Cortical abnormalities in bipolar disorder: an MRI analysis of 6503 individuals from the ENIGMA Bipolar Disorder Working Group

Corin Bourne; Dan Joseph Stein; Daniel H. Wolf; Dara M. Cannon; David C. Glahn; Dick J. Veltman; Edith Pomarol‐Clotet; Eduard Vieta; Erick J. Canales‐Rodríguez; Fabiano G. Nery; Fábio Duran; Geraldo F. Busatto; Gloria Roberts; Godfrey D. Pearlson; Guy M. Goodwin; Harald Kugel; Heather C. Whalley; Henricus G. Ruhé; Jair C. Soares; Janice M. Fullerton; Janusz Rybakowski; Jonathan Savitz; Kalil T Chaim; Mar Fatjó‐Vilas; Márcio Gerhardt Soeiro‐de‐Souza; Marco P. Boks; Marcus V. Zanetti; Maria Concepción García Otaduy; Maria Schaufelberger; Martin Alda; Martin Ingvar; Mary L. Phillips; Matthew J. Kempton; Michael Bauer; Mikael Landén; Derrek P. Hibar; Lars T. Westlye; Nhat Trung Doan; Neda Jahanshad; J. Cheung; Christopher R. K. Ching; Amelia Versace; Amy C. Bilderbeck; Anne Uhlmann; Benson Mwangi; Bernd Krämer; Bronwyn J. Overs; Cecilie B. Hartberg; Christoph Abé; Danai Dima; Dominik Grotegerd; Emma Sprooten; Erlend Bøen; Esther Jiménez; Fleur M. Howells; Giuseppe Delvecchio; Henk Temmingh; Jonathan Starke; Jorge Almeida; José Manuel Goikolea; Josselin Houenou; Lauren M. Beard; Lisa Rauer; Lucija Abramovic; M. Bonnin; Maria Francesca Ponteduro; Maria Keil; Maria M. Rive; Nailin Yao; Nefize Yalın; Pablo Najt; Pedro G. P. Rosa; Ronny Redlich; Sarah Trost; Saskia P. Hagenaars; Scott C. Fears; Sílvia Alonso-Lana; Theo G.M. van Erp; Thomas E. Nickson; Tiffany Chaim-Avancini; Timothy B. Meier; Torbjørn Elvsåshagen; Unn K. Haukvik; W H Lee; Aart H. Schene; Adrian J. Lloyd; Allan H. Young; Allison C. Nugent; Anders M. Dale; Andrea Pfennig; Andrew M. McIntosh; Beny Lafer; Bernhard T. Baune; Carl Johan Ekman; Carlos A. Zarate; Carrie E. Bearden; Chantal Henry; Christian Simhandl; Colm McDonald

doi:10.1038/mp.2017.73

Eduard Vieta

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Abstract

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 magnetic resonance imaging scans of 6503 individuals including 1837 unrelated adults with BD and 2582 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=1.71 × 10^-21), left fusiform gyrus (d=-0.288; P=8.25 × 10^-21) and left rostral middle frontal cortex (d=-0.276; P=2.99 × 10^-19). Longer duration of illness (after accounting for age at the 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. We found evidence of reduced cortical surface area associated with a history of psychosis but no associations with 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.

How to cite this publication

Corin Bourne, Dan Joseph Stein, Daniel H. Wolf, Dara M. Cannon, David C. Glahn, Dick J. Veltman, Edith Pomarol‐Clotet, Eduard Vieta, Erick J. Canales‐Rodríguez, Fabiano G. Nery, Fábio Duran, Geraldo F. Busatto, Gloria Roberts, Godfrey D. Pearlson, Guy M. Goodwin, Harald Kugel, Heather C. Whalley, Henricus G. Ruhé, Jair C. Soares, Janice M. Fullerton, Janusz Rybakowski, Jonathan Savitz, Kalil T Chaim, Mar Fatjó‐Vilas, Márcio Gerhardt Soeiro‐de‐Souza, Marco P. Boks, Marcus V. Zanetti, Maria Concepción García Otaduy, Maria Schaufelberger, Martin Alda, Martin Ingvar, Mary L. Phillips, Matthew J. Kempton, Michael Bauer, Mikael Landén, Derrek P. Hibar, Lars T. Westlye, Nhat Trung Doan, Neda Jahanshad, J. Cheung, Christopher R. K. Ching, Amelia Versace, Amy C. Bilderbeck, Anne Uhlmann, Benson Mwangi, Bernd Krämer, Bronwyn J. Overs, Cecilie B. Hartberg, Christoph Abé, Danai Dima, Dominik Grotegerd, Emma Sprooten, Erlend Bøen, Esther Jiménez, Fleur M. Howells, Giuseppe Delvecchio, Henk Temmingh, Jonathan Starke, Jorge Almeida, José Manuel Goikolea, Josselin Houenou, Lauren M. Beard, Lisa Rauer, Lucija Abramovic, M. Bonnin, Maria Francesca Ponteduro, Maria Keil, Maria M. Rive, Nailin Yao, Nefize Yalın, Pablo Najt, Pedro G. P. Rosa, Ronny Redlich, Sarah Trost, Saskia P. Hagenaars, Scott C. Fears, Sílvia Alonso-Lana, Theo G.M. van Erp, Thomas E. Nickson, Tiffany Chaim-Avancini, Timothy B. Meier, Torbjørn Elvsåshagen, Unn K. Haukvik, W H Lee, Aart H. Schene, Adrian J. Lloyd, Allan H. Young, Allison C. Nugent, Anders M. Dale, Andrea Pfennig, Andrew M. McIntosh, Beny Lafer, Bernhard T. Baune, Carl Johan Ekman, Carlos A. Zarate, Carrie E. Bearden, Chantal Henry, Christian Simhandl, Colm McDonald (2017). Cortical abnormalities in bipolar disorder: an MRI analysis of 6503 individuals from the ENIGMA Bipolar Disorder Working Group. , 23(4), DOI: https://doi.org/10.1038/mp.2017.73.

Cortical abnormalities in bipolar disorder: an MRI analysis of 6503 individuals from the ENIGMA Bipolar Disorder Working Group

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Cortical abnormalities in bipolar disorder: an MRI analysis of 6503 individuals from the ENIGMA Bipolar Disorder Working Group

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Eduard Vieta

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