Normal pituitary volumes in children and adolescents with bipolar disorder: A magnetic resonance imaging study

Department of Radiology, The University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229, USA.
Depression and Anxiety (Impact Factor: 4.41). 01/2004; 20(4):182-6. DOI: 10.1002/da.20044
Source: PubMed


The volume of the pituitary gland in adults with bipolar disorder has previously been reported to be smaller than that of healthy controls. Such abnormalities would be consistent with the HPA dysfunction reported in this illness. We conducted a study of children and adolescents with bipolar disorder to determine whether size abnormalities in the pituitary gland are already present early in illness course. Magnetic resonance imaging (MRI) morphometric analysis of the pituitary gland was carried out in 16 DSM-IV children and adolescents with bipolar disorder (mean age+/-sd=15.5+/-3.4 years) and 21 healthy controls (mean age+/-sd=16.9+/-3.8 years). Subjects underwent a 1.5 T MRI, with 3-D Spoiled Gradient Recalled (SPGR) acquisition. There was no statistically significant difference between pituitary gland volumes of bipolar patients compared to healthy controls (ANCOVA, age, gender, and ICV as covariates; F=1.77, df=1,32, P=.19). There was a statistically significant direct relationship between age and pituitary gland volume in both groups (r=.59, df=17, P=.007 for healthy controls; r=.61, df=12, P=.008 for bipolar patients). No evidence of size abnormalities in the pituitary gland was found in child and adolescent bipolar patients, contrary to reports involving adult bipolar patients. This suggests that anatomical abnormalities in this structure may develop later in illness course as a result of continued HPA dysfunction.

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Available from: Paolo Brambilla, May 18, 2015
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    • "In the study of [32] enlargement of the pituitary gland in unipolar depression was reported. In other studies no differences were found between unipolar depressed young patients [31] and healthy control subjects, as well as no change was observed during seasonal depression [35]. The study of [35] did not show influence of affective status on pituitary size whereas [33] "
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    ABSTRACT: Therapeutic effects of Interferon-α (IFN-α are known to be associated with CNS toxicity in humans, and in particular with depression symptoms. Animal models of IFN-α-induced depression (sickness behaviour) have been developed in rodents using various preparations, dosing schedules or routes of administrations. In this work, Manganese Enhanced MRI (MEMRI) has been applied to investigate an experimental model of sickness behaviour induced by administration of IFN-α in rats. IFN-α (3.105 units/kg), or vehicle, was daily administered i.p., for 7 days in rats (n=20 IFN-α treated and n=20 controls). After treatment, animals were assigned to behavioural (n=10 treated, n=10 control) or MRI (n=10 treated and n=10 control) studies. Animals assigned to the MRI study received two repeated i.p. injections of MnCl2, before image acquisition. Images were acquired at 4.7T using T1 mapping for determination of Mn concentration in brain. After co-registration of T1 maps to a digital brain atlas, differences between brains of treated and untreated animals were assessed pixel-to-pixel by statistical analysis. Behavioural tests showed alterations in freezing and struggling parameters, as expected in an experimental model of sickness behaviour. MRI showed a well defined brain region, mainly contained in the visual cortex, in which Mn uptake was significantly lower in treated than in control animals, indicating probably altered functionality. No significant difference was detected in other brain regions. In addition, a statistically significant decrease in the volume of the pituitary gland, paralleled by a slight increase in its Mn content, was detected in treated animals. MEMRI provides both morphological and functional information in the brain of small laboratory animals and can constitute a valuable tool in the investigation of experimental models of psychiatric diseases.
    Magnetic Resonance Imaging 06/2014; 32(5). DOI:10.1016/j.mri.2014.02.006 · 2.09 Impact Factor
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    • "Specifically, in established bipolar disorder, pituitary volumes have been shown to be abnormally small in adult patients (Sassi et al., 2001) and normal in children and adolescents (Chen et al., 2004). Also, the pituitary gland was normal in size in adult subjects with recurrent unipolar disorder (Sassi et al., 2001) and abnormally large in adolescents with depression (MacMaster and Kusumakar, 2004). "
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    ABSTRACT: Pituitary volumes were shown to be abnormally large in pre- or first-psychotic episode patients and abnormally reduced in established schizophrenia by magnetic resonance imaging (MRI) studies. We present here the results of the second ever published MRI study exploring pituitary size in a large population of patients with chronic schizophrenia recruited from the geographically defined catchment area of South Verona, Italy. No significant differences for pituitary volumes were reported between 65 subjects with chronic schizophrenia and 65 normal individuals (mean age+/-S.D.=42.31+/-11.44 and 40.54+/-11.12 years). In contrast to Pariante et al. (2004), normal pituitary size was found in our population of chronic schizophrenia. Discrepancies between these two studies may partially be accounted by sample age and gender. Considering increased pituitary volumes in pre- or first-psychotic episode patients, we put forward the hypothesis that pituitary size may normalize or reduce with the progression of the illness as a result of reduced numbers of acute episodes and consequent diminished hypothalamus-pituitary-adrenal axis activity. To better test this hypothesis, future large MRI studies should investigate pituitary volumes in chronic schizophrenia longitudinally, also collecting pituitary hormones and cortisol, and comparing the effects of typical and atypical antipsychotics on pituitary size in a randomized trial.
    Psychiatry Research 02/2007; 154(1):41-8. DOI:10.1016/j.pscychresns.2006.04.004 · 2.47 Impact Factor
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    • "ganglia 1 gray matter volume in basal ganglia, thalamus and left temporal lobe. 2 medial temporal lobe, orbito-frontal cortex and anterior cingulate. Chen et al (2004b) 16 BD (14 euthymic ϩ "
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    ABSTRACT: Advances in brain imaging techniques and cognitive neuropsychology have brought new possibilities for the in vivo study of the pathophysiology of neuropsychiatric disorders, including bipolar disorder (BD). Recently, such studies have been extended to the pediatric age range. Here we review the neuroimaging and neuropsychological studies conducted in BD children and adolescents. A review of the peer-reviewed published literature was conducted in Medline for the period of 1966 to April 2005. Magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) studies suggest abnormalities in fronto-limbic structures in pediatric BD patients, similar to those found in adults. A notable exception in pediatric BD patients is smaller amygdala volumes compared to healthy controls, contrary to what has been reported in most adult studies. Further research evaluating children and adolescents is needed to study the normal neurodevelopmental process and to answer how and when the illness processes that result in bipolar disorder exert their effects on the developing brain.
    Biological Psychiatry 11/2005; 58(7):525-31. DOI:10.1016/j.biopsych.2005.04.027 · 10.26 Impact Factor
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