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Updated: Dec 1, 2025
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Bipolar disorders and deep grey matter in multiple sclerosis: A preliminary quantitative MRI study
L Lorefice1, G Fenu1, E Carta2
1Multiple Sclerosis Centre, Binaghi Hospital, ATS Sardegna, ASSL Cagliari, Italy.
Background:
Bipolar disorder (BD) is frequently observed in patients affected by multiple sclerosis (MS), presenting a lifetime estimate of around 8%. However, uncertainty exists on the brain damage associated with this psychiatric comorbidity. This study aimed to investigate the effect of brain atrophy, particularly that of the subcortical grey matter (scGM) structures that notoriously regulate the affective functioning, on the co-occurrence of BD in patients with MS.
Methods:
A group of patients with MS affected by BD and a control group of patients with MS without any mood/psychiatric disorder, as defined using standardised diagnostic tools (Advanced Neuropsychiatric Tools and Assessment Schedule), were recruited. The patients underwent brain MRI, and the volumes of the whole brain (WB), white matter (WM), and grey matter (GM) were estimated using SIENAX. Thus, the scGM volumes of the putamen, caudate, thalamus, hippocampus, amygdala, nucleus accumbens, and pallidus were estimated using the FIRST tool.
Results:
The sample included 61 patients with MS, amongst whom 15 (24.6%) had BD. No differences in the WB, WM, and cortical GM volumes were observed between the patients with MS with and without BD. Conversely, the multiple regression analysis revealed a significant association of BD with lower volumes of the putamen (p = 0.032), nucleus accumbens (p = 0.029), and pallidus (p = 0.061; with a trend towards significance), independently from the demographic and MS clinical features.
Conclusions:
Our preliminary results indicated that the nucleus accumbens and putamen are smaller in MS patients with BD. Further investigations in larger cohorts of MS patients with affective disorders are necessary to confirm these data and understand the structural brain damage underlying this psychiatric comorbidity.
Insights
Bipolar disorder (BD) in multiple sclerosis (MS) patients is linked to reduced volumes in specific subcortical grey matter areas, including the putamen and nucleus accumbens. This suggests structural brain changes may underlie this common comorbidity.
Area of Science:
- Neuroscience
- Psychiatry
- Radiology
Background:
- Bipolar disorder (BD) affects approximately 8% of multiple sclerosis (MS) patients.
- Brain damage associated with BD comorbidity in MS remains unclear.
- Subcortical grey matter (scGM) structures are crucial for affective functioning.
Purpose of the Study:
- To investigate the association between brain atrophy, specifically in scGM structures, and the co-occurrence of BD in MS patients.
- To determine if reduced scGM volumes correlate with the presence of BD in individuals with MS.
Main Methods:
- Recruited MS patients with BD and a control group of MS patients without psychiatric disorders.
- Utilized brain MRI to estimate whole brain (WB), white matter (WM), and grey matter (GM) volumes using SIENAX.
- Estimated scGM volumes (putamen, caudate, thalamus, hippocampus, amygdala, nucleus accumbens, pallidus) using the FIRST tool.
Main Results:
- No significant differences in WB, WM, or cortical GM volumes were found between MS patients with and without BD.
- Multiple regression analysis revealed significantly lower volumes of the putamen and nucleus accumbens in MS patients with BD.
- A trend towards significance was observed for reduced pallidus volume in MS patients with BD.
Conclusions:
- Preliminary findings suggest that MS patients with BD exhibit smaller nucleus accumbens and putamen volumes.
- Further research with larger cohorts is needed to confirm these findings and elucidate the underlying structural brain damage.
- Understanding these structural changes is crucial for managing psychiatric comorbidities in MS.
