Out of control: An altered parieto-occipital-cerebellar network for impulsivity in bipolar disorder

Bipolar disorder is an affective disorder characterized by rapid fluctuations in mood ranging from episodes of depression to mania, as well as by increased impulsivity. Previous studies investigated the neural substrates of bipolar disorder mainly using univariate methods, with a particular focus on the neural circuitry underlying emotion regulation difficulties. In the present study, capitalizing on an innovative whole-brain multivariate method to structural analysis known as Source-based Morphometry, we investigated the neural substrates of bipolar disorder and their relation with impulsivity, assessed with both self-report measures and performance-based tasks. Structural images from 46 patients with diagnosis of bipolar disorder and 60 healthy controls were analysed. Compared to healthy controls, patients showed decreased gray matter concentration in a parietal-occipital-cerebellar network. Notably, the lower the gray matter concentration in this circuit, the higher the self-reported impulsivity. In conclusion, we provided new evidence of an altered brain network in bipolar disorder patients related to their abnormal impulsivity. Taken together, these findings extend our understanding of the neural and symptomatic characterization of bipolar disorder.