Journal
SCHIZOPHRENIA BULLETIN
Volume 45, Issue 2, Pages 464-473Publisher
OXFORD UNIV PRESS
DOI: 10.1093/schbul/sby047
Keywords
neuroimaging; bipolar disorder; pathophysiology; mania; magnetic resonance imaging; whole-brain statistical analysis
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Funding
- Instituto de Salud Carlos III-Subdireccion General de Evaluacion y Fomento de la Investigacion, Plan Nacional 2008-2011 and 2013-2016
- European Regional Development Fund (FEDER) [PI09/1927, CES 12/024, PI07/1278, PI10/02622, PI15/02242]
- Plan Nacional de I+ D+ i
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Background Brain structural and functional changes in bipolar disorder (BD) are well-established findings, but it is uncertain whether these changes are already present in first episode mania (FEM). Methods We compared 31 FEM subjects, with 31 healthy individuals matched for age, sex, and premorbid IQ. Whole-brain voxel-wise morphometry, functional magnetic resonance imaging during the n-back task, and a functional connectivity analysis were performed. Results There were no volumetric differences between the 2 groups. During the 2-back task, FEM patients did not perform differently from controls and activated similar regions, but they showed less deactivation in the ventromedial prefrontal cortex (vmPFC), the anterior hub of the default mode network (DMN). They showed preserved functional connectivity between the vmPFC and other regions of the DMN, but increased connectivity with the superior frontal gyrus. Conclusions The absence of volumetric changes in FEM patients suggests that these changes could be related to progression of the illness. On the other hand, the failure of deactivation of the anterior hub of the DMN is present from the onset of the illness and may represent a core pathophysiological feature of BD.
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