title: The influence of lithium on hippocampal volume in elderly bipolar patients: a study using voxel-based morphometry.
abstract: Recent studies have demonstrated that lithium (Li) exerts neuronal protective and regenerative effects both in vitro and in vivo. However, the effects of long-term Li treatment in the brain areas associated with memory impairment of elderly bipolar patients are still unknown. The aim of this study was to compare the hippocampal volumes of elderly bipolar patients using Li, elderly bipolar patients not using Li and healthy controls. Sociodemographic, clinical and magnetic resonance imaging data from 30 elderly euthymic bipolar patients who had been using Li for an average of >61 months; 27 elderly euthymic bipolar patients not taking Li for an average of 45 months; and 22 elderly healthy controls were analyzed. Volumetric differences in the hippocampus between groups were investigated with voxel-based morphometry (VBM) based on the Statistical Parametric Mapping technique. No statistical differences in sociodemographic and clinical characteristics and course of bipolar disorder between the two bipolar groups were observed. Using small volume correction in the VBM analysis (analysis of variance (ANOVA)), one voxel cluster of statistical significance was detected in the left hippocampus (P<0.05 corrected for multiple comparisons, extent threshold >10 voxels). Post hoc unpaired t-tests revealed increased left hippocampal volume in the Li-treated group compared with the non-Li-treated group, and decreased left hippocampal volume in the non-Li group relative to controls. Additional exploratory two-group comparisons indicated trends toward reduced right-hippocampal volumes in the non-Li-treated group relative to both the Li-treated group and controls. The findings suggested that the use of Li may influence the volume of the hippocampus, possibly due to its neuroprotective effects.
authors.affiliation: Department of Psychiatry, University of Sao Paulo Medical School (LIM-21 and LIM-23), Sao Paulo, Brazil.
authors.forename: S
authors.initials: S
authors.lastname: Zung
authors.affiliation: Department of Psychiatry, University of Sao Paulo Medical School (LIM-21 and LIM-23), Sao Paulo, Brazil.
authors.forename: F L
authors.initials: FL
authors.lastname: Souza-Duran
authors.affiliation: Department of Psychiatry, University of Sao Paulo Medical School (LIM-21 and LIM-23), Sao Paulo, Brazil.
authors.forename: M G
authors.initials: MG
authors.lastname: Soeiro-de-Souza
authors.affiliation: Department of Psychiatry, University of Sao Paulo Medical School (LIM-21 and LIM-23), Sao Paulo, Brazil.
authors.forename: R
authors.initials: R
authors.lastname: Uchida
authors.affiliation: Department of Psychiatry, University of Sao Paulo Medical School (LIM-21 and LIM-23), Sao Paulo, Brazil.
authors.forename: C M
authors.initials: CM
authors.lastname: Bottino
authors.affiliation: Department of Psychiatry, University of Sao Paulo Medical School (LIM-21 and LIM-23), Sao Paulo, Brazil.
authors.forename: G F
authors.initials: GF
authors.lastname: Busatto
authors.affiliation: Department of Psychiatry, University of Sao Paulo Medical School (LIM-21 and LIM-23), Sao Paulo, Brazil.
authors.forename: H
authors.identifier: 0000-0001-5123-8295
authors.initials: H
authors.lastname: Vallada
mesh_terms: D000367:Age Factors; D000368:Aged; D001714:Bipolar Disorder / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D016022:Case-Control Studies; D004292:Dominance, Cerebral / Q000187:drug effects; D005260:Female; D006624:Hippocampus / Q000000981:diagnostic imaging* / Q000187:drug effects*; D006801:Humans; D016651:Lithium Carbonate / Q000009:adverse effects* / Q000627:therapeutic use*; D008134:Long-Term Care; D008279:Magnetic Resonance Imaging; D008297:Male; D008568:Memory / Q000187:drug effects; D008875:Middle Aged; D018696:Neuroprotective Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D009929:Organ Size / Q000187:drug effects*; D013702:Temporal Lobe / Q000000981:diagnostic imaging / Q000187:drug effects
chemical_list: D018696:Neuroprotective Agents; D016651:Lithium Carbonate