(WM)integrity disrupt in the BD patients.Hope to find the gender difference in the pathophysiological mechanism of the BD patients,provides a reliable basis for the different treatments of different genders bipolar disorder patients.Methods: Performing 3.0T magnetic resonance imaging(MRI)to examine fractional anisotropy(FA)of WM in 105 participants with BD(13-29 years,60 females,45 males)and 119 age-matched healthy controls(HC)(13-29 years,63 females,56 males).Collecting basic clinical information of all participants,and clinical evaluation was conducted through Hamilton Depression Scale,Hamilton Anxiety Scale and Young Mania Rating scale.SPSS 24.0 statistical software was used to analyze the demographic data of the four groups of subjects.Full factorial ANOVA(two-way ANOVA)was performed in SPM8 with groups diagnose(BD/HC)and sex(males/females)as between-subject factors to investigate the FA values abnormalities between different genders.Results: 1.The main effect of diagnosis on FA values were significant reduced(P <0.001,corrected)in the right Inferior fronto-occipital fasciculus/right external capsule,right caudate and genu of corpus callosum when compared the BD and HC groups.2.The main effect of sex on FA values was significant increased(P < 0.001,corrected)in the right superior cerebellar peduncle,genu of corpus callosum,right inferior fronto-occipital fasciculus,left external capsule,left anterior limb of internal capsule,left retrolenticular part of internal capsule and left fornix when compared the males and female groups.3.The interaction effect of diagnosis by sex on FA values were statistically significant in the right cerebral peduncle,genu of corpus callosum and left occipital lobe(brodmann area 18,BA18).Post-hoc analyzes showed that females with BD had FA values significantly decreased in right cerebral peduncle,genu of corpus callosum and BA18(P < 0.05,corrected),compared to females HC;while males withBD in the right cerebral peduncle and BA18(P < 0.05,corrected)were actually increased,compared to males HC.Conclusion:The findings in this cross-sectional study observed sex-related patterns of abnormalities within the WM integrity disrupt,such as females BD locality white matter FA values consistency decreased while the males BD were increased in the areas of in cerebral peduncle,genu of corpus callosum and BA18.Suggesting differences in WM changes that may mediate sex differences in the clinical presentation of BD and potential targets for sex-differentiated treatment of the disorder.