Reconciling neuroimaging and neuropathological findings in schizophrenia and bipolar disorder.
OBJECTIVE
Although structural magnetic resonance imaging (sMRI) and neuropathological investigations offer complementary information that can be used to formulate and test hypotheses about pathophysiological mechanisms in psychiatric disorders, the findings from these two fields are seldom integrated in a systematic manner. In this study, we overview recent sMRI findings in schizophrenia and bipolar disorder and consider how they relate to neuropathological data.


RESULTS
sMRI research indicates that schizophrenia is associated with volumetric reductions in a network of frontal, temporal, limbic, striatal, and thalamic regions. Some of these abnormalities are apparent prior to psychosis onset and may progress with ongoing illness. sMRI findings in bipolar disorder have been more variable, with both volumetric increases and decreases being reported across several brain regions at different illness stages. Neuropathological studies of both patient groups suggest the cellular changes associated with these volumetric differences affect diverse tissue compartments in a regionally heterogeneous way.


CONCLUSIONS
These findings suggest that any putative pathophysiological mechanism in schizophrenia or bipolar disorder should account for the dynamic, complex, and regionally heterogeneous brain abnormalities seen in these patients. We contend that greater integration of the findings from these two fields will facilitate more targeted and hypothesis-driven research in the future.
Fornito
Alex
A
Faculty of Medicine, Dentistry & Health Science, Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne, Parkville, Victoria, Australia. fornitoa@unimelb.edu.au
Yücel
Murat
M
Pantelis
Christos
C
D001714:Bipolar Disorder / Q000175:diagnosis* / Q000503:physiopathology*; D001921:Brain / Q000033:anatomy & histology / Q000503:physiopathology*; D003342:Corpus Striatum / Q000033:anatomy & histology / Q000503:physiopathology; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000503:physiopathology; D005625:Frontal Lobe / Q000033:anatomy & histology / Q000503:physiopathology; D006179:Gyrus Cinguli / Q000033:anatomy & histology / Q000503:physiopathology; D006801:Humans; D008032:Limbic System / Q000033:anatomy & histology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D012559:Schizophrenia / Q000175:diagnosis* / Q000503:physiopathology*; D013702:Temporal Lobe / Q000033:anatomy & histology / Q000503:physiopathology; D013788:Thalamus / Q000033:anatomy & histology / Q000503:physiopathology