Original articleRegional brain gray matter volume differences in patients with bipolar disorder as assessed by optimized voxel-based morphometry
Section snippets
Subjects
Subjects were referred from an outside clinic or responded to an advertisement. They were assessed by clinical history, chart review, Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) (First et al 1995), review of systems, physical examination, routine blood tests, pregnancy test, and urine toxicology. Study entrance criteria for BD subjects included 1) age 18–65 years; 2) DSM-IV criteria for BD; 3) absence of lifetime history of alcohol or substance abuse or dependence; 4)
Optimized VBM: volumetric differences in BD sbjects
Optimized VBM analyses showed that BD subjects had smaller volumes in cingulate bilaterally (x = 0, y = 27, z = 21 through x = −3, y = −8, z = 45; Z = 4.28, pcorrected = .003) and left ventromedial temporal cortex (x = −20, y = −21, z = −21; Z = 5.08, pcorrected < .001) (Figure 1, Table 2) when compared with healthy volunteers. Larger volumes in BD subjects were seen in left insular/frontoparietal cortex (x = −45, y = −18, z = 28; Z = 5.47, pcorrected = .028) (Figure 2, Table 2) and left
Neuroanatomical differences in BD subjects compared with healthy volunteers
Previous structural MRI studies in BD subjects have been inconsistent. Generally, BD subjects have smaller PFC structures, larger amygdala, and possibly larger basal ganglia structures. Other temporal lobe structures have failed to show consistent volumetric change (for a summary see Table 1). It has been proposed that neuroanatomical abnormalities in limbic structures might represent a disruption in limbic circuitry and a consequent predisposition for depression, mania, and/or cycling
Acknowledgements
Funding was provided by The Stanley Medical Research Institute, American Foundation for Suicide Prevention, U.S. Public Health Service grants National Institute of Mental Health P30 MH46745 and MH40695, and the National Alliance for Research on Schizophrenia and Depression.
We thank the staff of the Brain Imaging Division, and the Department of Neuroscience.
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