The British Journal of Psychiatry (2009) 195: 194-201. doi: 10.1192/bjp.bp.108.059717
© 2009 The Royal College of Psychiatrists
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Data supplement
Right arrow Submit an eLetter
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Related articles in BJP
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Arnone, D.
Right arrow Articles by McIntosh, A. M.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Arnone, D.
Right arrow Articles by McIntosh, A. M.

REVIEW ARTICLE

Magnetic resonance imaging studies in bipolar disorder and schizophrenia: meta-analysis

D. Arnone, DM, MRCPsych

Neuroscience and Psychiatry Unit, University of Manchester, Manchester and University Department of Psychiatry, Oxford

J. Cavanagh, MD, FRCPsych

Division of Community Based Sciences, Faculty of Medicine, University of Glasgow, Glasgow

D. Gerber, MRCPsych

Gartnavel Royal Hospital, Glasgow

S. M. Lawrie, MD, FRCPsych

Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh

K. P. Ebmeier, MD

Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh and University Department of Psychiatry, Oxford

A. M. McIntosh, MD, MRCPsych

Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK

Correspondence: Danilo Arnone, Neuroscience and Psychiatry Unit, University of Manchester, G810 Stopford Building, Oxford Road, Manchester M13 9PT, UK. Email: danilo.arnone{at}manchester.ac.uk

Declaration of interest

None.

Funding

D.A. is currently supported by the UK Medical Research Council. A.M.M. is currently supported by the Health Foundation.

Background

Several magnetic resonance imaging (MRI) studies have identified structural abnormalities in association with bipolar disorder. The literature is, however, heterogeneous and there is remaining uncertainty about which brain areas are pivotal to the pathogenesis of the condition.

Aims

To identify, appraise and summarise volumetric MRI studies of brain regions comparing bipolar disorder with an unrelated control group and individuals with schizophrenia.

Method

A systematic review and random-effects meta-analysis was carried out to identify key areas of structural abnormality in bipolar disorder and whether the pattern of affected areas separated bipolar disorder from schizophrenia. Significant heterogeneity was explored using meta-regression.

Results

Participants with bipolar disorder are characterised by whole brain and prefrontal lobe volume reductions, and also by increases in the volume of the globus pallidus and lateral ventricles. In comparison with schizophrenia, bipolar disorder is associated with smaller lateral ventricular volume and enlarged amygdala volume. Heterogeneity was widespread and could be partly explained by clinical variables and year of publication, but generally not by differences in image acquisition.

Conclusions

There appear to be robust changes in brain volume in bipolar disorder compared with healthy volunteers, although most changes do not seem to be diagnostically specific. Age and duration of illness appear to be key issues in determining the magnitude of observed effect sizes.


Related articles in BJP:

From the Editor’s desk
Peter Tyrer
BJP 2009 195: 280. [Full Text]