This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (244)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Bipolar Disorder  • Magnetic Resonance Imaging  • Alert me on articles by topic

Stephen M. Strakowski, MD; Melissa P. DelBello, MD; Kenji W. Sax, PhD; Molly E. Zimmerman; Paula K. Shear, PhD; John M. Hawkins, MD; Eric R. Larson, MA

Arch Gen Psychiatry. 1999;56:254-260.

Background  The neuropathogenesis of bipolar disorder remains poorly described. Previous work suggests that patients with bipolar disorder may have abnormalities in neural pathways that are hypothesized to modulate human mood states. We examined differences in brain structural volumes associated with these pathways between patients with bipolar disorder hospitalized with mania and healthy community volunteers.

Methods  Twenty-four patients with bipolar disorder and mania were recruited from hospital admission records. Twenty-two healthy volunteers were recruited from the community who were similar to the patients in age, sex, race, height, handedness, and education. All subjects were scanned using a 3-dimensional radio-frequency–spoiled Fourier acquired steady state acquisition sequence on a 1.5-T magnetic resonance imaging scanner. Scans were analyzed using commercial software. Prefrontal, thalamic, hippocampal, amygdala, pallidal, and striatal volumetric measurements were compared between the 2 groups.

Results  Patients with bipolar disorder demonstrated a significant (=0.64; F_6,37=3.4; P=.009) overall difference in structural volumes in these regions compared with controls. In particular, the amygdala was enlarged in the patients. Brain structural volumes were not significantly associated with duration of illness, prior medication exposure, number of previous hospital admissions, or duration of substance abuse. Separating patients into first-episode (n=12) and multiple-episode (n=12) subgroups revealed no significant differences in any structure (P>.10).

Conclusion  Patients with bipolar disorder exhibit structural abnormalities in neural pathways thought to modulate human mood.

From the Bipolar and Psychotic Disorders Research Program, Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, Ohio.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Meta-analysis, Database, and Meta-regression of 98 Structural Imaging Studies in Bipolar Disorder
Kempton et al.
Arch Gen Psychiatry 2008;65:1017-1032.
ABSTRACT | FULL TEXT  

Neurocognitive Allied Phenotypes for Schizophrenia and Bipolar Disorder
Hill et al.
Schizophr Bull 2008;34:743-759.
ABSTRACT | FULL TEXT  

Neurocognitive Impairment and Dementia in Mood Disorders
Pfennig et al.
J. Neuropsychiatry Clin. Neurosi. 2007;19:373-382.
ABSTRACT | FULL TEXT  

Identifying Functional Neuroimaging Biomarkers of Bipolar Disorder: Toward DSM-V
Phillips and Vieta
Schizophr Bull 2007;33:893-904.
ABSTRACT | FULL TEXT  

Association of the Brain-Derived Neurotrophic Factor Val66Met Polymorphism With Reduced Hippocampal Volumes in Major Depression
Frodl et al.
Arch Gen Psychiatry 2007;64:410-416.
ABSTRACT | FULL TEXT  

Limbic hyperactivation during processing of neutral facial expressions in children with bipolar disorder
Rich et al.
Proc. Natl. Acad. Sci. USA 2006;103:8900-8905.
ABSTRACT | FULL TEXT  

Hippocampal and Amygdala Volumes According to Psychosis Stage and Diagnosis: A Magnetic Resonance Imaging Study of Chronic Schizophrenia, First-Episode Psychosis, and Ultra-High-Risk Individuals
Velakoulis et al.
Arch Gen Psychiatry 2006;63:139-149.
ABSTRACT | FULL TEXT  

Reduced NAA Levels in the Dorsolateral Prefrontal Cortex of Young Bipolar Patients
Sassi et al.
Am. J. Psychiatry 2005;162:2109-2115.
ABSTRACT | FULL TEXT  

Abnormal fMRI Brain Activation in Euthymic Bipolar Disorder Patients During a Counting Stroop Interference Task
Strakowski et al.
Am. J. Psychiatry 2005;162:1697-1705.
ABSTRACT | FULL TEXT  

Structural Brain Magnetic Resonance Imaging of Limbic and Thalamic Volumes in Pediatric Bipolar Disorder
Frazier et al.
Am. J. Psychiatry 2005;162:1256-1265.
ABSTRACT | FULL TEXT  

