Reduction of cingulate gray matter density in poor outcome bipolar illness

Prefrontal gray matter increases in healthy individuals after lithium treatment: A voxel-based morphometry study

“…Left ACC gray matter volume is reduced in adult [10] and juvenile [11] bipolar patients. Research employing a statistical parametric mapping approach also revealed reduced gray matter density in the fronto-limbic cortex, particularly in the cingulate [12,13], and in Bearden and colleagues' study [5] greatest differences in gray matter density were found in the bilateral cingulate and paralimbic cortices in lithium-treated bipolar patients (n=20) compared to those not taking lithium (n=8) and healthy controls (n=28). The DLPFC is an understudied region in bipolar disorder, with one study [14] showing significantly smaller gray matter volumes in the left middle and superior, and the right middle and inferior prefrontal regions in 17 bipolar patients hospitalized for a manic episode and receiving various psychotropic medications, and another study demonstrating decreased gray matter volume in the left DLPFC in pediatric bipolar patients [15].…”

Combined analysis of grey matter voxel-based morphometry and white matter tract-based spatial statistics in late-life bipolar disorder

“…These observations are in line with several previous VBM studies in young patients with bipolar disorder that pointed to a possible involvement of certain parts of the anterior limbic network known to participate in visceromotor and emotion regulation in patients with bipolar disorder. [6][7][8][9][10][11][12][13] However, results show that in elderly patients, this involvement mainly concerns the frontostriatal network. Recent neuropsychologic and functional MRI studies in young 42,43 and elderly patients 44 also postulated the presence of a disconnection in the transfer of information within the frontostriatal network that could affect both cognitive and affective processing.…”

“…[3][4][5][6][7] Voxel-based morphometry (VBM), a fully automated image analysis of the whole brain that is free from a priori hypotheses, partly confirmed this viewpoint by revealing decreased grey matter concentration and volume in the ventrolateral prefrontal, anterior cingulate, temporal and parietal cortices. [6][7][8][9][10][11][12][13] However, negative data were also reported, pointing to the heterogeneity of the bipolar disorder spectrum. 5,14 Severe white matter abnormalities in patients with bipolar disorder have been usually investigated using magnetic resonance imaging (MRI) studies of white matter volumes and hyperintensities, magnetization transfer studies and MRI spectroscopy.…”

A 1HMRS study of the anterior cingulate gyrus in euthymic bipolar patients

“…In vivo imaging studies have presented evidences of structural abnormalities in the ACC of bipolar patients, such as decreased gray matter density in the ACC (Doris et al, 2004) and smaller left (Drevets et al, 1997, Hirayasu et al, 1999, Lyoo et al, 2004, Sassi et al, 2004 and right (Sharma et al, 2003) anterior cingulate volume, but not by all (Lopez-Larson et al, 2002). The patients studied by Drevets et al (1997) also presented a decrease in blood flow and glucose metabolism in the left subgenual cingulate cortex measured by positron emission tomography (PET).…”