Meta-analysis of magnetic resonance imaging brain morphometry studies in bipolar disorder

doi:10.1016/j.biopsych.2004.06.021

Biological Psychiatry

Volume 56, Issue 6, 15 September 2004, Pages 411-417

https://doi.org/10.1016/j.biopsych.2004.06.021 Get rights and content

Background

Several studies assessing volumetric measurements of regional brain structure in bipolar disorder have been published in recent years, but their results have been inconsistent. Our aim was to complete a meta-analysis of regional morphometry in bipolar disorder as assessed using magnetic resonance imaging (MRI).

Methods

We conducted a systematic literature search of MRI studies of bipolar disorder and identified studies which reported volume measurements in a selected number of regions. Twenty-six studies comprising volumetric measurements on up to 404 independent patients with bipolar disorder were included. A meta-analysis was carried out comparing the volumes of regions in bipolar disorder to comparison subjects using a random effects model.

Results

Patients with bipolar disorder had enlargement of the right lateral ventricle, but no other regional volumetric deviations which reached significance. Strong heterogeneity existed for several regions, including the third ventricle, left subgenual prefrontal cortex, bilateral amygdala and thalamus.

Conclusions

Regional volume of most structures we studied is preserved in bipolar disorder as a whole, which was significantly associated only with right-sided ventricular enlargement. However the extensive heterogeneity detected indicates the need for further studies to establish if consistent regional brain volume deviation exists in bipolar disorder or in specific clinical subsets of the illness.

Section snippets

Study ascertainment

Studies were considered for inclusion if they 1) were published by December 2003, 2) compared a group of subjects with bipolar disorder and a normal comparison group, and 3) reported volumetric brain measurements of any structure considered in this meta-analysis. Our criteria for the inclusion of a structure was that it had to have been evaluated by at least three volumetric MRI studies and data had to be available for at least 50 bipolar patients and control subjects. If measurements were

Results of the systematic search

Of the 252 publications initially found by the systematic search of databases, review articles, and hand searches, 72 structural MRI studies were identified that compared subjects with bipolar disorders with a comparison group. Of these, 34 studies did not satisfy inclusion criteria mainly because of qualitative measurements, no absolute regional volumes, incomplete regional volumes, or area measurements only. Of the 38 studies that satisfied inclusion criteria, 6 were superseded by subsequent

Discussion

The results of this study, the first meta-analysis of regional morphometric MRI studies in bipolar disorder, demonstrate that bipolar disorder is associated with right lateral ventricular enlargement but, surprisingly, no significant differences in the other structures examined. Thus, we confirm the conclusion from recent reviews that bipolar disorder is associated with mild ventricular enlargement but demonstrate that this appears more prominent on the right side of the brain. This finding

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Meta-analysis of magnetic resonance imaging brain morphometry studies in bipolar disorder

Background

Methods

Results

Conclusions

Section snippets

Study ascertainment

Results of the systematic search

Discussion

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Neuropsychopharmacology

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Schizophr Res

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Lancet

Psychiatry Res Neuroimaging

Prog Neuropsychopharmacol Biol Psychiatry

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Neurosci Lett

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Amygdala enlargement in bipolar disorder and hippocampal reduction in schizophreniaAn MRI study demonstrating neuroanatomic specificity

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Am J Psychiatry