Background
There is substantial inconsistency in results of brain structural magnetic resonance
imaging studies in adult bipolar disorder. This is likely consequent upon limited
statistical power of studies together with their clinical and methodological heterogeneity.
The current study was undertaken to perform an international collaborative mega-analysis
of regional volumetric measurements of individual patient and healthy subject data,
to optimize statistical power, detect case-control differences, assess the association
of psychotropic medication usage with brain structural variation, and detect other
possible sources of heterogeneity.
Methods
Eleven international research groups contributed published and unpublished data on
321 individuals with bipolar disorder I and 442 healthy subjects. We used linear mixed
effects regression models to evaluate differences in brain structure between patient
groups.
Results
Individuals with bipolar disorder had increased right lateral ventricular, left temporal
lobe, and right putamen volumes. Bipolar patients taking lithium displayed significantly
increased hippocampal and amygdala volume compared with patients not treated with
lithium and healthy comparison subjects. Cerebral volume reduction was significantly
associated with illness duration in bipolar individuals.
Conclusions
The application of mega-analysis to bipolar disorder imaging identified lithium use
and illness duration as substantial and consistent sources of heterogeneity, with
lithium use associated with regionally specific increased brain volume.
Key Words
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Article info
Publication history
Published online: October 28, 2010
Accepted:
August 13,
2010
Received in revised form:
August 13,
2010
Received:
February 16,
2010
Identification
Copyright
© 2011 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
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- Structural Trait Markers of Bipolar Disorder: Disruption of White Matter Integrity and Localized Gray Matter Abnormalities in Anterior Fronto-Limbic RegionsBiological PsychiatryVol. 69Issue 4
- PreviewKraepelinian's classification of major psychoses suggests that bipolar disorder (BD) is an illness distinct from schizophrenia. Traditionally, neuroanatomical abnormalities were considered as trait markers of schizophrenia rather than BD. Schizophrenia is associated with enlargement of ventricles; gray matter abnormalities in a number of regions including the insula, superior temporal gyrus, anterior cingulate cortex (ACC), hippocampus, and thalamus (1,2); and disrupted white matter integrity in frontosubcortical, frontotemporal, and interhemispheric tracts (3) (Bora et al.
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