Frontal signal hyperintensities in mania in old age

Jose M. De Asis, Blaine S. Greenwald, George S. Alexopoulos, Dimitris N. Kiosses, Manzar Ashtari, Moonseong Heo, Robert C. Young

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


Objective: Signal hyperintensities (SH) on magnetic resonance (MR) imaging have been associated with increased age and with mood disorders. Frontal and subcortical neuropathology has been implicated in the pathophysiology of mania and bipolar disorders. The authors assessed frontal and subcortical SH in elderly bipolar manic patients and the comparison group, and hypothesized that SH scores would be greater in the patient group. Method: MR imaging was performed in patients aged ≥60 years with bipolar disorder, mania, and in a same-aged community comparison group. SH were rated blindly using the Boyko system. Frontal deep white matter and basal ganglia SH were assessed in the left and right hemispheres. Results: SH scores were significantly greater in patients (N = 40) than the comparison group (N = 15) in frontal deep white matter (left: p = 0.003; right: p = 0.023) based on Mann-Whitney two-sample exact tests. The SH scores in the subcortical gray regions overlapped in these groups. In patients, higher right frontal SH scores were associated with later age at onset of mania. Conclusions: Frontal deep white matter SH may be increased in elders with bipolar disorder. Further study of the relationship of SH to age at onset in elders is warranted.

Original languageEnglish (US)
Pages (from-to)598-604
Number of pages7
JournalAmerican Journal of Geriatric Psychiatry
Issue number7
StatePublished - Jul 2006
Externally publishedYes


  • Geriatric mania
  • Illness onset
  • MRI
  • Signal hyperintensities

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health


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