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Cortical thickness and subcortical volumes alterations in euthymic bipolar I patients treated with different mood stabilizers

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Abstract

Reported structural abnormalities of patients with bipolar disorder (BD) are inconsistent and the use of psychotropic medication is one of the sources of heterogeneity. A fairly small number of morphometric studies have involved comparison of BD on different mood stabilizers. Here in this study, we aimed to investigate the cortical thickness and subcortical volumes in euthymic BD patients on lithium and valproate and healthy controls (HC), and to elucidate the relationship between the use of medication and brain structure variations. We acquired structural magnetic resonance imaging data from 35 BD patients (19/valproate;16/lithium) and 30 HC subjects. Cortical thickness was compared in multiple locations across the continuous cortical surface, and subcortical volumes were compared on a structure-by-structure basis. Group analyses revealed widespread thinning of the prefrontal cortex in BD. Compared with BD on valproate, BD on lithium showed significant increased cortical thickness of the left rostral middle frontal cortex and right superior frontal cortex, while cortical thickness was not significantly different between BD on lithium and HC in the bilateral rostral middle frontal cortex. Moreover, no significant difference was observed in subcortical volume. Limitations of this study comprise the possible effect of other psychotropic drugs, small sample size and the cross-sectional design. Therefore, the results suggest medication-related neurobiological difference between BD patients on different mood stabilizers, but no casual role can be proposed. Our findings provided new evidence about the effects of psychotropic medication upon neuroanatomy in BD, and could help to explain the inconsistency of existing studies as well as contribute to the extraction of reliable neuroimaging biomarkers in BD.

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Funding

This work was supported by the Science and Technology Bureau of Shenzhen city (grant number JCYJ20150402093137765 and 20170814183413357), the Sanming Project of Medicine in Shenzhen (grant number SZSM201612006), the National Natural Science Foundation of China (grant number 81871443), and the Shenzhen Peacock Plan (grant number KQTD2016053112051497).

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Authors and Affiliations

  1. School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen 518060, China

    Linling Li, Fei Tang & Zhiguo Zhang

  2. Department for Affective Disorders, Shenzhen Mental Health Centre, Shenzhen Key Lab for Psychological Healthcare, Shenzhen 518020, China

    Linling Li, Erni Ji, Yuanhan Bai & Haichen Yang

  3. Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging, Shenzhen University, Shenzhen 518060, China

    Linling Li, Fei Tang & Zhiguo Zhang

  4. Mental Health Institute of the Second Xiangya Hospital, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha 410011, China

    Xue Han

  5. Department of Mental Health, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518060, China

    Xue Han

  6. Department for Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China

    Daihui Peng & Yiru Fang

  7. Department of Communication Engineering, Shenzhen University, Shenzhen 518060, China

    Shengli Zhang

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  1. Linling Li
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  9. Zhiguo Zhang
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  10. Haichen Yang
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Correspondence to Zhiguo Zhang or Haichen Yang.

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Linling Li, Erni Ji, Xue Han, Fei Tang, Yuanhan Bai, Daihui Peng, Yiru Fang, Shengli Zhang, Zhiguo Zhang and Haichen Yang declare that they have no conflicts of interest.

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All procedures performed in this study were approved by the Human Research Ethics Committee of the Shenzhen Mental Health Centre, and were conducted in accordance with the 1964 Helsinki declaration and its later amendments.

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Informed consent was obtained from all individual participants included in the study.

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Li, L., Ji, E., Han, X. et al. Cortical thickness and subcortical volumes alterations in euthymic bipolar I patients treated with different mood stabilizers. Brain Imaging and Behavior 13, 1255–1264 (2019). https://doi.org/10.1007/s11682-018-9950-9

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