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Cortical abnormalities in bipolar disorder: An MRI analysis of 6,503 individuals from the ENIGMA-Bipolar Disorder Working Group

Andreassen, Ole A, Hibar, Derrek P, Westlye, Lars T and Caseras, Xavier 2017. Cortical abnormalities in bipolar disorder: An MRI analysis of 6,503 individuals from the ENIGMA-Bipolar Disorder Working Group. Molecular Psychiatry 23 , pp. 932-942. 10.1038/mp.2017.73

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Despite decades of research, the pathophysiology of bipolar disorder (BD) is still not well understood. Structural brain differences have been associated with BD, but results from neuroimaging studies have been inconsistent. To address this, we performed the largest study to date of cortical gray matter thickness and surface area measures from brain MRI scans of 6,503 individuals including 1,837 unrelated adults with BD and 2,582 unrelated healthy controls for group differences while also examining the effects of commonly prescribed medications, age of illness onset, history of psychosis, mood state, age and sex differences on cortical regions. In BD, cortical gray matter was thinner in frontal, temporal and parietal regions of both brain hemispheres. BD had the strongest effects on left pars opercularis (Cohen’s d = -0.293; P = 1.71x10-21), left fusiform gyrus (d = -0.288; P = 8.25x10-21), and left rostral middle frontal cortex (d = -0.276; P = 2.99x10-19). Longer duration of illness (after accounting for age at time of scanning) was associated with reduced cortical thickness in frontal, medial parietal, and occipital regions. We found that several commonly prescribed medications, including lithium, antiepileptic, and antipsychotic treatment showed significant associations with cortical thickness and surface area, even after accounting for patients who received multiple medications. Further, we did not detect cortical differences associated with a history of psychosis or mood state at the time of scanning. Our analysis revealed previously undetected associations and provides an extensive analysis of potential confounding variables in neuroimaging studies of BD.

Item Type: Article
Date Type: Published Online
Status: Published
Schools: Medicine
MRC Centre for Neuropsychiatric Genetics and Genomics (CNGG)
Subjects: R Medicine > R Medicine (General)
Uncontrolled Keywords: bipolar disorder, cortical thickness and surface area, subtype diagnosis, lithium, antiepileptics, antipsychotics
Publisher: Nature Publishing Group: Open Access Hybrid Model Option B
ISSN: 1359-4184
Date of First Compliant Deposit: 1 March 2017
Date of Acceptance: 10 February 2017
Last Modified: 02 Aug 2018 14:01

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