Exploring the neuroanatomical bases of psychotic features in bipolar disorder

Although bipolar disorder (BD) is traditionally conceptualised as one diagnostic entity, the heterogeneity of pathophysiological manifestations in BD suggests the need to classify the subtypes of the illness based on neural markers. Specifically, the presence of psychotic symptoms seems to be releva...

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Bibliographic Details
Published in:Epidemiology and psychiatric sciences 2017-08, Vol.26 (4), p.358-363
Main Authors: Maggioni, E., Altamura, A. C., Brambilla, P.
Format: Article
Language:English
Subjects:
Anatomy
Anatomy & physiology
Basal ganglia
Bipolar disorder
Bipolar Disorder - physiopathology
Brain - physiopathology
Brain research
Epidemiology for Behavioural Neurosciences
Gray Matter - diagnostic imaging
Heterogeneity
Humans
Magnetic Resonance Imaging
Mental disorders
Neuroanatomy
Neurobiology
NMR
Nuclear magnetic resonance
Psychiatry
Psychotic Disorders - physiopathology
Resonance
Substantia grisea
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Summary:Although bipolar disorder (BD) is traditionally conceptualised as one diagnostic entity, the heterogeneity of pathophysiological manifestations in BD suggests the need to classify the subtypes of the illness based on neural markers. Specifically, the presence of psychotic symptoms seems to be relevant for the clinical outcome and may have specific neuroanatomical bases. The main objective of the present review was to assess whether the distinction between psychotic BD (PBD) and non-psychotic BD (NPBD) can improve the identification of the neurobiological markers of this complex illness. To this end, we summarised the findings from the magnetic resonance imaging studies that explored the cerebral correlates of psychosis in BD in terms of grey matter volume (GMV). Overall, the results suggest the presence of peculiar GMV differences between PBD and NPBD. Specifically, psychosis in BD seems to be associated with cortical GMV deficits compared with both healthy controls and NPBD, mainly in the frontal region. Conversely, NPBD patients showed GMV deficits in selective regions of the basal ganglia when compared with the other groups. Taken together, this evidence confirms the importance to classify BD based on the psychotic dimension, which may have a specific neurobiological architecture that partially overlaps across multiple psychotic disorders.
ISSN:2045-7960
2045-7979
DOI:10.1017/S2045796017000087