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Structural Brain Abnormalities in Bipolar Disorder 

Structural Brain Abnormalities in Bipolar Disorder
Structural Brain Abnormalities in Bipolar Disorder

Koji Matsuo

, Marsal Sanches

, Paolo Brambilla

, and Jair C. Soares

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date: 29 July 2021

Structural brain imaging, particularly using fMRI, provides a means to identify the neuroanatomic substrate for psychiatric conditions, including bipolar disorder. Regional brain volumetric studies suggest enlargement in several key structures that subsume emotional and cognitive control, including striatum (particularly putamen) and possibly amygdala in adult bipolar subjects. Decreased volumes have been observed in prefrontal areas, the cerebellar vermis and white matter structures. Unlike findings in adults, bipolar youth exhibit decreased amygdala volumes, suggestion developmental specificity of abnormalities within this structure. The functional meaning of these abnormalities has been difficult to ascertain, as correlations with clinical data are often inconsistent. Nonetheless, some changes seem to reflect progression related to the number of affective episodes as well as potentially from treatment exposure. In particular, lithium may increase gray matter volumes in some structures (e.g., amygdala) over time. White matter abnormalities have also been relatively consistently demonstrated using various structural imaging techniques in bipolar disorder. These findings support a neuroanatomic model of bipolar disorder involving abnormalities within ventral brain networks that modulate mood.

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