Structural abnormalities of ventrolateral and orbitofrontal cortex in patients with familial bipolar disorder.
OBJECTIVE
Abnormalities of ventral prefrontal function have been widely reported in bipolar disorder, but reports of structural abnormalities in the same region are less consistent. We examined the presence and location of ventral prefrontal abnormalities in a large sample of individuals with bipolar disorder and their relationship to gender, psychotic symptoms, and age.


METHODS
Structural magnetic resonance imaging brain scans were carried out on 66 individuals with bipolar disorder, type I, and 66 controls. Voxel-based morphometry was used to examine differences in grey and white matter density between the groups and their relationship with a lifetime occurrence of psychotic symptoms and age.


RESULTS
Reductions in grey matter density were seen in the left and right lateral orbital gyri and the right inferior frontal gyrus, while white matter density reductions were seen in the corona radiata and the left temporal stem. In contrast, hallucinations and positive symptoms were associated with grey matter reduction in the left middle temporal gyrus. Age was more strongly associated with the right inferior frontal gyrus grey matter reductions in the bipolar group than in the controls, but not with any other finding.


CONCLUSIONS
Abnormalities of the ventral prefrontal cortex are likely to be involved in the aetiopathology of bipolar disorder, while hallucinations appear to be more closely associated with temporal lobe abnormality, extending earlier work in schizophrenia. Further prospective studies are required to comprehensively address the trajectory of these findings.
Stanfield
Andrew C
AC
Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK. andrew.stanfield@ed.ac.uk
Moorhead
T William J
TW
Job
Dominic E
DE
McKirdy
James
J
Sussmann
Jessika E D
JE
Hall
Jeremy
J
Giles
Stephen
S
Johnstone
Eve C
EC
Lawrie
Stephen M
SM
McIntosh
Andrew M
AM
D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D001714:Bipolar Disorder / Q000150:complications / Q000473:pathology*; D005260:Female; D006212:Hallucinations / Q000209:etiology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D017397:Prefrontal Cortex / Q000473:pathology*