title: Neural correlates of delusion in bipolar depression.
abstract: Approximately one-half of all patients affected by bipolar disorder present psychotic features at least in one occasion. This factor worsens the personal and social burden of the disease. Several studies find an altered brain activity in mesolimbic and prefrontal regions in relation to aberrant attribution of salience to stimuli in delusional patients. The aim of the present study is to investigate gray matter (GM) structural correlates of the past history of delusions in a sample of bipolar patients. The sample includes 34 delusional and 39 non-delusional bipolar patients. Brain-imaging volumetric sequences were acquired on a 3.0 T scanner. Voxel based morphometry (VBM) was performed comparing delusional and non-delusional patients. VBM analysis found significant (p=0.001) differences in prefrontal areas and in the insula where delusional patients show lower GM volume compared to non-delusional patients. The main finding of the present study is a reduction of gray matter volume in the dorsolateral prefrontal cortex and in the insula of delusional patients. This result supports the hypothesis of abnormalities in salience and executive-control networks of delusional patients, which could be associated with an aberrant assignment of salience to the elements of one's own experience that is linked to delusion and psychotic symptoms.
authors.affiliation: Department of Clinical Neurosciences, Scientific Institute, University Vita-Salute San Raffaele, Milan, Italy; Centro di Eccellenza Risonanza Magnetica ad Alto Campo (C.E.R.M.A.C.), University Vita-Salute San Raffaele, Milan, Italy. Electronic address: radaelli.daniele@hsr.it.
authors.forename: Daniele
authors.initials: D
authors.lastname: Radaelli
authors.affiliation: Department of Clinical Neurosciences, Scientific Institute, University Vita-Salute San Raffaele, Milan, Italy; Centro di Eccellenza Risonanza Magnetica ad Alto Campo (C.E.R.M.A.C.), University Vita-Salute San Raffaele, Milan, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Poletti
authors.affiliation: Department of Clinical Neurosciences, Scientific Institute, University Vita-Salute San Raffaele, Milan, Italy.
authors.forename: Irene
authors.initials: I
authors.lastname: Gorni
authors.affiliation: Department of Clinical Neurosciences, Scientific Institute, University Vita-Salute San Raffaele, Milan, Italy; Centro di Eccellenza Risonanza Magnetica ad Alto Campo (C.E.R.M.A.C.), University Vita-Salute San Raffaele, Milan, Italy.
authors.forename: Clara
authors.initials: C
authors.lastname: Locatelli
authors.affiliation: Department of Clinical Neurosciences, Scientific Institute, University Vita-Salute San Raffaele, Milan, Italy; Centro di Eccellenza Risonanza Magnetica ad Alto Campo (C.E.R.M.A.C.), University Vita-Salute San Raffaele, Milan, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Smeraldi
authors.affiliation: Department of Clinical Neurosciences, Scientific Institute, University Vita-Salute San Raffaele, Milan, Italy; Centro di Eccellenza Risonanza Magnetica ad Alto Campo (C.E.R.M.A.C.), University Vita-Salute San Raffaele, Milan, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Colombo
authors.affiliation: Department of Clinical Neurosciences, Scientific Institute, University Vita-Salute San Raffaele, Milan, Italy; Centro di Eccellenza Risonanza Magnetica ad Alto Campo (C.E.R.M.A.C.), University Vita-Salute San Raffaele, Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Benedetti
mesh_terms: D000328:Adult; D001931:Brain Mapping; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000473:pathology*; D003702:Delusions / Q000473:pathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009929:Organ Size / Q000502:physiology; D017397:Prefrontal Cortex / Q000473:pathology*; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index
keywords: Bipolar disorder; Delusion; Salience; Voxel based morphometry