title: Olfactocentric paralimbic cortex morphology in adolescents with bipolar disorder.
abstract: The olfactocentric paralimbic cortex plays a critical role in the regulation of emotional and neurovegetative functions that are disrupted in core features of bipolar disorder. Adolescence is thought to be a critical period in both the maturation of the olfactocentric paralimbic cortex and in the emergence of bipolar disorder pathology. Together, these factors implicate a central role for the olfactocentric paralimbic cortex in the development of bipolar disorder and suggest that abnormalities in this cortex may be expressed by adolescence in the disorder. We tested the hypothesis that differences in olfactocentric paralimbic cortex structure are a morphological feature in adolescents with bipolar disorder. Subjects included 118 adolescents (41 with bipolar disorder and 77 healthy controls). Cortical grey matter volume differences between adolescents with and without bipolar disorder were assessed with voxel-based morphometry analyses of high-resolution structural magnetic resonance imaging scans. Compared with healthy comparison adolescents, adolescents with bipolar disorder demonstrated significant volume decreases in olfactocentric paralimbic regions, including orbitofrontal, insular and temporopolar cortices. Findings in these regions survived small volume correction (P < 0.05, corrected). Volume decreases in adolescents with bipolar disorder were also noted in inferior prefrontal and superior temporal gyri and cerebellum. The findings suggest that abnormalities in the morphology of the olfactocentric paralimbic cortex may contribute to the bipolar disorder phenotype that emerges in adolescence. The morphological development of the olfactocentric paralimbic cortex has received little study. The importance of these cortices in emotional and social development, and support for a central role for these cortices in the development of bipolar disorder, suggest that study of the development of these cortices in health and in bipolar disorder is critically needed.
authors.affiliation: Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, USA.
authors.forename: Fei
authors.initials: F
authors.lastname: Wang
authors.forename: Jessica H
authors.initials: JH
authors.lastname: Kalmar
authors.forename: Fay Y
authors.initials: FY
authors.lastname: Womer
authors.forename: Erin E
authors.initials: EE
authors.lastname: Edmiston
authors.forename: Lara G
authors.initials: LG
authors.lastname: Chepenik
authors.forename: Rachel
authors.initials: R
authors.lastname: Chen
authors.forename: Linda
authors.initials: L
authors.lastname: Spencer
authors.forename: Hilary P
authors.initials: HP
authors.lastname: Blumberg
mesh_terms: D000293:Adolescent; D001714:Bipolar Disorder / Q000473:pathology*; D001931:Brain Mapping; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008032:Limbic System / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D009434:Neural Pathways / Q000473:pathology; D017397:Prefrontal Cortex / Q000473:pathology*; D055815:Young Adult