With great interest, we have read the recent paper by Keramatian and colleagues entitled "Grey Matter Abnormalities in First Episode Mania: A Systematic Review and Meta-analysis of Voxel-Based Morphometry Studies" in Bipolar Disorders. 1 The authors systematically reviewed 15 voxel-based morphometry (VBM) studies and observed heterogeneous findings regarding the brain regions affected and the direction of grey matter (GM) alterations (decreases/increases) as well as statistically non-significant alterations in patients with first episode mania (FEM) relative to healthy controls. They further performed a quantitative coordinate-based meta-analysis (CBMA) of 12 whole-brain VBM studies and identified consistent GM alterations in the bilateral pregenual anterior cingulate cortex (ACC) in FEM. 1 The paper provided a thorough profile of GM volume alterations in FEM; however, we have some methodological concerns in the CBMA that compromised the validity of the metaanalytic results. Over the last two decades, CBMA has been a powerful metaanalytic technique to quantitatively integrate individual voxel-based neuroimaging studies to identify convergent findings for a particular research question. 2 The methods for CBMA are constantly evolving. The latest algorithm for CBMA is Seed-based d Mapping with

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