A role for white matter abnormalities in the pathophysiology of bipolar disorder

Katie Mahon, Katherine E. Burdick, Philip R. Szeszko

Research output: Contribution to journalReview articlepeer-review

164 Scopus citations

Abstract

Bipolar disorder is a chronically disabling psychiatric disorder characterized by manic states that is often interspersed with periods of depression whose neurobiology remains largely unknown. There is, however, increasing evidence that white matter (WM) abnormalities may play an important role in the neurobiology of the disorder. In this review we critically evaluate evidence for WM abnormalities in bipolar disorder obtained from neuroimaging, neuropathological, and genetic research. Increased rates of white matter hyperintensities, regional volumetric abnormalities, abnormal water diffusion along prefrontal-subcortical tracts, fewer oligodendrocytes in prefrontal WM, and alterations in the expression of myelin- and oligodendrocyte-related genes are among the most consistent findings. Abnormalities converge in the prefrontal WM and, in particular, tracts that connect prefrontal regions and subcortical gray matter structures known to be involved in emotion. Taken together, the evidence supports and clarifies a model of BD that involves disconnectivity in regions implicated in emotion generation and regulation.

Original languageEnglish
Pages (from-to)533-554
Number of pages22
JournalNeuroscience and Biobehavioral Reviews
Volume34
Issue number4
DOIs
StatePublished - Mar 2010
Externally publishedYes

Keywords

  • Bipolar disorder
  • Diffusion tensor imaging
  • White matter

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