Comparison of first-episode and multiple-episode bipolar disorder: A surface-based morphometry study

Area of Science:

• Neuroscience
• Psychiatry
• Radiology

Background:

• Bipolar disorder (BD) is characterized by mood disturbances, but the progression of associated structural brain abnormalities remains unclear.
• Understanding whether these changes are static or progressive is crucial for diagnosis and treatment.

Purpose of the Study:

• To compare cortical thickness, surface area, and volume between patients with BD and healthy volunteers (HV).
• To investigate differences in these measures between BD patients with single versus multiple manic episodes.

Main Methods:

• Structural magnetic resonance imaging (MRI) was performed on 30 patients with Type I BD and 30 age/sex-matched HV.
• Cortical volume, thickness, and surface area were quantified using Freesurfer's QDEC tool, controlling for age and intracranial volume.

Main Results:

• BD patients exhibited significantly lower surface area in the bilateral cuneus, right postcentral gyrus, and rostral middle frontal gyri.
• Lower cortical volume was observed in the left middle temporal gyrus, right postcentral gyrus, and right cuneus of BD patients.
• BD patients with multiple episodes showed reduced cortical measures compared to HV, whereas single-episode patients had comparable measures.

Conclusions:

• The findings suggest that the pathophysiological processes in bipolar disorder may be progressive.
• Early diagnosis and intervention are potentially vital for preventing deterioration and improving functional recovery in BD patients.