Neuroprogressive effects of lifetime illness duration in older adults with bipolar disorder

Authors

  • Ariel G Gildengers,

    1. Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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  • Kuo-Hsuan Chung,

    1. Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University
    2. Department of Psychiatry and Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
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  • Shou-Hung Huang,

    Corresponding author
    1. Department of Psychiatry and Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
    • Corresponding author:

      Shang-Ying Tsai, M.D.

      252, Wu-Hsing Street

      Taipei 110

      Taiwan

      Fax: +886-2-66315033

      E-mail: tmcpsyts@tmu.edu.tw

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  • Amy Begley,

    1. Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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  • Howard J Aizenstein,

    1. Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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  • Shang-Ying Tsai

    1. Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University
    2. Department of Psychiatry and Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
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Abstract

Objective

The aim of the present study was to examine the long-term effects of bipolar disorder (BD) on brain structure (gray matter volumes).

Methods

Fifty-four adults with BD [mean (standard deviation) age = 64.4 (5.4) years] underwent brain MR imaging along with comprehensive clinical assessment. Total gray matter, hippocampal, and amygdala volumes were extracted using methods developed through the Geriatric Neuroimaging Laboratory at the University of Pittsburgh (Pittsburgh, PA, USA).

Results

Lower total gray matter volumes were related to longer duration of BD, even when controlling for current age and cerebrovascular accident (CVA) risk/burden. Additionally, longer exposure to antipsychotic medication was related to lower gray matter volumes. Lower hippocampal volumes were related to total years of antipsychotic agent exposure and CVA risk/burden scores. Older age was related to lower total gray matter, hippocampal, and amgydala volumes.

Conclusions

Our study of older adults with BD supports the understanding that BD is a neuroprogressive disorder with a longer duration of illness and more antipsychotic agent exposure related to lower gray matter volume.

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