Regional cerebral cortical thinning in bipolar disorder. Bipolar Disord 8:65-74

McLean Hospital Brain Imaging Center, Harvarrd Medical School, Boston, MA, USA.
Bipolar Disorders (Impact Factor: 4.97). 03/2006; 8(1):65-74. DOI: 10.1111/j.1399-5618.2006.00284.x
Source: PubMed


This study was conducted to explore differences in cortical thickness between subjects with bipolar disorder and healthy comparison subjects using cortical surface-based analysis.
Brain magnetic resonance images were acquired from 25 subjects with bipolar disorder and 21 healthy comparison subjects. Cortical surface-based analysis was conducted using the Freesurfer application. Group differences in cortical thickness, defined by the distance from gray/white boundary to the pial surface, were assessed using statistical difference maps.
Subjects with bipolar disorder exhibited significantly decreased cortical thickness in left cingulate cortex, left middle frontal cortex, left middle occipital cortex, right medial frontal cortex, right angular cortex, right fusiform cortex and bilateral postcentral cortices, relative to healthy comparison subjects (all p < 0.001). Duration of illness in bipolar subjects was inversely correlated with the cortical thickness of the left middle frontal cortex.
Cortical thinning was present in multiple prefrontal cortices in bipolar disorder. There was also cortical thinning in sensory and sensory association cortices, which has not been reported in previous studies using region-of-interest or voxel-based morphometry methods. Cortical thinning observed in the current study may be related to impairment of emotional, cognitive, and sensory processing in bipolar disorder but longitudinal studies will be necessary to test this hypothesis.

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    • "The finding of fewer degrees of the inferior occipital regions is consistent with the observation of deficits in processing speed and visual–spatial memory in the UHR offspring. This observation seems to support the notion that abnormalities of the occipital region may be related to the impairments of cognitive function in BP (Fears et al., 2015; Lyoo et al., 2006). Additionally, it is possible that the involvement of the inferior occipital region reflects the high vulnerability to developing severe forms of bipolar disorder because the abnormalities of this site are relatively common in psychotic bipolar disorder, schizoaffective disorder, (Ivleva et al., 2013), and poor-outcome BP (Bonne et al., 1996). "
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    • "Findings, however, have been largely inconsistent across studies. Some studies with samples consisting of bipolar patients with mixed lithium usage show significantly thinner cortices in the left rostral and right dorsal paracingulate cortex (Fornito et al., 2008) and other studies demonstrate more widespread differences in cortical thickness when compared to healthy controls (Lyoo et al., 2006). It has also been found that relative to healthy control subjects, currently euthymic lithium-free patients with bipolar disorder have significantly thinner gray matter in bilateral prefrontal cortex and the left anterior cingulate cortex, a finding that was more pronounced in patients with a history of psychosis (Foland-Ross, 2011). "
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    • "To note, these abnormalities have mostly been described in the sub-genual ACC, which is regarded as a central node of the FFFS (Pearlson, 1999; Fountoulakis , 2008; Sanches et al., 2008). In a similar manner, reduced gray matter volumes have been found in BD in several prefrontal cortices (PFC), spanning more than one motivation subsystem, including ventro-medial PFC for BIS (Doris et al., 2004; Lyoo et al., 2004), dorso-medial PFC for BAS (Locke and Braver, 2008) and Orbito Frontal Cortex (OFC; Haznedar et al., 2005; Lyoo et al., 2006), a region which some relate to BAS (Depue and Collins, 1999). Interestingly, Diffusion Tensor Imaging (DTI) analysis further demonstrated reduced integrity of white matter tracts in OFC (Beyer et al., 2005). "
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