Poster No:
1910
Submission Type:
Abstract Submission
Authors:
Julia Hubbert1, Linda Bonnekoh1, Kira Flinkenflügel2, Judith Krieger3, Christoph Jurischka3, Georg Romer4, Frederike Stein5, Florian Thomas-Odenthal5, Teutenberg Lea5, Paul Usemann5, Igor Nenadić6, Benjamin Straube5, Nina Alexander5, Andreas Jansen5, Hamidreza Jamalabadi5, Tilo Kircher6, Udo Dannlowski2, Susanne Meinert7
Institutions:
1Institute for Translational Psychiatry, University of Münster, Germany, Münster, North Rhine-Westphalia, 2Institute for Translational Psychiatry, Münster, North Rhine-Westphalia, 3Institute for Translational Psychiatry, University of Münster, Germany, Münster, North Rhine-Westphalia, 4Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Münster, North Rhine-Westphalia, 5Department of Psychiatry and Psychotherapy, University of Marburg, Germany, Marburg, Hesse, 6Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Hesse, 7Institute for Translational Psychiatry, University of Münster, Münster, North Rhine-Westphalia
First Author:
Julia Hubbert
Institute for Translational Psychiatry, University of Münster, Germany
Münster, North Rhine-Westphalia
Co-Author(s):
Linda Bonnekoh
Institute for Translational Psychiatry, University of Münster, Germany
Münster, North Rhine-Westphalia
Judith Krieger
Institute for Translational Psychiatry, University of Münster, Germany
Münster, North Rhine-Westphalia
Christoph Jurischka
Institute for Translational Psychiatry, University of Münster, Germany
Münster, North Rhine-Westphalia
Georg Romer
Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy
Münster, North Rhine-Westphalia
Frederike Stein
Department of Psychiatry and Psychotherapy, University of Marburg, Germany
Marburg, Hesse
Teutenberg Lea
Department of Psychiatry and Psychotherapy, University of Marburg, Germany
Marburg, Hesse
Paul Usemann
Department of Psychiatry and Psychotherapy, University of Marburg, Germany
Marburg, Hesse
Igor Nenadić
Department of Psychiatry and Psychotherapy, University of Marburg
Marburg, Hesse
Benjamin Straube
Department of Psychiatry and Psychotherapy, University of Marburg, Germany
Marburg, Hesse
Andreas Jansen
Department of Psychiatry and Psychotherapy, University of Marburg, Germany
Marburg, Hesse
Hamidreza Jamalabadi
Department of Psychiatry and Psychotherapy, University of Marburg, Germany
Marburg, Hesse
Tilo Kircher
Department of Psychiatry and Psychotherapy, University of Marburg
Marburg, Hesse
Udo Dannlowski
Institute for Translational Psychiatry
Münster, North Rhine-Westphalia
Susanne Meinert
Institute for Translational Psychiatry, University of Münster
Münster, North Rhine-Westphalia
Introduction:
In major psychiatric disorders such as anxiety disorders (AXD), major depressive disorder (MDD), bipolar disorder (BD) and psychotic spectrum disorders (SSD) including schizophrenia and schizoaffective disorder, educational and occupational attainment is described as protective against an unfavorable trajectory of disease and cognitive impairment (Robinson & Ferrier, 2006; Rock et al., 2013; Kahn & Keefe, 2013; Moran, 2016). Both cognitive impairment as a core symptom of major psychiatric diseases and an unfavorable disease course have been linked to changes in white matter fiber structure (Holleran et al., 2020; Meinert et al., 2021, Flinkenflügel et al., 2024). We hypothesize that a higher level of education is not only protective on a phenomenological level (disease course, cognitive impairment) but also buffers the adverse effect on neurobiological development, which could make it a prime target for potential preventive strategies in the future. Furthermore, we expect that this protective effect will become increasingly apparent with advancing age, when cumulative exposure to disease-related stressors may lead to accelerated cognitive decline.
Methods:
A total of N=1424 participants (N=141 AXD, N=468 MDD, N=99 BD, N=69 SSD and N=647 healthy controls [HC]) were selected from the Marburg-Münster Affective Disorders Cohort Study (Kircher et al., 2018). First, an analysis of variance (ANOVA) with cognitive performance as dependent variable, the educational and occupational attainment, diagnosis (HC vs. AXD vs. MDD vs. BD vs. SZ) and their interaction as independent variables, with age, age² and sex as covariates was conducted. The interaction of age x attainment was included in order to examine whether the positive effect of education increases with age. Fiber microstructure was analyzed with diffusion tensor imaging (DTI) employing tract-based spatial statistics. Second, a generalized linear model with FA as dependent variable, diagnosis, educational and occupational attainment and their interaction as independent variables and the nuisance variables age, age² sex, total intracranial volume, and dummy coded site/scanner variables was analyzed. The interaction of age x attainment was included in order to examine whether the protective effect of education is more apparent at older age.
