Effects of lithium on cortical thickness and hippocampal subfield volumes in psychotic bipolar disorder

C I Giakoumatos¹, P Nanda², I T Mathew³, N Tandon⁴, J Shah⁵, J R Bishop⁶, B A Clementz⁷, G D Pearlson⁸, J A Sweeney⁹, C A Tamminga⁹, M S Keshavan¹⁰

Affiliations

¹ Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Harvard South Shore Psychiatry Residency Program, Harvard Medical School, Brockton, MA, USA.
² Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; College of Physicians & Surgeons, Columbia University Medical Center, New York, NY, USA.
³ Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA.
⁴ Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Baylor College of Medicine, Texas Medical Center, Houston, TX, USA.
⁵ Program for Prevention and Early Intervention for Psychosis, Douglas Mental Health University Institute, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada.
⁶ Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN, USA.
⁷ Department of Psychology, BioImaging Research Center, University of Georgia, Athens, GA, USA; Department of Neuroscience, BioImaging Research Center, University of Georgia, Athens, GA, USA.
⁸ Olin Neuropsychiatry Research Center, Institute of Living, Hartford, CT, USA; Departments of Psychiatry and Neurobiology, Yale University School of Medicine, New Haven, CT, USA.
⁹ Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.
¹⁰ Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA. Electronic address: mkeshava@bidmc.harvard.edu.

PMID: 25563516
PMCID: PMC4859940
DOI: 10.1016/j.jpsychires.2014.12.008

Effects of lithium on cortical thickness and hippocampal subfield volumes in psychotic bipolar disorder

C I Giakoumatos et al. J Psychiatr Res. 2015 Feb.

. 2015 Feb:61:180-7.

doi: 10.1016/j.jpsychires.2014.12.008. Epub 2014 Dec 23.

Authors

C I Giakoumatos¹, P Nanda², I T Mathew³, N Tandon⁴, J Shah⁵, J R Bishop⁶, B A Clementz⁷, G D Pearlson⁸, J A Sweeney⁹, C A Tamminga⁹, M S Keshavan¹⁰

Affiliations

¹ Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Harvard South Shore Psychiatry Residency Program, Harvard Medical School, Brockton, MA, USA.
² Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; College of Physicians & Surgeons, Columbia University Medical Center, New York, NY, USA.
³ Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA.
⁴ Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Baylor College of Medicine, Texas Medical Center, Houston, TX, USA.
⁵ Program for Prevention and Early Intervention for Psychosis, Douglas Mental Health University Institute, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada.
⁶ Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN, USA.
⁷ Department of Psychology, BioImaging Research Center, University of Georgia, Athens, GA, USA; Department of Neuroscience, BioImaging Research Center, University of Georgia, Athens, GA, USA.
⁸ Olin Neuropsychiatry Research Center, Institute of Living, Hartford, CT, USA; Departments of Psychiatry and Neurobiology, Yale University School of Medicine, New Haven, CT, USA.
⁹ Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.
¹⁰ Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA. Electronic address: mkeshava@bidmc.harvard.edu.

PMID: 25563516
PMCID: PMC4859940
DOI: 10.1016/j.jpsychires.2014.12.008

Abstract

Relative to healthy controls, lithium free bipolar patients exhibit significant gray matter abnormalities. Lithium, the long-time reference standard medication treatment for bipolar disorder, has been proposed to be neuro-protective against these abnormalities. However, its effects on cortical thickness and hippocampal subfield (HSF) volumes remain unstudied and unclear, respectively, in bipolar disorder. This study included 342 healthy controls (HC), 51 lithium free PBD patients (NoLi), and 51 PBD patients taking lithium (Li). Regional gray matter thickness and HSF volume values were extracted from 3T MRI images. After matching NoLi and Li samples, regions where HC differed from either Li or NoLi were identified. In regions of significant or trending HC-NoLi difference, Li-NoLi comparisons were made. No significant HC-Li thickness or HSF volume differences were found. Significantly thinner occipital cortices were observed in NoLi compared to HC. In these regions, Li consistently exhibited non-significant trends for greater cortical thickness relative to NoLi. Significantly less volume was observed in NoLi compared to both HC and Li in right HSFs. Our results suggest that PBD in patients not treated with Li is associated with thinner occipital cortices and reduced HSF volumes compared with HC. Patients treated with Li exhibited significantly larger HSF volumes than NoLi, and those treated with Li were no different from HC in cortical thickness or hippocampal volumes. This evidence directly supports the hypothesis that Li may counteract the locally thinner and smaller gray matter structure found in PBD.

Keywords: Bipolar disorder; Cortical thickness; Hippocampus; Lithium; MRI; Neuro-protective.

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Conflict of interest statement

Conflict of interest

The other authors report no disclosures.

Figures

**Fig. 1**
Effect sizes (Cohen’s d) for regional contrasts demonstrating thinner cortex in lithium free probands relative to controls.

**Fig. 2**
Effect sizes (Cohen’s d) for contrasts demonstrating reduced HSF volumes in lithium free probands relative to controls (HC).

See this image and copyright information in PMC

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Effects of lithium on cortical thickness and hippocampal subfield volumes in psychotic bipolar disorder

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Effects of lithium on cortical thickness and hippocampal subfield volumes in psychotic bipolar disorder

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Conflict of interest statement

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