TY - JOUR
T1 - Prefrontal-temporal gray matter deficits in bipolar disorder patients with persecutory delusions
AU - Tost, Heike
AU - Ruf, Matthias
AU - Schmäl, Christine
AU - Schulze, Thomas G.
AU - Knorr, Carolin
AU - Vollmert, Christian
AU - Bößhenz, Katja
AU - Ende, Gabriele
AU - Meyer-Lindenberg, Andreas
AU - Henn, Fritz A.
AU - Rietschel, Marcella
N1 - Funding Information:
This work was supported by grants from the National German Genome Research Network (NGFN) of the Federal Ministry of Education and Research (BMBF). NGFN and BMBF had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.
PY - 2010/1
Y1 - 2010/1
N2 - Objectives: Although brain structural deficits have been repeatedly associated with bipolar disorder (BD), inconsistency in morphometric results has been a feature of neuroimaging studies. We hypothesize that this discrepancy is related to the heterogeneity of BD, and examine the question of whether or not more homogeneous clinical subgroups display a more coherent pattern of morphometric abnormalities. Methods: In a case-control design, we examined differences in gray matter (GM), white matter (WM) and cerebrospinal fluid (CSF) concentration in 42 BD patients and 42 healthy matched controls using optimized voxel-based morphometry (VBM). Subgroup analyses of patients with a lifetime history of psychotic symptoms (BDP, n = 30) and patients with mood-incongruent psychotic symptoms in the form of persecutory delusions (BDPD, n = 15) were performed to accord with previous genetic findings. Results: Analysis of the total BD sample was largely inconclusive, but the BDPD patient subgroup displayed a widespread pattern of significant decreases in GM concentration in the dorsolateral prefrontal (DLPFC), temporal and cingulate cortices, and a significant CSF increase in the adjacent outer ventricular sulci. Comparison of BDPD patients versus BD and BDP patients without persecutory delusions revealed a significant GM decrease in the left DLPFC for the former group. Conclusions: BDPD show pronounced structural abnormalities of the prefrontal and temporal lobes which are similar to the deficits previously reported for schizophrenia (SCZ). Our findings suggest that stratification based solely on psychotic symptoms is insufficient for the differentiation of BD into biologically meaningful subgroups, but also question the pathophysiological validity of the dichotomy in classification between schizophrenia and BD.
AB - Objectives: Although brain structural deficits have been repeatedly associated with bipolar disorder (BD), inconsistency in morphometric results has been a feature of neuroimaging studies. We hypothesize that this discrepancy is related to the heterogeneity of BD, and examine the question of whether or not more homogeneous clinical subgroups display a more coherent pattern of morphometric abnormalities. Methods: In a case-control design, we examined differences in gray matter (GM), white matter (WM) and cerebrospinal fluid (CSF) concentration in 42 BD patients and 42 healthy matched controls using optimized voxel-based morphometry (VBM). Subgroup analyses of patients with a lifetime history of psychotic symptoms (BDP, n = 30) and patients with mood-incongruent psychotic symptoms in the form of persecutory delusions (BDPD, n = 15) were performed to accord with previous genetic findings. Results: Analysis of the total BD sample was largely inconclusive, but the BDPD patient subgroup displayed a widespread pattern of significant decreases in GM concentration in the dorsolateral prefrontal (DLPFC), temporal and cingulate cortices, and a significant CSF increase in the adjacent outer ventricular sulci. Comparison of BDPD patients versus BD and BDP patients without persecutory delusions revealed a significant GM decrease in the left DLPFC for the former group. Conclusions: BDPD show pronounced structural abnormalities of the prefrontal and temporal lobes which are similar to the deficits previously reported for schizophrenia (SCZ). Our findings suggest that stratification based solely on psychotic symptoms is insufficient for the differentiation of BD into biologically meaningful subgroups, but also question the pathophysiological validity of the dichotomy in classification between schizophrenia and BD.
KW - Bipolar disorder
KW - Cerebrospinal fluid
KW - Gray matter
KW - Persecutory delusions
KW - Schizophrenia
KW - Voxel-based morphometry
UR - http://www.scopus.com/inward/record.url?scp=71649085303&partnerID=8YFLogxK
U2 - 10.1016/j.jad.2009.04.009
DO - 10.1016/j.jad.2009.04.009
M3 - Article
C2 - 19419772
AN - SCOPUS:71649085303
SN - 0165-0327
VL - 120
SP - 54
EP - 61
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
IS - 1-3
ER -