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Published Online: 1 May 2011

Investigation of Cortical Thickness Abnormalities in Lithium-Free Adults With Bipolar I Disorder Using Cortical Pattern Matching

Lara C. Foland-Ross, Ph.D., Paul M. Thompson, Ph.D., Catherine A. Sugar, Ph.D., Sarah K. Madsen, B.A., Jim K. Shen, B.S., Conor Penfold, B.A., Kyle Ahlf, B.A., Paul E. Rasser, M.S., Jeffrey Fischer, B.A., Yilan Yang, B.A., Jennifer Townsend, B.A., Susan Y. Bookheimer, Ph.D., and Lori L. Altshuler, M.D.Authors Info & Affiliations
Publication: American Journal of Psychiatry
Volume 168, Number 5
https://doi.org/10.1176/appi.ajp.2010.10060896
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Abstract

Objective:

Although several lines of evidence implicate gray matter abnormalities in the prefrontal cortex and anterior cingulate cortex in patients with bipolar disorder, findings have been largely inconsistent across studies. Differences in patients' medication status or mood state or the application of traditional volumetric methods that are insensitive to subtle neuroanatomical differences may have contributed to variations in findings. The authors used MRI in conjunction with cortical pattern matching methods to assess cortical thickness abnormalities in euthymic bipolar patients who were not receiving lithium treatment.

Method:

Thirty-four lithium-free euthymic patients with bipolar I disorder and 31 healthy comparison subjects underwent MRI scanning. Data were processed to measure cortical gray matter thickness. Thickness maps were spatially normalized using cortical pattern matching and were analyzed to assess illness effects and associations with clinical variables.

Results:

Relative to healthy comparison subjects, euthymic bipolar patients had significantly thinner gray matter in the left and right prefrontal cortex (Brodmann's areas 11, 10, 8, and 44) and the left anterior cingulate cortex (Brodmann's areas 24/32). Thinning in these regions was more pronounced in patients with a history of psychosis. No areas of thicker cortex were detected in bipolar patients relative to healthy comparison subjects.

Conclusions:

Using a technique that is highly sensitive to subtle neuroanatomical differences, significant regional cortical thinning was found in lithium-free euthymic patients with bipolar disorder.

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Information & Authors

Information

Published In

Go to American Journal of Psychiatry
Go to American Journal of Psychiatry
American Journal of Psychiatry
Volume 168 • Number 5 • May 2011
Pages: 530 - 539
PubMed: 21285139

History

Received: 24 June 2010
Revision received: 7 October 2010
Accepted: 29 October 2010
Published online: 1 May 2011
Published in print: May 2011

