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Cortical gray matter differences identified by structural magnetic resonance imaging in pediatric bipolar disorder

Authors

  • Jean A Frazier,

    1. Department of Psychiatry, Harvard Medical School, Boston
    2. Department of Psychiatry, Cambridge Health Alliance, Cambridge
    3. Department of Psychiatry, McLean Hospital, Belmont
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  • Janis L Breeze,

    1. Department of Psychiatry, Cambridge Health Alliance, Cambridge
    2. Department of Psychiatry, McLean Hospital, Belmont
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  • Nikos Makris,

    1. Center for Morphometric Analysis, Massachusetts General Hospital, Charlestown
    2. Neuroscience Program, Harvard Medical School, Boston
    3. Department of Neurology, Massachusetts, General Hospital, Boston
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  • Anthony S Giuliano,

    1. Department of Psychiatry, Harvard Medical School, Boston
    2. Department of Psychiatry, Cambridge Health Alliance, Cambridge
    3. Department of Psychiatry, McLean Hospital, Belmont
    4. Department of Psychiatry, Massachusetts Mental Health Center, Boston
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  • Martha R Herbert,

    1. Center for Morphometric Analysis, Massachusetts General Hospital, Charlestown
    2. Neuroscience Program, Harvard Medical School, Boston
    3. Department of Neurology, Massachusetts, General Hospital, Boston
    4. Department of Pediatric Neurology, Massachusetts General Hospital, Boston
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  • Larry Seidman,

    1. Department of Psychiatry, Harvard Medical School, Boston
    2. Neuroscience Program, Harvard Medical School, Boston
    3. Department of Psychiatry, Massachusetts Mental Health Center, Boston
    4. Pediatric Psychopharmacology Unit, Massachusetts General Hospital, Boston
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  • Joseph Biederman,

    1. Department of Psychiatry, Harvard Medical School, Boston
    2. Pediatric Psychopharmacology Unit, Massachusetts General Hospital, Boston
    3. Department of Psychiatry, Massachusetts General Hospital, Boston
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  • Steven M Hodge,

    1. Center for Morphometric Analysis, Massachusetts General Hospital, Charlestown
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  • Megan E Dieterich,

    1. Department of Psychiatry, Cambridge Health Alliance, Cambridge
    2. Department of Psychiatry, McLean Hospital, Belmont
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  • Emily D Gerstein,

    1. Department of Psychiatry, Cambridge Health Alliance, Cambridge
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  • David N Kennedy,

    1. Center for Morphometric Analysis, Massachusetts General Hospital, Charlestown
    2. Neuroscience Program, Harvard Medical School, Boston
    3. Department of Neurology, Massachusetts, General Hospital, Boston
    4. Department of Pediatric Neurology, Massachusetts General Hospital, Boston
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  • Scott L Rauch,

    1. Department of Psychiatry, Harvard Medical School, Boston
    2. Neuroscience Program, Harvard Medical School, Boston
    3. Department of Psychiatry, Massachusetts General Hospital, Boston
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  • Bruce M Cohen,

    1. Department of Psychiatry, Harvard Medical School, Boston
    2. Department of Psychiatry, McLean Hospital, Belmont
    3. Brain Imaging Center, McLean Hospital, Belmont
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  • Verne S Caviness

    1. Center for Morphometric Analysis, Massachusetts General Hospital, Charlestown
    2. Neuroscience Program, Harvard Medical School, Boston
    3. Department of Neurology, Massachusetts, General Hospital, Boston
    4. Department of Pediatric Neurology, Massachusetts General Hospital, Boston
    5. Pediatric Psychopharmacology Unit, Massachusetts General Hospital, Boston
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  • The authors of this paper do not have any commercial associations that might pose a conflict of interest in connection with this manuscript.

Jean A Frazier MD, Child and Adolescent Neuropsychiatric Research Program, Cambridge Health Alliance, 10 President's Landing, Medford, MA 02155, USA. Fax: +1 781 306 8644;
e-mail: jfrazier@challiance.org

Abstract

Objective:  Few magnetic resonance imaging (MRI) studies of bipolar disorder (BPD) have investigated the entire cerebral cortex. Cortical gray matter (GM) volume deficits have been reported in some studies of adults with BPD; this study assessed the presence of such deficits in children with BPD.

Methods:  Thirty-two youths with DSM-IV BPD (mean age 11.2 ± 2.8 years) and 15 healthy controls (HC) (11.2 ± 3.0 years) had structured and clinical interviews, neurological examinations, neurocognitive testing, and MRI scanning on a 1.5 T GE Scanner. Image parcellation divided the neocortex into 48 gyral-based units per hemisphere, and these units were combined into frontal (FL), temporal (TL), parietal (PL), and occipital (OL) lobe volumes. Volumetric differences were examined using univariate linear regression models with α = 0.05.

Results:  Relative to controls, the BPD youth had significantly smaller bilateral PL, and left TL. Analysis of PL and TL gyri showed significantly smaller volume in bilateral postcentral gyrus, and in left superior temporal and fusiform gyri, while the parahippocampal gyri were bilaterally increased in the BPD group. Although the FL overall did not differ between groups, an exploratory analysis showed that the right middle frontal gyrus was also significantly smaller in the BPD group.

Conclusions:  Children with BPD showed deficits in PL and TL cortical GM. Further analyses of the PL and TL found differences in areas involved in attentional control, facial recognition, and verbal and declarative memory. These cortical deficits may reflect early age of illness onset.

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