Cortical abnormalities in bipolar disorder: an MRI analysis of 6503 individuals from the ENIGMA Bipolar Disorder Working Group

D P Hibar^{1

2}, L T Westlye^{3

4

5}, N T Doan^{3

4}, N Jahanshad¹, J W Cheung¹, C R K Ching^{1

6}, A Versace⁷, A C Bilderbeck⁸, A Uhlmann^{9

10}, B Mwangi¹¹, B Krämer¹², B Overs¹³, C B Hartberg³, C Abé¹⁴, D Dima^{15

16}, D Grotegerd¹⁷, E Sprooten¹⁸, E Bøen¹⁹, E Jimenez²⁰, F M Howells⁹, G Delvecchio²¹, H Temmingh⁹, J Starke⁹, J R C Almeida²², J M Goikolea²⁰, J Houenou^{23

24}, L M Beard²⁵, L Rauer¹², L Abramovic²⁶, M Bonnin²⁰, M F Ponteduro¹⁶, M Keil²⁷, M M Rive²⁸, N Yao^{29

30}, N Yalin³¹, P Najt³², P G Rosa^{33

34}, R Redlich¹⁷, S Trost²⁷, S Hagenaars³⁵, S C Fears^{36

37}, S Alonso-Lana^{38

39}, T G M van Erp⁴⁰, T Nickson³⁵, T M Chaim-Avancini^{33

34}, T B Meier^{41

42}, T Elvsåshagen^{3

43}, U K Haukvik^{3

44}, W H Lee¹⁸, A H Schene^{45

46}, A J Lloyd⁴⁷, A H Young³¹, A Nugent⁴⁸, A M Dale^{49

50}, A Pfennig⁵¹, A M McIntosh³⁵, B Lafer³³, B T Baune⁵², C J Ekman¹⁴, C A Zarate⁴⁸, C E Bearden^{53

54}, C Henry^{23

55}, C Simhandl⁵⁶, C McDonald³², C Bourne^{8

57}, D J Stein^{9

10}, D H Wolf²⁵, D M Cannon³², D C Glahn^{29

30}, D J Veltman⁵⁸, E Pomarol-Clotet^{38

39}, E Vieta²⁰, E J Canales-Rodriguez^{38

39}, F G Nery^{33

59}, F L S Duran^{33

34}, G F Busatto^{33

34}, G Roberts⁶⁰, G D Pearlson^{29

30}, G M Goodwin⁸, H Kugel⁶¹, H C Whalley³⁵, H G Ruhe^{8

28

62}, J C Soares¹¹, J M Fullerton^{13

63}, J K Rybakowski⁶⁴, J Savitz^{42

65}, K T Chaim^{66

67}, M Fatjó-Vilas^{38

39}, M G Soeiro-de-Souza³³, M P Boks²⁶, M V Zanetti^{33

34}, M C G Otaduy^{66

67}, M S Schaufelberger^{33

34}, M Alda⁶⁸, M Ingvar^{14

69}, M L Phillips⁷, M J Kempton¹⁶, M Bauer⁵¹, M Landén^{14

70}, N S Lawrence⁷¹, N E M van Haren²⁶, N R Horn⁹, N B Freimer⁷², O Gruber¹², P R Schofield^{13