Frontotemporal Alterations in Pediatric Bipolar Disorder: Results of a Voxel-Based Morphometry Study
Dickstein et al.
Arch Gen Psychiatry 2005;62:734-741.
ABSTRACT | FULL TEXT  

Increased Amygdala Activation During Mania: A Functional Magnetic Resonance Imaging Study
Altshuler et al.
Am. J. Psychiatry 2005;162:1211-1213.
ABSTRACT | FULL TEXT  

Cannabinoids in bipolar affective disorder: a review and discussion of their therapeutic potential
Ashton et al.
J Psychopharmacol 2005;19:293-300.
ABSTRACT  

Amygdala Morphometry in Affective Disorders
van ELST
Am. J. Psychiatry 2005;162:629-629.
FULL TEXT  

Hippocampal Volume and Depression: A Meta-Analysis of MRI Studies
Videbech and Ravnkilde
Am. J. Psychiatry 2004;161:1957-1966.
ABSTRACT | FULL TEXT  

Brain Metabolic Alterations in Medication-Free Patients With Bipolar Disorder
Dager et al.
Arch Gen Psychiatry 2004;61:450-458.
ABSTRACT | FULL TEXT  

Stress-induced structural remodeling in hippocampus: Prevention by lithium treatment
Wood et al.
Proc. Natl. Acad. Sci. USA 2004;101:3973-3978.
ABSTRACT | FULL TEXT  

Neural response to emotional prosody in schizophrenia and in bipolar affective disorder
Mitchell et al.
Br. J. Psychiatry 2004;184:223-230.
ABSTRACT | FULL TEXT  

Amygdala and Hippocampal Volumes in Adolescents and Adults With Bipolar Disorder
Blumberg et al.
Arch Gen Psychiatry 2003;60:1201-1208.
ABSTRACT | FULL TEXT  

Decreased Thalamic Expression of the Homeobox Gene DLX1 in Psychosis
Kromkamp et al.
Arch Gen Psychiatry 2003;60:869-874.
ABSTRACT | FULL TEXT  

Lower Concentration of Hippocampal N-Acetylaspartate in Familial Bipolar I Disorder
Deicken et al.
Am. J. Psychiatry 2003;160:873-882.
ABSTRACT | FULL TEXT  

Ventricular and Periventricular Structural Volumes in First- Versus Multiple-Episode Bipolar Disorder
Strakowski et al.
Am. J. Psychiatry 2002;159:1841-1847.
ABSTRACT | FULL TEXT  

The neuropathology of primary mood disorder
Harrison
Brain 2002;125:1428-1449.
ABSTRACT | FULL TEXT  

Amygdala pathology in psychosis of epilepsy: A magnetic resonance imaging study in patients with temporal lobe epilepsy
Tebartz van Elst et al.
Brain 2002;125:140-149.
ABSTRACT | FULL TEXT  

Neuroanatomical studies on bipolar disorder
BAUMANN and BOGERTS
Br. J. Psychiatry 2001;178 :s142-s147.
ABSTRACT | FULL TEXT  

Hippocampus and Amygdala Pathology in Depression
TEBARTZ VAN ELST et al.
Am. J. Psychiatry 2001;158:652-a-653.
FULL TEXT  

High Vesicular Monoamine Transporter Binding in Asymptomatic Bipolar I Disorder: Sex Differences and Cognitive Correlates
Zubieta et al.
Am. J. Psychiatry 2000;157:1619-1628.
ABSTRACT | FULL TEXT  

The Kraepelinian Dichotomy: Evidence From Developmental and Neuroimaging Studies
Curtis et al.
J. Neuropsychiatry Clin. Neurosi. 2000;12:398-405.
FULL TEXT  

Volumetry of Hippocampus and Amygdala with High-resolution MRI and Three-dimensional Analysis Software: Minimizing the Discrepancies between Laboratories
Pruessner et al.
Cereb Cortex 2000;10:433-442.
ABSTRACT | FULL TEXT  

In Reply
BAUMANN
J. Neuropsychiatry Clin. Neurosi. 1999;11 :515-516.
FULL TEXT