Regional brain gray matter volume differences in patients with bipolar disorder as assessed by optimized voxel-based morphometry

Department of Neuroscience, New York State Psychiatric Institute, New York, New York 10032, USA.
Biological Psychiatry (Impact Factor: 10.26). 07/2004; 55(12):1154-62. DOI: 10.1016/j.biopsych.2004.02.026
Source: PubMed


Structural magnetic resonance imaging (MRI) studies of regions of interest in brain have been inconsistent in demonstrating volumetric differences in subjects with bipolar disorder (BD). Voxel-based morphometry (VBM) provides an unbiased survey of the brain, can identify novel brain areas, and validates previously hypothesized regions. We conducted both optimized VBM, comparing MRI gray matter volume, and traditional VBM, comparing MRI gray matter density, in 11 BD subjects and 31 healthy volunteers. To our knowledge, these are the first VBM analyses of BD.
Segmented MRI gray matter images were normalized into standardized stereotactic space, modulated to allow volumetric analysis (optimized only), smoothed, and compared at the voxel level with statistical parametric mapping.
Optimized VBM showed that BD subjects had smaller volume in left ventromedial temporal cortex and bilateral cingulate cortex and larger volume in left insular/frontoparietal operculum cortex and left ventral occipitotemporal cortex. Traditional VBM showed that BD subjects had less gray matter density in left ventromedial temporal cortex and greater gray matter density in left insular/frontoparietal operculum cortex and bilateral thalamic cortex. Exploratory analyses suggest that these abnormalities might differ according to gender.
Bipolar disorder is associated with volumetric and gray matter density changes that involve brain regions hypothesized to influence mood.

  • Source
    • "The second finding of this study was that BD patients had reduced GM volumes in the bilateral thalamus compared with HC, and this finding was also present after controlling for possible confounding effects of age and gender. This result is consistent with some (Dasari et al., 1999; McIntosh et al., 2004; Frazier et al., 2005; Hallahan et al., 2011), but not all structural neuroimaging studies in BD (Dupont et al., 1995; Strakowski et al., 1999; Caetano et al., 2001; Strakowski et al., 2002; Lochhead et al., 2004; McDonald et al., 2005; Adler et al., 2007; Ivleva et al., 2013; Amann et al., 2015). The thalamus is a difficult structure to study using neuroimaging techniques, due to the heterogeneity of its nuclei and the difficulty in isolating the subthalamic nuclei with the most relevant connections with other fronto-limbic areas (Blond et al., 2012). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Bipolar disorder (BD) is highly heritable. First-degree relatives of BD patient have an increased risk to develop the disease. We investigated abnormalities in gray matter (GM) volumes in healthy first-degree relatives of BD patients to identify possible brain structural endophenotypes for the disorder. 3D T1-weighted magnetic resonance images were obtained from 25 DSM-IV BD type I patients, 23 unaffected relatives, and 27 healthy controls (HC). A voxel-based morphometry protocol was used to compare differences in GM volumes between groups. BD patients presented reduced GM volumes bilaterally in the thalamus compared with HC. Relatives presented no global or regional GM differences compared with HC. Our negative results do not support the role of GM volume abnormalities as endophenotypes for BD. Thalamic volume abnormalities may be associated the pathophysiology of the disease.
    Full-text · Article · Sep 2015 · Psychiatry Research: Neuroimaging
    • "Another VBM study reported greater GM density in the ACC of bipolar patients than in controls and lithium-treated patients showed significantly greater GM density in the right ACC than patients not-taking lithium (Bearden et al., 2007). Decreased (Atmaca et al., 2007; Chiu et al., 2008; Kaur et al., 2005; Lochhead et al., 2004; Lyoo et al., 2004) or unchanged (Biederman et al., 2008; Brambilla et al., 2002; Zimmerman et al., 2006) GM density/volume in the ACC of bipolar patients have also been reported. Although an association between GM deficits in the right ACC and the genetic risk for bipolar disorder has been reported in one high-risk design MRI study using a quantitative measure of genetic liability and computational morphometric techniques (McDonald et al., 2004), we did not replicate this finding in our sample using VBM. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Bipolar disorder (BD) is a highly heritable mental illness which is associated with neuroanatomical abnormalities. Investigating healthy individuals at high genetic risk for bipolar disorder may help to identify neuroanatomical markers of risk and resilience without the confounding effects of burden of illness or medication. Structural magnetic resonance imaging scans were acquired from 30 euthymic patients with BD-I (BP), 28 healthy first degree relatives of BD-I patients (HR), and 30 healthy controls (HC). Data was analyzed using DARTEL for voxel based morphometry in SPM8. Whole-brain analysis revealed a significant main effect of group in the gray matter volume in bilateral inferior frontal gyrus, left parahippocampal gyrus, left lingual gyrus and cerebellum, posterior cingulate gyrus, and supramarginal gyrus (alphasim corrected (≤0.05 FWE)). Post-hoc t-tests showed that inferior frontal gyrus volumes were bilaterally larger both in BP and HR than in HC. BP and HR also had smaller cerebellar volume compared with HC. In addition, BP had smaller left lingual gyrus volume, whereas HR had larger left parahippocampal and supramarginal gyrus volume compared with HC. This study was cross-sectional and the sample size was not large. All bipolar patients were on medication, therefore we were not able to exclude medication effects in bipolar group in this study. Our findings suggest that increased inferior frontal gyrus and decreased cerebellar volumes might be associated with genetic predisposition for bipolar disorder. Longitudinal studies are needed to better understand the predictive and prognostic value of structural changes in these regions. Copyright © 2015 Elsevier B.V. All rights reserved.
    No preview · Article · Jul 2015 · Journal of Affective Disorders
  • Source
    • "Matsuo et al. (2012) reported reduced left anterior insular gray matter volumes in BD type I patients and their unaffected first degree relatives. Lochhead et al. (2004) reported larger volumes in the left insular cortex of 11 BD patients compared with 31 healthy volunteers using optimized voxel-based morphometry (VBM). Takahashi et al. (2010) "
    [Show abstract] [Hide abstract]
    ABSTRACT: Bipolar depression (BD) is a common psychiatric illness characterized by deficits in emotional and cognitive processing. Abnormalities in the subregions of the insula are common findings in neuroanatomical studies of patients with bipolar disorder. However, the specific relationships between morphometric changes in specific insular subregions and the pathogenesis of BD are not clear. In this study, structural magnetic resonance imaging (MRI) was used to investigate gray matter volume abnormalities in the insular subregion in 27 patients with BD and in 27 age and sex-matched controls. Using DARTEL (diffeomorphic anatomical registration through exponentiated lie algebra) for voxel-based morphometry (VBM), we examined changes in regional gray matter volumes of the insula in patients with BD. As compared with healthy controls, the BD patients showed decreased gray matter volumes in the right posterior insula and left ventral anterior insula and increased gray matter volumes in the left dorsal anterior insula. Consistent with the emerging theory of insular interference as a contributor to emotional-cognitive dysregulation, the current findings suggest that the insular cortex may be involved in the neural substrates of BD.
    Full-text · Article · Aug 2014 · Psychiatry Research: Neuroimaging
Show more