Cortical gray matter differences identified by structural magnetic resonance imaging in pediatric bipolar disorder.
OBJECTIVE
Few magnetic resonance imaging (MRI) studies of bipolar disorder (BPD) have investigated the entire cerebral cortex. Cortical gray matter (GM) volume deficits have been reported in some studies of adults with BPD; this study assessed the presence of such deficits in children with BPD.


METHODS
Thirty-two youths with DSM-IV BPD (mean age 11.2 +/- 2.8 years) and 15 healthy controls (HC) (11.2 +/- 3.0 years) had structured and clinical interviews, neurological examinations, neurocognitive testing, and MRI scanning on a 1.5 T GE Scanner. Image parcellation divided the neocortex into 48 gyral-based units per hemisphere, and these units were combined into frontal (FL), temporal (TL), parietal (PL), and occipital (OL) lobe volumes. Volumetric differences were examined using univariate linear regression models with alpha = 0.05.


RESULTS
Relative to controls, the BPD youth had significantly smaller bilateral PL, and left TL. Analysis of PL and TL gyri showed significantly smaller volume in bilateral postcentral gyrus, and in left superior temporal and fusiform gyri, while the parahippocampal gyri were bilaterally increased in the BPD group. Although the FL overall did not differ between groups, an exploratory analysis showed that the right middle frontal gyrus was also significantly smaller in the BPD group.


CONCLUSIONS
Children with BPD showed deficits in PL and TL cortical GM. Further analyses of the PL and TL found differences in areas involved in attentional control, facial recognition, and verbal and declarative memory. These cortical deficits may reflect early age of illness onset.
Frazier
Jean A
JA
Department of Psychiatry, Harvard Medical School, Boston, MA, USA. jfrazier@challiance.org
Breeze
Janis L
JL
Makris
Nikos
N
Giuliano
Anthony S
AS
Herbert
Martha R
MR
Seidman
Larry
L
Biederman
Joseph
J
Hodge
Steven M
SM
Dieterich
Megan E
ME
Gerstein
Emily D
ED
Kennedy
David N
DN
Rauch
Scott L
SL
Cohen
Bruce M
BM
Caviness
Verne S
VS
D000293:Adolescent; D001714:Bipolar Disorder / Q000473:pathology*; D001931:Brain Mapping; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000473:pathology*; D002648:Child; D005260:Female; D007839:Functional Laterality; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008279:Magnetic Resonance Imaging; D008297:Male; D015999:Multivariate Analysis; D012044:Regression Analysis