title: Effects of lithium on cortical thickness and hippocampal subfield volumes in psychotic bipolar disorder.
abstract: Relative to healthy controls, lithium free bipolar patients exhibit significant gray matter abnormalities. Lithium, the long-time reference standard medication treatment for bipolar disorder, has been proposed to be neuro-protective against these abnormalities. However, its effects on cortical thickness and hippocampal subfield (HSF) volumes remain unstudied and unclear, respectively, in bipolar disorder. This study included 342 healthy controls (HC), 51 lithium free PBD patients (NoLi), and 51 PBD patients taking lithium (Li). Regional gray matter thickness and HSF volume values were extracted from 3T MRI images. After matching NoLi and Li samples, regions where HC differed from either Li or NoLi were identified. In regions of significant or trending HC-NoLi difference, Li-NoLi comparisons were made. No significant HC-Li thickness or HSF volume differences were found. Significantly thinner occipital cortices were observed in NoLi compared to HC. In these regions, Li consistently exhibited non-significant trends for greater cortical thickness relative to NoLi. Significantly less volume was observed in NoLi compared to both HC and Li in right HSFs. Our results suggest that PBD in patients not treated with Li is associated with thinner occipital cortices and reduced HSF volumes compared with HC. Patients treated with Li exhibited significantly larger HSF volumes than NoLi, and those treated with Li were no different from HC in cortical thickness or hippocampal volumes. This evidence directly supports the hypothesis that Li may counteract the locally thinner and smaller gray matter structure found in PBD.
authors.affiliation: Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Harvard South Shore Psychiatry Residency Program, Harvard Medical School, Brockton, MA, USA.
authors.forename: C I
authors.initials: CI
authors.lastname: Giakoumatos
authors.affiliation: Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; College of Physicians & Surgeons, Columbia University Medical Center, New York, NY, USA.
authors.forename: P
authors.initials: P
authors.lastname: Nanda
authors.affiliation: Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA.
authors.forename: I T
authors.initials: IT
authors.lastname: Mathew
authors.affiliation: Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Baylor College of Medicine, Texas Medical Center, Houston, TX, USA.
authors.forename: N
authors.initials: N
authors.lastname: Tandon
authors.affiliation: Program for Prevention and Early Intervention for Psychosis, Douglas Mental Health University Institute, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Shah
authors.affiliation: Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN, USA.
authors.forename: J R
authors.initials: JR
authors.lastname: Bishop
authors.affiliation: Department of Psychology, BioImaging Research Center, University of Georgia, Athens, GA, USA; Department of Neuroscience, BioImaging Research Center, University of Georgia, Athens, GA, USA.
authors.forename: B A
authors.initials: BA
authors.lastname: Clementz
authors.affiliation: Olin Neuropsychiatry Research Center, Institute of Living, Hartford, CT, USA; Departments of Psychiatry and Neurobiology, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: G D
authors.initials: GD
authors.lastname: Pearlson
authors.affiliation: Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Sweeney
authors.affiliation: Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Tamminga
authors.affiliation: Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA. Electronic address: mkeshava@bidmc.harvard.edu.
authors.forename: M S
authors.initials: MS
authors.lastname: Keshavan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018692:Antimanic Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy / Q000473:pathology*; D002540:Cerebral Cortex / Q000187:drug effects* / Q000473:pathology; D005260:Female; D006624:Hippocampus / Q000187:drug effects* / Q000473:pathology; D006801:Humans; D018020:Lithium Compounds / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D018692:Antimanic Agents; D018020:Lithium Compounds
keywords: Bipolar disorder; Cortical thickness; Hippocampus; Lithium; MRI; Neuro-protective