Neuroprogressive effects of lifetime illness duration in older adults with bipolar disorder.
OBJECTIVE
The aim of the present study was to examine the long-term effects of bipolar disorder (BD) on brain structure (gray matter volumes).


METHODS
Fifty-four adults with BD [mean (standard deviation) age = 64.4 (5.4) years] underwent brain MR imaging along with comprehensive clinical assessment. Total gray matter, hippocampal, and amygdala volumes were extracted using methods developed through the Geriatric Neuroimaging Laboratory at the University of Pittsburgh (Pittsburgh, PA, USA).


RESULTS
Lower total gray matter volumes were related to longer duration of BD, even when controlling for current age and cerebrovascular accident (CVA) risk/burden. Additionally, longer exposure to antipsychotic medication was related to lower gray matter volumes. Lower hippocampal volumes were related to total years of antipsychotic agent exposure and CVA risk/burden scores. Older age was related to lower total gray matter, hippocampal, and amgydala volumes.


CONCLUSIONS
Our study of older adults with BD supports the understanding that BD is a neuroprogressive disorder with a longer duration of illness and more antipsychotic agent exposure related to lower gray matter volume.
Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Ariel G
AG
Gildengers
Kuo-Hsuan
KH
Chung
Shou-Hung
SH
Huang
Amy
A
Begley
Howard J
HJ
Aizenstein
Shang-Ying
SY
Tsai
D000368:Aged; D001714:Bipolar Disorder / Q000473:pathology*; D001921:Brain / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D066128:Gray Matter / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis
amygdala; bipolar disorder; brain; hippocampus; lithium; neuroimaging; neuroprogression