title: Anterior cingulate cortex abnormalities associated with a first psychotic episode in bipolar disorder.
abstract: BACKGROUND
  The anterior cingulate cortex is frequently implicated in the pathophysiology of bipolar disorder, but magnetic resonance imaging (MRI) studies have reported variable findings owing to a reliance on patient samples with chronic illness and to limited appreciation of the region's heterogeneity.
  
  
  OBJECTIVE
  To characterise anterior cingulate cortex abnormalities in patients with bipolar disorder experiencing their first episode of psychosis while accounting for regional anatomical variability.
  
  
  METHODS
  Grey matter volume, surface area and cortical thickness were measured in six anterior cingulate cortex subregions per hemisphere using MRI scans acquired from 26 patients with bipolar I disorder experiencing first-episode psychosis and 26 healthy controls matched for age, gender and regional morphological variability.
  
  
  RESULTS
  Relative to controls, male patients displayed increased thickness in the right subcallosal limbic anterior cingulate cortex. No significant differences were identified in females for grey matter volume or surface area measures. The findings were not attributable to medication effects.
  
  
  CONCLUSIONS
  These data suggest that first-episode psychosis in bipolar disorder is associated with a gender-specific, right-lateralised thickness increase in anterior cingulate cortex subregions known to play a role in regulating physiological stress responses.
authors.affiliation: Melbourne Neuropsychiatry Centre, Department of Psychiatry, School of Behavioural Science, University of Melbourne, National Neuroscience Facility, 161 Barry Street, Carlton South, VIC 3053, Australia. fornitoa@unimelb.edu.au
authors.forename: Alex
authors.initials: A
authors.lastname: Fornito
authors.forename: Murat
authors.initials: M
authors.lastname: Yücel
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Wood
authors.forename: Andreas
authors.initials: A
authors.lastname: Bechdolf
authors.forename: Simon
authors.initials: S
authors.lastname: Carter
authors.forename: Chris
authors.initials: C
authors.lastname: Adamson
authors.forename: Dennis
authors.initials: D
authors.lastname: Velakoulis
authors.forename: Michael M
authors.initials: MM
authors.lastname: Saling
authors.forename: Patrick D
authors.initials: PD
authors.lastname: McGorry
authors.forename: Christos
authors.initials: C
authors.lastname: Pantelis
mesh_terms: D001714:Bipolar Disorder / Q000473:pathology* / Q000503:physiopathology; D001931:Brain Mapping / Q000379:methods; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006179:Gyrus Cinguli / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D011237:Predictive Value of Tests; D012737:Sex Factors; D013312:Stress, Physiological; D055815:Young Adult