63}, P B Mitchell⁶⁰, R S Kahn²⁶, R Lenroot^{13

73}, R Machado-Vieira^{33

74}, R A Ophoff^{26

72}, S Sarró^{38

39}, S Frangou¹⁸, T D Satterthwaite²⁵, T Hajek^{68

75}, U Dannlowski¹⁷, U F Malt^{76

77}, V Arolt¹⁷, W F Gattaz³³, W C Drevets⁷⁸, X Caseras⁷⁹, I Agartz^{3

19}, P M Thompson¹, O A Andreassen^{3

4}

Affiliations

¹ Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, USA.
² Janssen Research & Development, San Diego, CA, USA.
³ NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
⁴ Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
⁵ Department of Psychology, University of Oslo, Oslo, Norway.
⁶ Neuroscience Interdepartmental Graduate Program, University of California, Los Angeles, Los Angeles, CA, USA.
⁷ Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
⁸ University Department of Psychiatry and Oxford Health NHS Foundation Trust, University of Oxford, Oxford, UK.
⁹ Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
¹⁰ MRC Unit on Anxiety and Stress Disorders, Groote Schuur Hospital (J-2), University of Cape Town, Cape Town, South Africa.
¹¹ UT Center of Excellence on Mood Disorders, Department of Psychiatry & Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA.
¹² Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany.
¹³ Neuroscience Research Australia, Sydney, NSW, Australia.
¹⁴ Department of Clinical Neuroscience, Osher Centre, Karolinska Institutet, Stockholm, Sweden.
¹⁵ Department of Psychology, City University London, London, UK.
¹⁶ Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
¹⁷ Department of Psychiatry, University of Münster, Münster, Germany.
¹⁸ Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
¹⁹ Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway.
²⁰ Hospital Clinic, IDIBAPS, University of Barcelona, CIBERSAM, Barcelona, Spain.
²¹ IRCCS "E. Medea" Scientific Institute, San Vito al Tagliamento, Italy.
²² Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.
²³ INSERM U955 Team 15 'Translational Psychiatry', University Paris East, APHP, CHU Mondor, Fondation FondaMental, Créteil, France.
²⁴ NeuroSpin, UNIACT Lab, Psychiatry Team, CEA Saclay, Gif Sur Yvette, France.
²⁵ Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
²⁶ Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
²⁷ Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany.
²⁸ Program for Mood Disorders, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
²⁹ Department of Psychiatry, Yale University, New Haven, CT, USA.
³⁰ Olin Neuropsychiatric Research Center, Institute of Living, Hartford Hospital, Hartford, CT, USA.
³¹ Centre for Affective Disorders, King's College London, London, UK.
³² Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland.
³³ Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
³⁴ Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, São Paulo, Brazil.
³⁵ Division of Psychiatry, University of Edinburgh, Edinburgh, UK.
³⁶ Department of Psychiatry, University of California, Los Angeles, Los Angeles, CA, USA.
³⁷ West Los Angeles Veterans Administration, Los Angeles, CA, USA.
³⁸ FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain.
³⁹ Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
⁴⁰ Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA.
⁴¹ Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.
⁴² Laureate Institute for Brain Research, Tulsa, OK, USA.
⁴³ Department of Neurology, Oslo University Hospital, Oslo, Norway.
⁴⁴ Department of Adult Psychiatry, University of Oslo, Oslo, Norway.
⁴⁵ Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands.
⁴⁶ Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands.
⁴⁷ Academic Psychiatry and Northern Centre for Mood Disorders, Newcastle University/Northumberland Tyne & Wear NHS Foundation Trust, Newcastle, UK.
⁴⁸ Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA.
⁴⁹ MMIL, Department of Radiology, University of California San Diego, San Diego, CA, USA.
⁵⁰ Department of Cognitive Science, Neurosciences and Psychiatry, University of California, San Diego, San Diego, CA, USA.
⁵¹ Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
⁵² Department of Psychiatry, University of Adelaide, Adelaide, SA, Australia.
⁵³ Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA.
⁵⁴ Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA.
⁵⁵ Institut Pasteur, Unité Perception et Mémoire, Paris, France.
⁵⁶ Bipolar Center Wiener Neustadt, Wiener Neustadt, Austria.
⁵⁷ Department of Psychology & Counselling, Newman University, Birmingham, UK.
⁵⁸ Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands.
⁵⁹ Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
⁶⁰ School of Psychiatry and Black Dog Institute, University of New South Wales, Sydney, NSW, Australia.
⁶¹ Department of Clinical Radiology, University of Münster, Münster, Germany.
⁶² Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
⁶³ School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia.
⁶⁴ Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland.
⁶⁵ Faculty of Community Medicine, The University of Tulsa, Tulsa, OK, USA.
⁶⁶ Department of Radiology, University of São Paulo, São Paulo, Brazil.
⁶⁷ LIM44-Laboratory of Magnetic Resonance in Neuroradiology, University of São Paulo, São Paulo, Brazil.
⁶⁸ Department of Psychiatry, Dalhousie University, Halifax, NS, Canada.
⁶⁹ Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden.
⁷⁰ Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the Gothenburg University, Goteborg, Sweden.
⁷¹ Department of Psychology, University of Exeter, Exeter, UK.
⁷² Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA.
⁷³ School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.
⁷⁴ National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA.
⁷⁵ National Institute of Mental Health, Klecany, Czech Republic.
⁷⁶ Division of Clinical Neuroscience, Department of Research and Education, Oslo University Hospital, Oslo, Norway.
⁷⁷ Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
⁷⁸ Janssen Research & Development, Titusville, NJ, USA.
⁷⁹ MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK.

