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342. Anatomical MRI study of basal ganglia in bipolar disorder patients
Friday Abstracts
temporal and prefrontal structures, and a reduction in overall neocortical gray matter. However, the specificity of the overall gray matter reduction to schizophrenia compared with other psychotic disorders was not clear. To determine the specificity of changes to schizophrenic psychosis, an automatic segmentation program was applied to high resolution MRI with affective psychosis subjects as a contrast group. MR images were obtained at first hospitalization from patients with schizophrenia (n ⫽ 23), and from age-matched subjects with affective psychosis (n ⫽ 29, n ⫽ 25 manic), and normal controls (n ⫽ 29). The intensity information from both the SPGR and T2 images was then used in a fully automated segmentation program to classify tissue into gray matter, white matter, or CSF. Subsequent manual editing separated neocortical from non-neocortical gray matter. (Medial temporal structures, i.e., amygdala and hippocampus, were excluded.) Lateral ventricles were also delineated. Repeated measures ANCOVA showed a GROUP ⫻ SIDE interaction based on relative volumes [(ROI volume/intra-cranial volume) ⫻ 100]. Follow up ANCOVA revealed that left cortical gray matter volume was significantly reduced in schizophrenia compared to affective psychotic subjects (3.8% reduction in schizophrenia) and normal controls (5.4% reduction in schizophrenia). Schizophrenia subjects also showed significant increases in CSF volume of subarachnoid space, 29.0% relative to affective psychosis and 43.3% relative to controls. These findings suggest that left hemisphere cortical gray abnormalities may be present at first hospitalization in schizophrenic but not in affective psychosis patients. Based on other data from our laboratory, this reduction may be relatively greater in temporal and frontal lobes.
342. ANATOMICAL MRI STUDY OF BASAL GANGLIA IN BIPOLAR DISORDER PATIENTS P. Brambilla, K. Harenski, M. Nicoletti, A.G. Mallinger, E. Frank, D.J. Kupfer, M.S. Keshavan, J.C. Soares Neurochemical Brain Imaging Laboratory, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA 15213 Findings from MRI studies suggested basal ganglia abnormalities in unipolar depression. In bipolar disorder, the available results have been mostly inconclusive. This study examined further the possibility of anatomical basal ganglia abnormalities in bipolar subjects. 7 DSM-IV drug-free bipolar patients (mean ⫾ S.D. age ⫽ 37.4 ⫾ 6.3), 15 lithium-treated bipolar patients (mean ⫾ S.D. age ⫽ 34.9 ⫾ 9.4) and 16 healthy controls (mean ⫾ S.D. age ⫽ 36.0 ⫾ 9.3) were studied. A 1.5T GE Signa magnet with Signa 5.4.3 software (General Electrics, Inc. Milwaukee, WI) was used. 3D gradient echo imaging (SPGR) was used (TR ⫽ 25 ms, TE ⫽ 5 ms, nutation angle ⫽ 40°, FOV ⫽ 24 cm, slice thickness ⫽ 1.5 mm, NEX ⫽ 1, matrix size ⫽ 256 ⫻ 192). Image analysis was conducted blindly on the semi-automated software Scion Image (Scion Corporation, Inc., Frederick, MD). No significant differences were found among groups for caudate and putamen gray matter volumes (ANOVA, p ⬎ 0.05). However, significant inverse correlation with age was found for right caudate, and right and left putamen gray matter volumes in patients (r ⫽ ⫺0.488, p ⫽ 0.021; r ⫽ ⫺0.453, p ⫽ 0.034; r ⫽ ⫺0.546, p ⫽ 0.009), but not in controls. A significant inverse correlation between length of illness and left putamen gray matter volumes was also found in patients (Spearman Coefficient ⫽ ⫺0.427, p ⫽ 0.048). MRI anatomical abnormalities in basal ganglia may be more characteristic of unipolar than bipolar disorder. However, our results suggest that age and length of illness could be relevant factors leading to increased loss of gray matter volume in basal ganglia structures, and part of the brain mechanisms that may be implicated in the pathophysiology of bipolar disorder.
BIOL PSYCHIATRY 2000;47:1S–173S
103S
This study was supported by MH 29618 and MH 30915, Stanley Foundation, and NARSAD.
