Structural correlates of creative thinking in patients with bipolar disorder and healthy controls-a voxel-based morphometry study.
This study investigated the structural correlates of creative thinking in patients with bipolar disorder (BD) to understand the possible neural mechanism of creative thinking in BD.



We recruited 59 patients with BD I or BD II (35.3±8.5 y) and 56 age- and sex-matched controls (HCs; 34±7.4 y). Each participant underwent structural magnetic resonance imaging and evaluation of creative thinking, which was assessed using two validated tools: the Chinese version of the Abbreviated Torrance Test for Adults for divergent thinking and the Chinese Word Remote Associates Test for remote association. Voxel-based morphometry was performed using SPM12.



In patients with BD, divergent thinking positively correlated with the gray matter volume (GMV) in right medial frontal gyrus (Brodmann area [BA] 9), and remote association positively correlated with the GMV in the medial prefrontal gyrus (BA 10). In the HCs, divergent thinking negatively correlated with the GMV in left superior frontal gyrus (BA 8) and positively correlated with the GMV in the precuneus and occipital regions, and remote association positively correlated with the GMV in the hippocampus.



Patients with BD were receiving various dosages of antipsychotics, antidepressants and mood stabilizer. These medications may confound the GMV-creative thinking relationship in patients with BD.



Our findings indicate that medial prefrontal cortex plays a major and positive role in creative thinking in patients with BD. By contrary, creative thinking involves more diverse structures, and the prefrontal cortex may have an opposite effect in HCs.
Department of Medical Research, Taipei Veterans General Hospital, Taipei 112, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, Taipei 112, Taiwan; Institute of Philosophy of Mind and Cognition, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.
Pei-Chi
PC
Tu
Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.
Yi-Hsuan
YH
Kuan
Department of Psychiatry, Taipei Veterans General Hospital, Taipei 112, Taiwan; Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.
Cheng-Ta
CT
Li
Department of Psychiatry, Taipei Veterans General Hospital, Taipei 112, Taiwan; Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan. Electronic address: tomsu0402@gmail.com.
Tung-Ping
TP
Su
D000328:Adult; D001714:Bipolar Disorder / Q000473:pathology / Q000523:psychology*; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000033:anatomy & histology*; D003405:Creativity; D005260:Female; D066128:Gray Matter / Q000033:anatomy & histology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009929:Organ Size; D017397:Prefrontal Cortex / Q000033:anatomy & histology; D013850:Thinking
Bipolar disorder; Creative thinking; GMV; The abbreviated torrance test for adults; The chinese word remote associates test; Voxel-based morphometry