title: Bipolar II disorder is associated with thinning of prefrontal and temporal cortices involved in affect regulation.
abstract: OBJECTIVE
  The neurobiological substrate of bipolar II disorder (BD-II) remains largely unknown. A few previous studies have found evidence for cerebral cortical thinning in mixed samples of BD-II and bipolar I disorder patients; however, no study of cortical thickness or surface area has been limited to BD-II. In the present study, we compared magnetic resonance imaging (MRI)-based indices of cortical thickness and surface area between individuals with BD-II and healthy controls.
  
  
  METHODS
  Thirty-six individuals with a DSM-IV diagnosis of BD-II and 42 controls underwent 3T MRI. Comparisons of thickness and relative surface areal expansion across the cerebral cortical mantle were performed using Freesurfer.
  
  
  RESULTS
  Individuals with BD-II showed significant thinning in two prefrontal clusters primarily comprising the left subgenual anterior cingulate cortex, left perigenual ventromedial prefrontal cortex (PFC), bilateral dorsomedial PFC, and bilateral dorsolateral PFC (p < 0.0002 for both clusters, cluster size corrected) and in a left temporal cluster involving the superior, middle, and inferior temporal gyrus (p = 0.006, cluster size corrected). No group differences in cortical surface area were found. No significant effect of medication, mood state, illness duration, or family history of bipolar disorders on cortical thinning was observed.
  
  
  CONCLUSIONS
  These results indicate that BD-II is associated with thinning of prefrontal and temporal cortices implicated in the expression and regulation of negative and positive affect. Longitudinal studies are needed to clarify whether cortical thinning is a stable trait of BD-II, an illness effect that might progress during the course of the disease, or a combination of the two.
authors: Department of Psychosomatic Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
authors: Torbjørn
authors: T
authors: Elvsåshagen
authors: Lars T
authors: LT
authors: Westlye
authors: Erlend
authors: E
authors: Bøen
authors: Per K
authors: PK
authors: Hol
authors: Ole A
authors: OA
authors: Andreassen
authors: Birgitte
authors: B
authors: Boye
authors: Ulrik F
authors: UF
authors: Malt
mesh_terms: D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000473:pathology*; D001931:Brain Mapping; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D017397:Prefrontal Cortex / Q000473:pathology*; D011569:Psychiatric Status Rating Scales; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013702:Temporal Lobe / Q000473:pathology*; D055815:Young Adult
keywords: bipolar II disorder; cortical surface area; cortical thickness; cortical thinning; prefrontal cortex; temporal cortex