Corpus callosum area in patients with bipolar disorder with and without psychotic features: an international multicentre study

Abstract

Background: Previous studies have reported MRI abnormalities of the corpus callosum (CC) in patients with bipolar disorder (BD), although only a few studies have directly compared callosal areas in psychotic versus nonpsychotic patients with this disorder. We sought to compare regional callosal areas in a large international multicentre sample of patients with BD and healthy controls.

Methods: We analyzed anatomic T1 MRI data of patients with BD-I and healthy controls recruited from 4 sites (France, Germany, Ireland and the United States). We obtained the mid-sagittal areas of 7 CC subregions using an automatic CC delineation. Differences in regional callosal areas between patients and controls were compared using linear mixed models (adjusting for age, sex, handedness, brain volume, history of alcohol abuse/dependence, lithium or antipsychotic medication status, symptomatic status and site) and multiple comparisons correction. We also compared regional areas of the CC between patients with BD with and without a history of psychotic features.

Results: We included 172 patients and 146 controls in our study. Patients with BD had smaller adjusted mid-sagittal CC areas than controls along the posterior body, the isthmus and the splenium of the CC. Patients with a positive history of psychotic features had greater adjusted area of the rostral CC region than those without a history of psychotic features.

Limitations: We found small to medium effect sizes, and there was no calibration technique among the sites.

Conclusion: Our results suggest that BD with psychosis is associated with a different pattern of interhemispheric connectivity than BD without psychosis and could be considered a relevant neuroimaging subtype of BD.

Fig. 1

Illustration of the automated processing pipeline for 1 participant. (A) Reoriented midsaggital slice. (B) Automatic localization of the anterior commissure (green cross) and of the posterior commissure (red cross). Automatic delineation of the corpus callosum based on a multiatlas model (white border, blue crosses). (C and D) Automatic segmentation of the corpus callosum based on the geometrical method described by Witelson and colleagues.