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Multimodal Brain Changes in First-Episode Mania: A Voxel-Based Morphometry, Functional Magnetic Resonance Imaging,
José M Goikolea1, Danai Dima2,3, Ramón Landín-Romero4
1Barcelona Bipolar Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
Schizophrenia Bulletin
|April 20, 2018
Summary
First episode mania (FEM) in bipolar disorder (BD) shows no brain volume differences but reveals altered default mode network (DMN) function, suggesting DMN dysfunction is an early feature of BD.
Area of Science:
- Neuroscience
- Psychiatry
- Brain Imaging
Background:
- Bipolar disorder (BD) is associated with known brain structural and functional alterations.
- It remains unclear if these neurobiological changes are present at the earliest stages of the illness, specifically in first episode mania (FEM).
Purpose of the Study:
- To investigate whether neurobiological differences exist between individuals experiencing their first episode of mania and healthy controls.
- To examine brain structure, task-based function, and functional connectivity in FEM patients.
Main Methods:
- Comparison of 31 FEM subjects with 31 age-, sex-, and IQ-matched healthy controls.
- Utilized whole-brain voxel-wise morphometry to assess brain structure.
- Employed functional magnetic resonance imaging (fMRI) during an n-back task and functional connectivity analysis.
Main Results:
- No significant volumetric differences were observed between FEM patients and controls.
- FEM patients exhibited similar task performance and brain activation patterns during the 2-back task compared to controls.
- FEM patients showed reduced deactivation in the ventromedial prefrontal cortex (vmPFC), the anterior hub of the default mode network (DMN), and altered DMN connectivity.
Conclusions:
- The lack of volumetric changes in FEM suggests that structural alterations may develop with illness progression.
- Impaired deactivation of the anterior DMN hub is present from the onset of mania, indicating it may be a core pathophysiological feature of bipolar disorder.
Keywords:
bipolar disordermagnetic resonance imagingmanianeuroimagingpathophysiologywhole-brain statistical analysisMore Related Videos
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