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Reply: Lithium and Increased Cortical Gray Matter—More Tissue or More Water?

      We thank Dr. Regenold for his interest and comment on our recent article, in which we identified significantly increased gray matter (GM) density, particularly within the bilateral cingulate and paralimbic cortices, in lithium-treated patients with bipolar disorder, relative to healthy control subjects (
      • Bearden C.E.
      • Thompson P.M.
      • Dalwani M.
      • Hayashi K.M.
      • Lee A.D.
      • Nicoletti M.
      • et al.
      Greater cortical gray matter density in lithium-treated patients with bipolar disorder.
      ). Dr. Regenold voices some disappointment that we did not determine whether an increase in brain tissue water might have contributed to our findings. Although GM increases might, in part, reflect expansion of neuropil content, unfortunately brain imaging cannot confirm which cellular changes are occurring in living patients.
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      Linked Article

      • Lithium and Increased Cortical Gray Matter—More Tissue or More Water?
        Biological PsychiatryVol. 63Issue 3
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          I read Bearden and colleagues’ “Greater Cortical Gray Matter Density in Lithium-Treated Patients with Bipolar Disorder” with great interest. I was hoping to learn that they had performed analyses to determine whether an increase in brain tissue water could have contributed to their finding increased cortical gray matter density in lithium-treated patients. However, like other investigators finding increased cortical thickness in bipolar subjects taking lithium (1,2), Bearden and colleagues did not report any data measuring gray matter water content.
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