Prefrontal-temporal gray matter deficits in bipolar disorder patients with persecutory delusions

Tost, H., Ruf, M., Schmal, C., Schulze, T. G., Knorr, C., Vollmert, C., Bosshenz, K., Ende, G., Meyer-Lindenberg, A., Henn, F. A., Rietschel, M. (January 2010) Prefrontal-temporal gray matter deficits in bipolar disorder patients with persecutory delusions. Journal of Affective Disorders, 120 (1-3). pp. 54-61. ISSN 0165-0327

URL: http://www.ncbi.nlm.nih.gov/pubmed/19419772
DOI: 10.1016/j.jad.2009.04.009

Abstract

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.

Item Type: Paper
Uncontrolled Keywords: Adult Bipolar Disorder/cerebrospinal fluid/*diagnosis/*epidemiology Case-Control Studies Comorbidity Delusions/cerebrospinal fluid/diagnosis/*epidemiology Diagnostic and Statistical Manual of Mental Disorders Female Humans Magnetic Resonance Imaging Male Prefrontal Cortex/*anatomy & histology/*pathology Temporal Lobe/*anatomy & histology/*pathology
Subjects: diseases & disorders > mental disorders > personality disorders > bipolar disorder
organs, tissues, organelles, cell types and functions > tissues types and functions > prefrontal cortex
CSHL Authors:
Communities: CSHL labs > Henn lab
Depositing User: Matt Covey
Date: January 2010
Date Deposited: 06 Jun 2014 18:58
Last Modified: 06 Jun 2014 18:58
Related URLs:
URI: http://repository.cshl.edu/id/eprint/30266

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