Authors

Affiliations

Lara C. Foland-Ross, Ph.D.
From the Laboratory of NeuroImaging, Department of Neurology, and the Ahmanson-Lovelace Brain Mapping Center, UCLA School of Medicine, Los Angeles; the Departments of Biostatistics and of Psychiatry and Biobehavioral Sciences, UCLA; the Schizophrenia Research Institute, Darlinghurst, New South Wales, Australia; the Priority Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, New South Wales; the Department of Psychiatry, VA Greater Los Angeles Healthcare System; and West Los Angeles Healthcare Center.
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Paul M. Thompson, Ph.D.
From the Laboratory of NeuroImaging, Department of Neurology, and the Ahmanson-Lovelace Brain Mapping Center, UCLA School of Medicine, Los Angeles; the Departments of Biostatistics and of Psychiatry and Biobehavioral Sciences, UCLA; the Schizophrenia Research Institute, Darlinghurst, New South Wales, Australia; the Priority Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, New South Wales; the Department of Psychiatry, VA Greater Los Angeles Healthcare System; and West Los Angeles Healthcare Center.
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Catherine A. Sugar, Ph.D.
From the Laboratory of NeuroImaging, Department of Neurology, and the Ahmanson-Lovelace Brain Mapping Center, UCLA School of Medicine, Los Angeles; the Departments of Biostatistics and of Psychiatry and Biobehavioral Sciences, UCLA; the Schizophrenia Research Institute, Darlinghurst, New South Wales, Australia; the Priority Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, New South Wales; the Department of Psychiatry, VA Greater Los Angeles Healthcare System; and West Los Angeles Healthcare Center.
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Sarah K. Madsen, B.A.
From the Laboratory of NeuroImaging, Department of Neurology, and the Ahmanson-Lovelace Brain Mapping Center, UCLA School of Medicine, Los Angeles; the Departments of Biostatistics and of Psychiatry and Biobehavioral Sciences, UCLA; the Schizophrenia Research Institute, Darlinghurst, New South Wales, Australia; the Priority Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, New South Wales; the Department of Psychiatry, VA Greater Los Angeles Healthcare System; and West Los Angeles Healthcare Center.
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Jim K. Shen, B.S.
From the Laboratory of NeuroImaging, Department of Neurology, and the Ahmanson-Lovelace Brain Mapping Center, UCLA School of Medicine, Los Angeles; the Departments of Biostatistics and of Psychiatry and Biobehavioral Sciences, UCLA; the Schizophrenia Research Institute, Darlinghurst, New South Wales, Australia; the Priority Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, New South Wales; the Department of Psychiatry, VA Greater Los Angeles Healthcare System; and West Los Angeles Healthcare Center.
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Conor Penfold, B.A.
From the Laboratory of NeuroImaging, Department of Neurology, and the Ahmanson-Lovelace Brain Mapping Center, UCLA School of Medicine, Los Angeles; the Departments of Biostatistics and of Psychiatry and Biobehavioral Sciences, UCLA; the Schizophrenia Research Institute, Darlinghurst, New South Wales, Australia; the Priority Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, New South Wales; the Department of Psychiatry, VA Greater Los Angeles Healthcare System; and West Los Angeles Healthcare Center.
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Kyle Ahlf, B.A.
From the Laboratory of NeuroImaging, Department of Neurology, and the Ahmanson-Lovelace Brain Mapping Center, UCLA School of Medicine, Los Angeles; the Departments of Biostatistics and of Psychiatry and Biobehavioral Sciences, UCLA; the Schizophrenia Research Institute, Darlinghurst, New South Wales, Australia; the Priority Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, New South Wales; the Department of Psychiatry, VA Greater Los Angeles Healthcare System; and West Los Angeles Healthcare Center.
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Paul E. Rasser, M.S.
From the Laboratory of NeuroImaging, Department of Neurology, and the Ahmanson-Lovelace Brain Mapping Center, UCLA School of Medicine, Los Angeles; the Departments of Biostatistics and of Psychiatry and Biobehavioral Sciences, UCLA; the Schizophrenia Research Institute, Darlinghurst, New South Wales, Australia; the Priority Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, New South Wales; the Department of Psychiatry, VA Greater Los Angeles Healthcare System; and West Los Angeles Healthcare Center.
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Jeffrey Fischer, B.A.
From the Laboratory of NeuroImaging, Department of Neurology, and the Ahmanson-Lovelace Brain Mapping Center, UCLA School of Medicine, Los Angeles; the Departments of Biostatistics and of Psychiatry and Biobehavioral Sciences, UCLA; the Schizophrenia Research Institute, Darlinghurst, New South Wales, Australia; the Priority Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, New South Wales; the Department of Psychiatry, VA Greater Los Angeles Healthcare System; and West Los Angeles Healthcare Center.
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Yilan Yang, B.A.
From the Laboratory of NeuroImaging, Department of Neurology, and the Ahmanson-Lovelace Brain Mapping Center, UCLA School of Medicine, Los Angeles; the Departments of Biostatistics and of Psychiatry and Biobehavioral Sciences, UCLA; the Schizophrenia Research Institute, Darlinghurst, New South Wales, Australia; the Priority Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, New South Wales; the Department of Psychiatry, VA Greater Los Angeles Healthcare System; and West Los Angeles Healthcare Center.
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Jennifer Townsend, B.A.
From the Laboratory of NeuroImaging, Department of Neurology, and the Ahmanson-Lovelace Brain Mapping Center, UCLA School of Medicine, Los Angeles; the Departments of Biostatistics and of Psychiatry and Biobehavioral Sciences, UCLA; the Schizophrenia Research Institute, Darlinghurst, New South Wales, Australia; the Priority Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, New South Wales; the Department of Psychiatry, VA Greater Los Angeles Healthcare System; and West Los Angeles Healthcare Center.
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Susan Y. Bookheimer, Ph.D.
From the Laboratory of NeuroImaging, Department of Neurology, and the Ahmanson-Lovelace Brain Mapping Center, UCLA School of Medicine, Los Angeles; the Departments of Biostatistics and of Psychiatry and Biobehavioral Sciences, UCLA; the Schizophrenia Research Institute, Darlinghurst, New South Wales, Australia; the Priority Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, New South Wales; the Department of Psychiatry, VA Greater Los Angeles Healthcare System; and West Los Angeles Healthcare Center.
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Lori L. Altshuler, M.D.
From the Laboratory of NeuroImaging, Department of Neurology, and the Ahmanson-Lovelace Brain Mapping Center, UCLA School of Medicine, Los Angeles; the Departments of Biostatistics and of Psychiatry and Biobehavioral Sciences, UCLA; the Schizophrenia Research Institute, Darlinghurst, New South Wales, Australia; the Priority Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, New South Wales; the Department of Psychiatry, VA Greater Los Angeles Healthcare System; and West Los Angeles Healthcare Center.
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Notes

Address correspondence and reprint requests to Dr. Altshuler, 300 UCLA Medical Plaza, Suite 1544, Box 957057, Los Angeles, CA 90095-7057; [email protected] (e-mail).

Funding Information

Dr. Altshuler has served on advisory boards or speakers bureaus for Forest Laboratories, Merck, and Sepracor. The other authors report no financial relationships with commercial interests.Supported by NIMH grants MH078556, MH075944, and MH01848; NARSAD; National Center for Research Resources grants AG016570, EB01651, RR019771, RR12169, RR13642, and RR00865; and the National Institute on Aging, the National Institute of Biomedical Imaging and Bioengineering, the Brain Mapping Medical Research Organization, the Brain Mapping Support Foundation, the Pierson-Lovelace Foundation, the Ahmanson Foundation, the William M. and Linda R. Dietel Philanthropic Fund at the Northern Piedmont Community Foundation, the Tamkin Foundation, the Jennifer Jones-Simon Foundation, the Capital Group Companies Charitable Foundation, the Robson Family, and the Northstar Fund.

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