TY - JOUR
T1 - White matter hyperintensities on magnetic resonance imaging of the brain in children with psychiatric disorders
AU - Lyoo, Kyoon
AU - Lee, Ho Kyu
AU - Jung, Ji Hyun
AU - Noam, Gil G.
AU - Renshaw, Perry F.
N1 - Funding Information:
From the Brain Imaging Center, McLean Hospital, Belmont, MA; Consolidated Department of Psychiatry, Harvard Medical School, Boston, MA; and the Department of R adiology, College of Medicine, Ulsan University, Seoul, Korea. Supported in part by a Young Investigator Award from the National Alliance for R esearch on Schizophrenia and Depression and the Harvard-MIT Clinical Investigator Training Program (I.K.L.) and the Stanley Foundation Bipolar Disorders R esearch Center at McLean Hospital, and MH58681 (P.F.R .). Address reprint requests to In Kyoon Lyoo, M.D., Ph.D., McLean Hospital, 115 Mill St, Belmont, MA 02478. Copyright 2002, Elsevier Science (USA). All rights reserved. 0010-440X/02/4305-0011$35.00/0 doi:10.1053/comp.2002.34636
PY - 2002
Y1 - 2002
N2 - The current study sought to determine the prevalence, severity, and location of white matter signal hyperintensities (WMH) on brain magnetic resonance imaging assessments of children and adolescents with psychiatric disorders. Seventy-one percent (N = 934) of children admitted to the McLean Hospital Child and Adolescent inpatient treatment unit were evaluated with the Diagnostic Interview Schedule for Children (DISC) within 7 days of admission during the period 1988 to 1993 (total, 1, 308 admissions). Four hundred eight of these subjects (43.7%) were referred for brain magnetic resonance imaging (MRI) scans and became our study subjects (mean age, 12.4 years [SD = 2.7]; male/female, 230/178). Study subjects were grouped according to a hierarchical diagnostic system as follows: schizophrenia (n = 42), bipolar disorder (n = 56), unipolar depression (n = 94), conduct disorder/attention deficit disorder (n = 103), and other neurotic disorders (n = 30). Subjects without any level 2 diagnosis on DISC (n = 83) constituted the comparison group. Bipolar disorder, unipolar depression, and conduct disorder/attention deficit disorder groups were significantly more likely to have severe levels of WMH than the comparison group (prevalence rates: 17.9%, 13.8%, 13.6% v 1.2%). In addition, the bipolar disorder group was significantly more likely to have severe levels of WMH than the schizophrenia group (prevalence rates: 17.9% v 2.4%). The frontal lobes were the predominant locations of WMH in the bipolar disorder and unipolar depression groups (76.9% and 60.0%, respectively) and also the most frequent location for the conduct disorder/attention deficit disorder group (35.7%). The current study reports an increased prevalence and severity of WMH in children with bipolar disorder, unipolar depression, and conduct disorder/attention deficit disorder relative to the comparison group and in children with bipolar disorder compared to those with schizophrenia. The development of brain WMH, especially in the frontal lobes, may play a role in the pathophysiology of affective disorders in children and adolescents.
AB - The current study sought to determine the prevalence, severity, and location of white matter signal hyperintensities (WMH) on brain magnetic resonance imaging assessments of children and adolescents with psychiatric disorders. Seventy-one percent (N = 934) of children admitted to the McLean Hospital Child and Adolescent inpatient treatment unit were evaluated with the Diagnostic Interview Schedule for Children (DISC) within 7 days of admission during the period 1988 to 1993 (total, 1, 308 admissions). Four hundred eight of these subjects (43.7%) were referred for brain magnetic resonance imaging (MRI) scans and became our study subjects (mean age, 12.4 years [SD = 2.7]; male/female, 230/178). Study subjects were grouped according to a hierarchical diagnostic system as follows: schizophrenia (n = 42), bipolar disorder (n = 56), unipolar depression (n = 94), conduct disorder/attention deficit disorder (n = 103), and other neurotic disorders (n = 30). Subjects without any level 2 diagnosis on DISC (n = 83) constituted the comparison group. Bipolar disorder, unipolar depression, and conduct disorder/attention deficit disorder groups were significantly more likely to have severe levels of WMH than the comparison group (prevalence rates: 17.9%, 13.8%, 13.6% v 1.2%). In addition, the bipolar disorder group was significantly more likely to have severe levels of WMH than the schizophrenia group (prevalence rates: 17.9% v 2.4%). The frontal lobes were the predominant locations of WMH in the bipolar disorder and unipolar depression groups (76.9% and 60.0%, respectively) and also the most frequent location for the conduct disorder/attention deficit disorder group (35.7%). The current study reports an increased prevalence and severity of WMH in children with bipolar disorder, unipolar depression, and conduct disorder/attention deficit disorder relative to the comparison group and in children with bipolar disorder compared to those with schizophrenia. The development of brain WMH, especially in the frontal lobes, may play a role in the pathophysiology of affective disorders in children and adolescents.
UR - http://www.scopus.com/inward/record.url?scp=0036735195&partnerID=8YFLogxK
U2 - 10.1053/comp.2002.34636
DO - 10.1053/comp.2002.34636
M3 - Article
C2 - 12216011
AN - SCOPUS:0036735195
SN - 0010-440X
VL - 43
SP - 361
EP - 368
JO - Comprehensive Psychiatry
JF - Comprehensive Psychiatry
IS - 5
ER -
