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          Cortical Abnormalities in Bipolar Disorder


          A global consortium published new research showed that people with the condition have differences in the brain regions that control inhibition and emotion in the largest MRI study on patients with bipolar disorder to date. The new study, published in Molecular Psychiatry found brain abnormalities in people with bipolar disorder. By revealing clear and consistent alterations in key brain regions, the findings shed light on the underlying mechanisms of bipolar disorder.

          The study was part of an international consortium called ENIGMA (Enhancing Neuro Imaging Genetics Through Meta Analysis), which spans 76 centers and includes 28 different research groups across the world. The researchers measured the MRI scans of 6,503 individuals, including 2,447 adults with bipolar disorder and 4,056 healthy controls. Researchers also observed the effects of commonly used prescription medications, age of illness onset, history of psychosis, mood state, age and sex differences on cortical regions.


          Results from the study reported that patients with bipolar disorder showed thinning of cortical gray matter in the brains compared to healthy controls. The greatest deficits were found in parts of the brain that control inhibition and emotion -- the frontal and temporal regions. Bipolar disorder patients with a history of psychosis showed greater deficits in the brain's gray matter. The findings also showed different brain signatures in patients who took lithium, antipsychotics and anti-epileptic treatments. Lithium treatment was associated with less thinning of gray matter, which suggests a protective effect of this medication on the brain. Study found evidence of reduced cortical surface area associated with a history of psychosis but no associations with mood state at the time of scanning.

          This new map of the bipolar brain gives us a roadmap of where to look for treatment effects. Future research will test how well different medications and treatments can shift or modify these brain measures as well as improve symptoms and clinical outcomes for patients.

          Source: Hibar DP, Westlye LT, Doan NT, et al. Cortical abnormalities in bipolar disorder: an MRI analysis of 6503 individuals from the ENIGMA Bipolar Disorder Working Group. Mol Psychiatry. 2017 May 2. doi: 10.1038/mp.2017.73.

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