Preliminary communicationA longitudinal study of fronto-limbic brain structures in patients with bipolar I disorder during lithium treatment
Introduction
Bipolar type I (BPI) disorder has been associated with regional changes in brain volume (Beyer and Krishnan, 2002). There are available treatments that help a substantial proportion of these patients, but their exact mechanisms of action are not yet clear. The effect of psychotropics on regional brain volumes of patients with BD is a major research focus in the quest to reveal the mechanisms of action of these drugs. Several studies have evaluated lithium, one of the mainstay treatments in BD, and reported its effect on specific brain regions (Monkul et al., 2007, Moore et al., 2009). Previous findings showed fronto-limbic volumetric increases during lithium treatment in patients with BD (Hallahan et al., 2011). However, no longitudinal study comparing healthy subjects and BD patients has so far been reported. Here we report changes in specific fronto-limbic regional brain volumes in BD subjects undergoing lithium treatment compared to untreated healthy comparison subjects.
Section snippets
Methods
Thirty BPI patients, diagnosed according to DSM-IV-TR criteria, and 11 healthy comparison subjects were enrolled. The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders Axis I (SCID I) was applied to patients in order to confirm the diagnosis of BPI. Subjects were right-handed according to the Edinburgh Inventory (Oldfield, 1971) and drug-free for at least 2 weeks before the study, and they had no comorbid psychiatric disorders, no severe systemic
Results
There were no significant differences between groups on age and sex (t=−0.808, p=0.434 and χ2=0.012, p=0.913, respectively). Some of the clinical variables are presented in Table 1. According to the baseline symptoms and the response definition described above, six patients were classified as euthymics, 12 were responders and six were non-responders after 4 weeks of lithium treatment. All patients, who were classified as euthymics at baseline, remained euthymic throughout the study.
Taken over
Discussion
We observed both disease-related between group differences and treatment-related within group changes in regional brain volumes of bipolar patients during lithium treatment.
Role of funding source
This study is partly supported by MH 68766 and RR 20571.
Conflict of interest
Dr. Soares received research grants from Repligen, GSK, Merck, BMS and Forrest, and served as consultant/speaker for Pfizer and Abbott. Dr. Hatch served as a paid consultant to the Biomedical Development Corporation, the Academy for Academic Leadership, and The University of Texas Health Science Center at Houston and his work was funded by the NIH. Dr. Selek received travel grant from Society of Biological Psychiatry. The other authors declare no conflict of interest.
Acknowledgments
This study is partly supported by MH 68766 and RR 20571.
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2018, Journal of Affective DisordersCitation Excerpt :A recent preliminary longitudinal study evaluating fronto-limbic structures in BD subjects treated with lithium for 4-weeks showed a decrease in the left hippocampus and right ACC volumes associated with non-response to lithium. In the same study, an increase in left PFC was associated with favorable response to lithium (Selek et al., 2013). Longer lithium exposure was also associated with improved white matter integrity in older adults with BD (Gildengers et al., 2015).