343. MRI INVESTIGATION OF CEREBELLAR ABNORMALITIES IN BIPOLAR DISORDER P. Brambilla, K. Harenski, M. Nicoletti, A.G. Mallinger, E. Frank, D.J. Kupfer, M.S. Keshavan, J.C. Soares Neurochemical Brain Imaging Laboratory, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, USA This MRI study was conducted to investigate the potential role of anatomical cerebellar abnormalities in the pathophysiology of bipolar disorder. 7 DSM-IV unmedicated bipolar patients (mean ⫾ S.D. age ⫽ 37.4 ⫾ 6.3), 15 lithium-treated bipolar patients (mean ⫾ S.D. age ⫽ 34.9 ⫾ 9.4) and 16 healthy controls (mean ⫾ S.D. age ⫽ 36.0 ⫾ 9.3) were studied. A 1.5T GE Signa magnet with 5.4.3 software (General Electrics, Inc., Milwaukee, WI) was used. 3D gradient echo imaging (SPGR) was performed (TR ⫽ 25 ms, TE ⫽ 5 ms, nutation-angle ⫽ 40°, FOV ⫽ 24 cm, slice thickness ⫽ 1.5 mm, NEX ⫽ 1, matrix size ⫽ 256 ⫻ 192). Image analysis was conducted blindly with the Scion Image software (Scion Corporation, Inc. Frederick, MD). In left cerebellar hemisphere, there were trends to decreased gray matter volumes in drug-free patients (mean ⫾ S.D. ⫽ 44.98 ⫾ 8.4 ml; t-test ⫽ 1.878, df ⫽ 21, p ⫽ 0.074), and increased gray matter volume in lithium-treated patients (mean ⫾ S.D. ⫽ 46.97 ⫾ 5.51 ml; t-test ⫽ 1.708, df ⫽ 29, p ⫽ .098) compared to controls (mean ⫾ S.D. ⫽ 50.14 ⫾ 4.81 ml). No significant differences were found between drug-free and lithium-treated patients. There was a trend to a significant inverse correlation between gray matter vermal volume and age in unmedicated patients (r ⫽ ⫺0.692, p ⫽ .085). No effects of length of illness or number of episodes were detected. We are currently measuring the areas of V1, V2 and V3 vermal regions, and those data will also be presented. In this preliminary study, no anatomical abnormalities were found in cerebellar and vermal volumes in drug-free or lithium-treated bipolar patients. However, sample size utilized was relatively small. Data from a larger patient sample will be presented. This study was supported by MH 29618 and MH 30915, Stanley Foundation, and NARSAD.
344. DORSOLATERAL PREFRONTAL CORTEX ABNORMALITIES IN BIPOLAR DISORDER—POSSIBLE EFFECTS OF LITHIUM TREATMENT? R. Figueroa, K. Harenski, M. Nicoletti, P. Brambilla, A.G. Mallinger, E. Frank, D.J. Kupfer, M.S. Keshavan, J.C. Soares Neurochemical Brain Imaging Laboratory, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA 15213 In vivo imaging studies suggested that the dorsolateral prefrontal cortex (DLPC) may be a site of abnormalities in mood disorders. We measured
temporal and prefrontal structures, and a reduction in overall neocortical gray matter. However, the specificity of the overall gray matter reduction to schizophrenia compared with other psychotic disorders was not clear. To determine the specificity of changes to schizophrenic psychosis, an automatic segmentation program was applied to high resolution MRI with affective psychosis subjects as a contrast group. MR images were obtained at first hospitalization from patients with schizophrenia (n ⫽ 23), and from age-matched subjects with affective psychosis (n ⫽ 29, n ⫽ 25 manic), and normal controls (n ⫽ 29). The intensity information from both the SPGR and T2 images was then used in a fully automated segmentation program to classify tissue into gray matter, white matter, or CSF. Subsequent manual editing separated neocortical from non-neocortical gray matter. (Medial temporal structures, i.e., amygdala and hippocampus, were excluded.) Lateral ventricles were also delineated. Repeated measures ANCOVA showed a GROUP ⫻ SIDE interaction based on relative volumes [(ROI volume/intra-cranial volume) ⫻ 100]. Follow up ANCOVA revealed that left cortical gray matter volume was significantly reduced in schizophrenia compared to affective psychotic subjects (3.8% reduction in schizophrenia) and normal controls (5.4% reduction in schizophrenia). Schizophrenia subjects also showed significant increases in CSF volume of subarachnoid space, 29.0% relative to affective psychosis and 43.3% relative to controls. These findings suggest that left hemisphere cortical gray abnormalities may be present at first hospitalization in schizophrenic but not in affective psychosis patients. Based on other data from our laboratory, this reduction may be relatively greater in temporal and frontal lobes.
