Brain Volume Reduced As Early As First Episode Of Mania

January 24, 2011 · Posted in Neurobiology 

brainResearchers Manpreet K. Singh and Kiki D. Chang et al. from Stanford reported at the 65th Annual Scientific Convention of the Society of Biological Psychiatry that adolescents experiencing a first episode of mania show reduced volume in the subgenual anterior cingulate cortex (Brodmann area 25).  Previous studies have indicated that teens and adults with bipolar disorder exhibit decreased volume in prefrontal gray matter.

Editor’s note:  The new data suggest that some deficits in volume may occur very early in the course of bipolar illness, and thus indirectly support the potential use of treatments that can increase gray matter volume, such as lithium and potentially rTMS.

Lithium has repeatedly shown consistent positive effects on brain measurements in humans. Lithium and the other mood stabilizers carbamazepine, valproate, and lamotrigine, in addition to the atypical quetiapine, all increase BDNF (brain-derived neurotrophic factor), which may be responsible for preventing gray matter loss. Lithium also increases: neurogenesis; N-acetylaspartate (NAA), a measure of neuronal integrity; grey matter volume in several cortical areas in patients with bipolar disorder (but not controls); and hippocampal volume; and lithium decreases cell death factors BAX and p53.

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