Voxel-based study of structural changes in first-episode patients with bipolar disorder.
BACKGROUND
Although morphometric studies of bipolar disorder (BD) suggest that neurofunctional abnormalities reflect underlying structural changes, it remains unclear whether abnormalities are present at illness onset or reflect disease progression. Previous voxel-based morphometry (VBM) findings suggest that ventrolateral prefrontal cortex (VLPFC) changes develop over time, whereas morphologic abnormalities elsewhere in the anterior limbic network (ALN) are present early in BD. In this study, we used VBM to explore structural brain changes in first-episode bipolar patients.


METHODS
First-episode bipolar (n = 33) and healthy (n = 33) subjects underwent magnetic resonance imaging. Images were normalized and compared on a voxel-by-voxel basis.


RESULTS
Bipolar subjects showed no change in VLPFC density or volume. We observed increased volume in left thalamus and fusiform and cerebellum bilaterally; increased gray matter density in anterior cingulate and posterior parietal structures; and increased gray matter volume and density in middle/superior temporal and posterior cingulate gyri. No areas of decreased volume or density were observed.


CONCLUSIONS
These data indicate that structural changes are absent from VLPFC early in the course of BD. Morphologic abnormalities are present in other portions of the ALN and in structures previously observed to mediate neurofunctional changes in BD, suggesting that dysfunctional neuronal proliferation or pruning may occur in bipolar patients.
Adler
Caleb M
CM
Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati, Ohio 45267, USA. adlercb@ucmail.uc.edu
DelBello
Melissa P
MP
Jarvis
Kelly
K
Levine
Ari
A
Adams
John
J
Strakowski
Stephen M
SM
D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000473:pathology*; D001921:Brain / Q000033:anatomy & histology / Q000473:pathology*; D002540:Cerebral Cortex / Q000033:anatomy & histology / Q000473:pathology; D005260:Female; D006801:Humans; D008032:Limbic System / Q000033:anatomy & histology / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D009929:Organ Size; D013788:Thalamus / Q000033:anatomy & histology / Q000502:physiology