Elevated serum measures of lipid peroxidation and abnormal prefrontal white matter in euthymic bipolar adults: toward peripheral biomarkers of bipolar disorder

Mol Psychiatry. 2014 Feb;19(2):200-8. doi: 10.1038/mp.2012.188. Epub 2013 Jan 29.


Diffusion tensor imaging (DTI) studies consistently reported abnormalities in fractional anisotropy (FA) and radial diffusivity (RD), measures of the integrity of white matter (WM), in bipolar disorder (BD), that may reflect underlying pathophysiologic processes. There is, however, a pressing need to identify peripheral measures that are related to these WM measures, to help identify easily obtainable peripheral biomarkers of BD. Given the high lipid content of axonal membranes and myelin sheaths, and that elevated serum levels of lipid peroxidation are reported in BD, these serum measures may be promising peripheral biomarkers of underlying WM abnormalities in BD. We used DTI and probabilistic tractography to compare FA and RD in ten prefrontal-centered WM tracts, 8 of which are consistently shown to have abnormal FA (and/or RD) in BD, and also examined serum lipid peroxidation (lipid hydroperoxides, LPH and 4-hydroxy-2-nonenal, 4-HNE), in 24 currently euthymic BD adults (BDE) and 19 age- and gender-matched healthy adults (CONT). There was a significant effect of group upon FA in these a priori WM tracts (BDE<CONT: F[1,41]=6.8; P=0.013) and RD (BDE>CONT: F[1,41]=10.3; P=0.003), and a significant between-group difference in LPH (BDE>CONT: t[40]=2.4; P=0.022), but not in 4-HNE. Multivariate multiple regression analyses revealed that LPH variance explained, respectively, 59 and 51% of the variance of FA and RD across all study participants. This is the first study to examine relationships between measures of WM integrity and peripheral measures of lipid peroxidation. Our findings suggest that serum LPH may be useful in the development of a clinically relevant, yet easily obtainable and inexpensive, peripheral biomarkers of BD.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aldehydes / blood
  • Anisotropy
  • Biomarkers / blood
  • Bipolar Disorder / blood*
  • Bipolar Disorder / drug therapy
  • Bipolar Disorder / pathology*
  • Brain / pathology*
  • Diffusion Tensor Imaging
  • Female
  • Humans
  • Lipid Peroxidation*
  • Lipid Peroxides / blood
  • Male
  • Models, Statistical
  • Multivariate Analysis
  • Nerve Fibers, Myelinated / pathology*
  • Neural Pathways / pathology*
  • Prefrontal Cortex / pathology
  • Signal Processing, Computer-Assisted


  • Aldehydes
  • Biomarkers
  • Lipid Peroxides
  • 4-hydroxy-2-nonenal