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Three-dimensional mapping of hippocampal anatomy in adolescents with bipolar disorder.

OBJECTIVE: Early-onset bipolar disorder is thought to be a particularly severe variant of the illness. Continuity with the adult form of illness remains unresolved, but preliminary evidence suggests similar biological underpinnings. Recently, we observed localized hippocampal decreases in unmedicated adults with bipolar disorder that were not detectable with conventional volumetric measures. Using the same three-dimensional mapping methods, we sought to investigate whether a similar pattern exists in adolescents with bipolar disorder. METHOD: High-resolution brain magnetic resonance images were acquired from 16 adolescents meeting DSM-IV criteria for bipolar disorder (mean age 15.5 +/- 3.4 years, 50% female) and 20 demographically matched, typically developing control subjects. Three-dimensional parametric mesh models of the hippocampus were created from manual tracings of the hippocampal formation. RESULTS: Controlling for total brain volume, total hippocampal volume was significantly smaller in adolescent patients with bipolar disorder relative to controls (by 9.2%). Statistical mapping results, confirmed by permutation testing, revealed significant localized deformations in the head and tail of the left hippocampus in adolescents with bipolar disorder, relative to normal controls. In addition, there was a significant positive correlation between hippocampal size and age in patients with bipolar disorder, whereas healthy controls showed an inverse relation. DISCUSSION: Localized hippocampal deficits in adolescent patients with bipolar disorder suggest a possible neural correlate for memory deficits observed in this illness. Moreover, age-related increases in hippocampal size in patients with bipolar disorder, not observed in healthy controls, may reflect abnormal developmental mechanisms in bipolar disorder. This possibility must be confirmed by longitudinal studies.

Pubmed ID: 18356767

Authors

  • Bearden CE
  • Soares JC
  • Klunder AD
  • Nicoletti M
  • Dierschke N
  • Hayashi KM
  • Narr KL
  • Brambilla P
  • Sassi RB
  • Axelson D
  • Ryan N
  • Birmaher B
  • Thompson PM

Journal

Journal of the American Academy of Child and Adolescent Psychiatry

Publication Data

May 29, 2008

Associated Grants

  • Agency: NIA NIH HHS, Id: AG016570
  • Agency: NIBIB NIH HHS, Id: EB01651
  • Agency: NICHD NIH HHS, Id: HD050735
  • Agency: NIMH NIH HHS, Id: K23 MH074644
  • Agency: NIMH NIH HHS, Id: K23 MH074644-01
  • Agency: NIMH NIH HHS, Id: K23 MH074644-01
  • Agency: NCRR NIH HHS, Id: K24 RR020571-05
  • Agency: NIMH NIH HHS, Id: MH 068662
  • Agency: NCRR NIH HHS, Id: R21 RR019771
  • Agency: NCRR NIH HHS, Id: R21 RR019771-02
  • Agency: NCRR NIH HHS, Id: RR019771
  • Agency: NCRR NIH HHS, Id: RR020571

Mesh Terms

  • Adolescent
  • Amygdala
  • Bipolar Disorder
  • Brain Mapping
  • Dominance, Cerebral
  • Emotions
  • Female
  • Gyrus Cinguli
  • Hippocampus
  • Humans
  • Image Processing, Computer-Assisted
  • Imaging, Three-Dimensional
  • Magnetic Resonance Imaging
  • Male
  • Mental Recall
  • Nerve Net
  • Neuropsychological Tests
  • Reference Values