Xiuli Wang, MD*; Qiang Luo, MM*; Fangfang Tian, MM; Bochao Cheng, MD, PhD; Lihua Qiu, MD, PhD; Song Wang, PhD; Manxi He, MD; Hongming Wang, MM; Mingjun Duan, MD; Zhiyun Jia, MD, PhD
Background: The literature on grey-matter volume alterations in bipolar disorder is heterogeneous in its findings.
Methods: Using effect-size differential mapping, we conducted a meta-analysis of grey-matter volume alterations in patients with bipolar disorder compared with healthy controls.
Results: We analyzed data from 50 studies that included 1843 patients with bipolar disorder and 2289 controls. Findings revealed lower grey-matter volumes in the bilateral superior frontal gyri, left anterior cingulate cortex and right insula in patients with bipolar disorder and in patients with bipolar disorder type I. Patients with bipolar disorder in the euthymic and depressive phases had spatially distinct regions of altered grey-matter volume. Meta-regression revealed that the proportion of female patients with bipolar disorder or bipolar disorder type I was negatively correlated with regional grey-matter alteration in the right insula; the proportion of patients with bipolar disorder or bipolar disorder type I taking lithium was positively correlated with regional grey-matter alterations in the left anterior cingulate/paracingulate gyri; and the proportion of patients taking antipsychotic medications was negatively correlated with alterations in the anterior cingulate/paracingulate gyri.
Limitations: This study was cross-sectional; analysis techniques, patient characteristics and clinical variables in the included studies were heterogeneous.
Conclusion: Structural grey-matter abnormalities in patients with bipolar disorder and bipolar disorder type I were mainly in the prefrontal cortex and insula. Patients’ mood state might affect grey-matter alterations. Abnormalities in regional grey-matter volume could be correlated with patients’ specific demographic and clinical features.
*These authors contributed equally to the work.
Submitted Jan. 3, 2018; Revised May 31, 2018; Revised Jun. 15, 2018; Accepted Jun. 18, 2018; Published online Oct. 24, 2018
Acknowledgements: This study was supported by the National Natural Science Foundation (grant nos. 81571637 and 81771812), the Sichuan Science and Technology Program (project no. 2018SZ0391), the Research Funds of Sichuan Provincial Health and Family Planning Commission (project no. 16PJ052), and the Medical Research Funds of Chengdu Municipal Health and Family Planning Commission (project no. 2015114).
Affiliations: From the Department of Psychiatry, the Fourth People’s Hospital of Chengdu, Chengdu, China (Duan, He, H. Wang, S. Wang, X. Wang); the Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China (Luo, Jia); the Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China (Tian, Jia); the Department of Radiology, West China Second University Hospital of Sichuan University, Chengdu, China (Cheng); and the Department of Radiology, the Second People’s Hospital of Yibin, Yibin, China (Qiu).
Competing interests: None declared.
Contributors: X. Wang and Z. Jia designed the study. F. Tian and H. Wang acquired the data, which X. Wang, Q. Luo, F. Tian, B. Cheng, L. Qiu, S. Wang, M. He, M. Duan and Z. Jia analyzed. X. Wang and Q. Luo wrote the article, which all authors reviewed. All authors approved the final version to be published and can certify that no other individuals not listed as authors have made substantial contributions to the paper.
Correspondence to: Z. Jia, Department of Nuclear Medicine, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan (610041), PR China; firstname.lastname@example.org