title: Gray and white matter brain volumes in older adults with bipolar disorder.
abstract: OBJECTIVE
  Structural magnetic resonance imaging (MRI) studies have been inconsistent in demonstrating volumetric differences in subjects with bipolar disorder. Most studies have not found difference in total gray or white matter in bipolar patients compared with controls, but there have been several studies suggesting that regional abnormalities are present. These have predominately been located in the frontal and temporal lobes. Since age has been inversely correlated with total gray matter in patients, analyses of gray matter changes in older adults or in studies that have included older subjects have been difficult. This study assessed the presence of gray matter volume, and the potential for regional volumetric differences in older adults with bipolar disorder.
  
  
  METHODS
  Fifty-six older adults with DSM-IV bipolar disorder (mean age 60.5) and 43 non-psychiatrically ill controls (mean age 58.1) had structured interviews and MRI scanning on a 1.5T GE Scanner. Image parcellation divided the cerebrum into 16 units. Volumetric differences were examined using the multivariate linear regression models with alpha = 0.05.
  
  
  RESULTS
  Relative to controls, the older adults with bipolar disorder had significantly smaller gray matter volumes bilaterally in the inferior frontal areas. White matter volume was also reduced in these same areas but did not reach statistical significance when controlled for gender and age. No significant difference was noted in total gray or white matter volumes.
  
  
  CONCLUSIONS
  Older adults with bipolar disorder showed gray matter volumetric deficits in inferior frontal lobe regions which include structures identified as contributing to the anterior limbic network.
authors.affiliation: Duke University Medical Center, Department of Psychiatry and Behavioral Sciences, Neuropsychiatric Imaging Research Laboratory, USA. Beyer001@mc.duke.edu
authors.forename: John L
authors.initials: JL
authors.lastname: Beyer
authors.forename: Maragatha
authors.initials: M
authors.lastname: Kuchibhatla
authors.forename: Martha E
authors.initials: ME
authors.lastname: Payne
authors.forename: James
authors.initials: J
authors.lastname: Macfall
authors.forename: Frederick
authors.initials: F
authors.lastname: Cassidy
authors.forename: K Ranga R
authors.initials: KR
authors.lastname: Krishnan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology* / Q000523:psychology; D001714:Bipolar Disorder / Q000473:pathology* / Q000523:psychology; D001921:Brain / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011569:Psychiatric Status Rating Scales