Results:
The ANOVA revealed a significant main effect of diagnosis (F(4,1411)=21.00, p<.001, Eta²=.056), whereas patients with major psychiatric disorders performed significantly worse on neurocognitive tests compared to HC (HC<AXD<MDD<BD<SSD). Moreover, a main effect of educational and occupational attainment (F(1,1411)=44.50, p<.001, Eta²=.031) on cognitive performance was found, where participants with higher educational level performed better on the tasks. The age x attainment interaction was significant (F(1,1410)=27.85, p<.001, Eta²=.019). While attainment had little to no protective effect in young participants, older participants showed a protective effect of attainment on cognitive performance. Further, a significant positive association between attainment and fractional anisotropy (FA) was detected (ptfce-FWE=.002, k=1217 voxels in one cluster, MNI-coordinates of peak voxel of largest cluster: x=9, y=28, z=11). The attainment × diagnosis interaction was not significant (F-contrast: ptfce-FWE=0.101). Instead, an attainment x age interaction was present (ptfce-FWE=.002, k=35802, x=16, y=-43, z=24), where the positive association between FA and attainment was stronger in older participants.
Conclusions:
This study successfully corroborates that white matter integrity and the educational and occupational attainment are linked indicating a protective influence of education on the course of disease across the transdiagnostic sample of patients with AXD, MDD, BD and SSD. Notably, this protective effect was most pronounced in older participants, implying that education plays a critical role in shielding against neurodegenerative processes throughout the lifespan.
Disorders of the Nervous System:
Psychiatric (eg. Depression, Anxiety, Schizophrenia) 2
Education, History and Social Aspects of Brain Imaging:
Education, History and Social Aspects of Brain Imaging
Modeling and Analysis Methods:
fMRI Connectivity and Network Modeling
Neuroanatomy, Physiology, Metabolism and Neurotransmission:
White Matter Anatomy, Fiber Pathways and Connectivity
Novel Imaging Acquisition Methods:
Diffusion MRI 1
Keywords:
Affective Disorders
MRI
White Matter
WHITE MATTER IMAGING - DTI, HARDI, DSI, ETC
Other - Eucation, Transdiagnostic, Cognitive Reserver, Resilience
1|2Indicates the priority used for review
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Healthy subjects only or patients (note that patient studies may also involve healthy subjects):
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Was this research conducted in the United States?
No
Were any human subjects research approved by the relevant Institutional Review Board or ethics panel?
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Please indicate which methods were used in your research:
Diffusion MRI
Neuropsychological testing
For human MRI, what field strength scanner do you use?
3.0T
Which processing packages did you use for your study?
FSL
Provide references using APA citation style.
Flinkenflügel, K., Meinert, S., Hirtsiefer, C., Grotegerd, D., Gruber, M., Goltermann, J., Winter, N. R., Stein, F., Brosch, K., Leehr, E. J., Böhnlein, J., Dohm, K., Bauer, J., Redlich, R., Hahn, T., Repple, J., Opel, N., Nitsch, R., Jamalabadi, H., . . . Dannlowski, U. (2024). Associations between white matter microstructure and cognitive decline in major depressive disorder versus controls in Germany: a prospective case-control cohort study. The Lancet Psychiatry, 11(11), 899–909. https://doi.org/10.1016/s2215-0366(24)00291-8
Holleran, L., Kelly, S., Alloza, C., Agartz, I., Andreassen, O. A., Arango, C., Banaj, N., Calhoun, V., Cannon, D., Carr, V., Corvin, A., Glahn, D. C., Gur, R., Hong, E., Hoschl, C., Howells, F. M., James, A., Janssen, J., Kochunov, P., . . . Donohoe, G. (2020). The Relationship Between White Matter Microstructure and General Cognitive Ability in Patients With Schizophrenia and Healthy Participants in the ENIGMA Consortium. American Journal Of Psychiatry, 177(6), 537–547. https://doi.org/10.1176/appi.ajp.2019.19030225
Kahn, R. S. & Keefe, R. S. E. (2013). Schizophrenia Is a Cognitive Illness. JAMA Psychiatry, 70(10), 1107. https://doi.org/10.1001/jamapsychiatry.2013.155
Kircher, T., Wöhr, M., Nenadic, I., Schwarting, R., Schratt, G., Alferink, J., Culmsee, C., Garn, H., Hahn, T., Müller-Myhsok, B., Dempfle, A., Hahmann, M., Jansen, A., Pfefferle, P., Renz, H., Rietschel, M., Witt, S. H., Nöthen, M., Krug, A. & Dannlowski, U. (2018). Neurobiology of the major psychoses: a translational perspective on brain structure and function—the FOR2107 consortium. European Archives Of Psychiatry And Clinical Neuroscience, 269(8), 949–962. https://doi.org/10.1007/s00406-018-0943-x
Meinert, S., Nowack, N., Grotegerd, D., Repple, J., Winter, N. R., Abheiden, I., Enneking, V., Lemke, H., Waltemate, L., Stein, F., Brosch, K., Schmitt, S., Meller, T., Pfarr, J., Ringwald, K., Steinsträter, O., Gruber, M., Nenadić, I., Krug, A., . . . Dannlowski, U. (2021). Association of brain white matter microstructure with cognitive performance in major depressive disorder and healthy controls: a diffusion-tensor imaging study. Molecular Psychiatry, 27(2), 1103–1110. https://doi.org/10.1038/s41380-021-01330-8
Moran, T. P. (2016). Anxiety and working memory capacity: A meta-analysis and narrative review. Psychological Bulletin, 142(8), 831–864. https://doi.org/10.1037/bul0000051
Robinson, L. J. & Ferrier, I. N. (2006). Evolution of cognitive impairment in bip
No