Cortical gray matter differences identified by structural magnetic resonance imaging in pediatric bipolar disorder
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Published on: November 27, 2019
Jean A Frazier1, Janis L Breeze, Nikos Makris
1Department of Psychiatry, Harvard Medical School, Boston, MA, USA. jfrazier@challiance.org
Insights
Children with bipolar disorder (BPD) exhibit reduced gray matter volume in the parietal and temporal lobes. These brain differences may be linked to early symptom onset and impact cognitive functions.
Area of Science:
- Neuroimaging
- Developmental Neuroscience
- Psychiatry
Background:
- Few magnetic resonance imaging (MRI) studies have examined the entire cerebral cortex in pediatric bipolar disorder (BPD).
- Previous research in adults with BPD suggests cortical gray matter (GM) volume deficits.
- This study investigates cortical GM volume in children diagnosed with BPD.
Purpose of the Study:
- To assess for cortical gray matter (GM) volume deficits in children with bipolar disorder (BPD).
- To compare cerebral cortex volumes between children with BPD and healthy controls (HC).
Main Methods:
- Thirty-two youths with BPD and 15 HC underwent MRI scans.
- Neocortical volume was parcellated into 48 gyral units per hemisphere, grouped into frontal, temporal, parietal, and occipital lobes.
- Univariate linear regression models were used to analyze volumetric differences.
Main Results:
- Children with BPD showed significantly smaller bilateral parietal lobe (PL) and left temporal lobe (TL) volumes compared to HC.
- Specific regions within the PL and TL, including the postcentral, superior temporal, and fusiform gyri, had reduced volumes.
- The BPD group exhibited bilaterally increased parahippocampal gyri volumes, and an exploratory analysis revealed a smaller right middle frontal gyrus.
Conclusions:
- Pediatric BPD is associated with cortical gray matter deficits in the parietal and temporal lobes.
- These findings suggest that observed differences in PL and TL may affect attentional control, facial recognition, and memory.
- The identified cortical deficits might be indicative of an early age of illness onset in BPD.
Objective:
Few magnetic resonance imaging (MRI) studies of bipolar disorder (BPD) have investigated the entire cerebral cortex. Cortical gray matter (GM) volume deficits have been reported in some studies of adults with BPD; this study assessed the presence of such deficits in children with BPD.
Methods:
Thirty-two youths with DSM-IV BPD (mean age 11.2 +/- 2.8 years) and 15 healthy controls (HC) (11.2 +/- 3.0 years) had structured and clinical interviews, neurological examinations, neurocognitive testing, and MRI scanning on a 1.5 T GE Scanner. Image parcellation divided the neocortex into 48 gyral-based units per hemisphere, and these units were combined into frontal (FL), temporal (TL), parietal (PL), and occipital (OL) lobe volumes. Volumetric differences were examined using univariate linear regression models with alpha = 0.05.
Results:
Relative to controls, the BPD youth had significantly smaller bilateral PL, and left TL. Analysis of PL and TL gyri showed significantly smaller volume in bilateral postcentral gyrus, and in left superior temporal and fusiform gyri, while the parahippocampal gyri were bilaterally increased in the BPD group. Although the FL overall did not differ between groups, an exploratory analysis showed that the right middle frontal gyrus was also significantly smaller in the BPD group.
Conclusions:
Children with BPD showed deficits in PL and TL cortical GM. Further analyses of the PL and TL found differences in areas involved in attentional control, facial recognition, and verbal and declarative memory. These cortical deficits may reflect early age of illness onset.
