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Springer Nature [academic journals on nature.com], Molecular Psychiatry, 12(21), p. 1710-1716, 2016

DOI: 10.1038/mp.2015.227

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Subcortical volumetric abnormalities in bipolar disorder

Journal article published in 2016 by Tgm G. M. van Erp, Nem E. M. van Haren, Lt T. Westlye ORCID, T. G. M. Van Erp, Dp P. Hibar, Cd D. Leonardo, Uk K. Haukvik ORCID, J. Rasmussen, Cb B. Hartberg, Nt T. Doan, Hibar Dp, J. Faskowitz, Am M. Dale, Westlye Lt, van Erp Tg and other authors.
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

Considerable uncertainty exists about the defining brain changes associated with bipolar disorder (BD). Understanding and quantifying the sources of uncertainty can help generate novel clinical hypotheses about etiology and assist in the development of biomarkers for indexing disease progression and prognosis. Here we were interested in quantifying case-control differences in intracranial volume (ICV) and each of eight subcortical brain measures: nucleus accumbens, amygdala, caudate, hippocampus, globus pallidus, putamen, thalamus, lateral ventricles. In a large study of 1710 BD patients and 2594 healthy controls, we found consistent volumetric reductions in BD patients for mean hippocampus (Cohen's d=-0.232; P=3.50 × 10 -7) and thalamus (d=-0.148; P=4.27 × 10 -3) and enlarged lateral ventricles (d=-0.260; P=3.93 × 10 -5) in patients. No significant effect of age at illness onset was detected. Stratifying patients based on clinical subtype (BD type I or type II) revealed that BDI patients had significantly larger lateral ventricles and smaller hippocampus and amygdala than controls. However, when comparing BDI and BDII patients directly, we did not detect any significant differences in brain volume. This likely represents similar etiology between BD subtype classifications. Exploratory analyses revealed significantly larger thalamic volumes in patients taking lithium compared with patients not taking lithium. We detected no significant differences between BDII patients and controls in the largest such comparison to date. Findings in this study should be interpreted with caution and with careful consideration of the limitations inherent to meta-analyzed neuroimaging comparisons.