RT Journal
A1 Blumberg HP, Kaufman J, Martin A, et al
T1 AMygdala and hippocampal volumes in adolescents and adults with bipolar disorder
JF Archives of General Psychiatry
JO Archives of General Psychiatry
YR 2003
FD December 1
VO 60
IS 12
SP 1201
OP 1208
DO 10.1001/archpsyc.60.12.1201
UL http://dx.doi.org/10.1001/archpsyc.60.12.1201
AB Background 
    The purported functions of medial temporal lobe structures suggest their involvement in the pathophysiology of bipolar disorder (BD). Previous reports of abnormalities in the volume of the amygdala and hippocampus in patients with BD have been inconsistent in their findings and limited to adult samples. Appreciation of whether volumetric abnormalities are early features of BD or whether the abnormalities represent neurodegenerative changes associated with illness duration is limited by the paucity of data in juvenile samples.Objective 
    To investigate amygdala and hippocampal volume in adults and adolescents with BD.Setting and Participants 
    Subjects included 36 individuals (14 adolescents and 22 adults) in outpatient treatment for BD type I at a university hospital or Veterans Affairs medical center or in the surrounding community, and 56 healthy comparison subjects(23 adolescents and 33 adults).Design and Main Outcome Measures 
    Amygdala and hippocampal volumes were defined and measured on high-resolution anatomic magnetic resonance imaging scans. We used a mixed-model, repeated-measures statistical analysis to compare amygdala and hippocampal volumes across groups while covarying for total brain volume, age, and sex. Potential effects of illness features were explored, including rapid cycling, medication, alcohol or other substance dependence, duration, and mood state.Results 
    For both the amygdala and hippocampal regions, we found an overall significant volume reduction in the BD compared with the control group (P<.0001). Amygdala volume reductions (15.6%) were highly significant(P<.0001). We observed a nonsignificant trend(P = .054) toward reductions in hippocampal volumes of lesser magnitude (5.3%). Effects of illness features were not detected.Conclusions 
    These results suggest that BD is associated with decreased volumes of medial temporal lobe structures, with greater effect sizes in the amygdala than in the hippocampus. These abnormalities are likely manifested early in the course of illness, as they affected adolescent and adult subjects similarly in this sample.