342. ANATOMICAL MRI STUDY OF BASAL GANGLIA IN BIPOLAR DISORDER PATIENTS P. Brambilla, K. Harenski, M. Nicoletti, A.G. Mallinger, E. Frank, D.J. Kupfer, M.S. Keshavan, J.C. Soares Neurochemical Brain Imaging Laboratory, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA 15213 Findings from MRI studies suggested basal ganglia abnormalities in unipolar depression. In bipolar disorder, the available results have been mostly inconclusive. This study examined further the possibility of anatomical basal ganglia abnormalities in bipolar subjects. 7 DSM-IV drug-free bipolar patients (mean ⫾ S.D. age ⫽ 37.4 ⫾ 6.3), 15 lithium-treated bipolar patients (mean ⫾ S.D. age ⫽ 34.9 ⫾ 9.4) and 16 healthy controls (mean ⫾ S.D. age ⫽ 36.0 ⫾ 9.3) were studied. A 1.5T GE Signa magnet with Signa 5.4.3 software (General Electrics, Inc. Milwaukee, WI) was used. 3D gradient echo imaging (SPGR) was used (TR ⫽ 25 ms, TE ⫽ 5 ms, nutation angle ⫽ 40°, FOV ⫽ 24 cm, slice thickness ⫽ 1.5 mm, NEX ⫽ 1, matrix size ⫽ 256 ⫻ 192). Image analysis was conducted blindly on the semi-automated software Scion Image (Scion Corporation, Inc., Frederick, MD). No significant differences were found among groups for caudate and putamen gray matter volumes (ANOVA, p ⬎ 0.05). However, significant inverse correlation with age was found for right caudate, and right and left putamen gray matter volumes in patients (r ⫽ ⫺0.488, p ⫽ 0.021; r ⫽ ⫺0.453, p ⫽ 0.034; r ⫽ ⫺0.546, p ⫽ 0.009), but not in controls. A significant inverse correlation between length of illness and left putamen gray matter volumes was also found in patients (Spearman Coefficient ⫽ ⫺0.427, p ⫽ 0.048). MRI anatomical abnormalities in basal ganglia may be more characteristic of unipolar than bipolar disorder. However, our results suggest that age and length of illness could be relevant factors leading to increased loss of gray matter volume in basal ganglia structures, and part of the brain mechanisms that may be implicated in the pathophysiology of bipolar disorder.
BIOL PSYCHIATRY 2000;47:1S–173S
103S
This study was supported by MH 29618 and MH 30915, Stanley Foundation, and NARSAD.
343. MRI INVESTIGATION OF CEREBELLAR ABNORMALITIES IN BIPOLAR DISORDER P. Brambilla, K. Harenski, M. Nicoletti, A.G. Mallinger, E. Frank, D.J. Kupfer, M.S. Keshavan, J.C. Soares Neurochemical Brain Imaging Laboratory, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, USA This MRI study was conducted to investigate the potential role of anatomical cerebellar abnormalities in the pathophysiology of bipolar disorder. 7 DSM-IV unmedicated bipolar patients (mean ⫾ S.D. age ⫽ 37.4 ⫾ 6.3), 15 lithium-treated bipolar patients (mean ⫾ S.D. age ⫽ 34.9 ⫾ 9.4) and 16 healthy controls (mean ⫾ S.D. age ⫽ 36.0 ⫾ 9.3) were studied. A 1.5T GE Signa magnet with 5.4.3 software (General Electrics, Inc., Milwaukee, WI) was used. 3D gradient echo imaging (SPGR) was performed (TR ⫽ 25 ms, TE ⫽ 5 ms, nutation-angle ⫽ 40°, FOV ⫽ 24 cm, slice thickness ⫽ 1.5 mm, NEX ⫽ 1, matrix size ⫽ 256 ⫻ 192). Image analysis was conducted blindly with the Scion Image software (Scion Corporation, Inc. Frederick, MD). In left cerebellar hemisphere, there were trends to decreased gray matter volumes in drug-free patients (mean ⫾ S.D. ⫽ 44.98 ⫾ 8.4 ml; t-test ⫽ 1.878, df ⫽ 21, p ⫽ 0.074), and increased gray matter volume in lithium-treated patients (mean ⫾ S.D. ⫽ 46.97 ⫾ 5.51 ml; t-test ⫽ 1.708, df ⫽ 29, p ⫽ .098) compared to controls (mean ⫾ S.D. ⫽ 50.14 ⫾ 4.81 ml). No significant differences were found between drug-free and lithium-treated patients. There was a trend to a significant inverse correlation between gray matter vermal volume and age in unmedicated patients (r ⫽ ⫺0.692, p ⫽ .085). No effects of length of illness or number of episodes were detected. We are currently measuring the areas of V1, V2 and V3 vermal regions, and those data will also be presented. In this preliminary study, no anatomical abnormalities were found in cerebellar and vermal volumes in drug-free or lithium-treated bipolar patients. However, sample size utilized was relatively small. Data from a larger patient sample will be presented. This study was supported by MH 29618 and MH 30915, Stanley Foundation, and NARSAD.
344. DORSOLATERAL PREFRONTAL CORTEX ABNORMALITIES IN BIPOLAR DISORDER—POSSIBLE EFFECTS OF LITHIUM TREATMENT? R. Figueroa, K. Harenski, M. Nicoletti, P. Brambilla, A.G. Mallinger, E. Frank, D.J. Kupfer, M.S. Keshavan, J.C. Soares Neurochemical Brain Imaging Laboratory, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA 15213 In vivo imaging studies suggested that the dorsolateral prefrontal cortex (DLPC) may be a site of abnormalities in mood disorders. We measured