PMID: 28461699
PMCID: PMC5668195
DOI: 10.1038/mp.2017.73

Cortical abnormalities in bipolar disorder: an MRI analysis of 6503 individuals from the ENIGMA Bipolar Disorder Working Group

D P Hibar et al. Mol Psychiatry. 2018 Apr.

. 2018 Apr;23(4):932-942.

doi: 10.1038/mp.2017.73. Epub 2017 May 2.

Authors

Affiliations

¹ Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, USA.
² Janssen Research & Development, San Diego, CA, USA.
³ NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
⁴ Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
⁵ Department of Psychology, University of Oslo, Oslo, Norway.
⁶ Neuroscience Interdepartmental Graduate Program, University of California, Los Angeles, Los Angeles, CA, USA.
⁷ Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
⁸ University Department of Psychiatry and Oxford Health NHS Foundation Trust, University of Oxford, Oxford, UK.
⁹ Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
¹⁰ MRC Unit on Anxiety and Stress Disorders, Groote Schuur Hospital (J-2), University of Cape Town, Cape Town, South Africa.
¹¹ UT Center of Excellence on Mood Disorders, Department of Psychiatry & Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA.
¹² Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany.
¹³ Neuroscience Research Australia, Sydney, NSW, Australia.
¹⁴ Department of Clinical Neuroscience, Osher Centre, Karolinska Institutet, Stockholm, Sweden.
¹⁵ Department of Psychology, City University London, London, UK.
¹⁶ Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
¹⁷ Department of Psychiatry, University of Münster, Münster, Germany.
¹⁸ Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
¹⁹ Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway.
²⁰ Hospital Clinic, IDIBAPS, University of Barcelona, CIBERSAM, Barcelona, Spain.
²¹ IRCCS "E. Medea" Scientific Institute, San Vito al Tagliamento, Italy.
²² Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.
²³ INSERM U955 Team 15 'Translational Psychiatry', University Paris East, APHP, CHU Mondor, Fondation FondaMental, Créteil, France.
²⁴ NeuroSpin, UNIACT Lab, Psychiatry Team, CEA Saclay, Gif Sur Yvette, France.
²⁵ Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
²⁶ Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
²⁷ Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany.
²⁸ Program for Mood Disorders, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
²⁹ Department of Psychiatry, Yale University, New Haven, CT, USA.
³⁰ Olin Neuropsychiatric Research Center, Institute of Living, Hartford Hospital, Hartford, CT, USA.
³¹ Centre for Affective Disorders, King's College London, London, UK.
³² Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland.
³³ Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
³⁴ Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, São Paulo, Brazil.
³⁵ Division of Psychiatry, University of Edinburgh, Edinburgh, UK.
³⁶ Department of Psychiatry, University of California, Los Angeles, Los Angeles, CA, USA.
³⁷ West Los Angeles Veterans Administration, Los Angeles, CA, USA.
³⁸ FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain.
³⁹ Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
⁴⁰ Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA.
⁴¹ Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.
⁴² Laureate Institute for Brain Research, Tulsa, OK, USA.
⁴³ Department of Neurology, Oslo University Hospital, Oslo, Norway.
⁴⁴ Department of Adult Psychiatry, University of Oslo, Oslo, Norway.
⁴⁵ Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands.
⁴⁶ Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands.
⁴⁷ Academic Psychiatry and Northern Centre for Mood Disorders, Newcastle University/Northumberland Tyne & Wear NHS Foundation Trust, Newcastle, UK.
⁴⁸ Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA.
⁴⁹ MMIL, Department of Radiology, University of California San Diego, San Diego, CA, USA.
⁵⁰ Department of Cognitive Science, Neurosciences and Psychiatry, University of California, San Diego, San Diego, CA, USA.
⁵¹ Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
⁵² Department of Psychiatry, University of Adelaide, Adelaide, SA, Australia.
⁵³ Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA.
⁵⁴ Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA.
⁵⁵ Institut Pasteur, Unité Perception et Mémoire, Paris, France.
⁵⁶ Bipolar Center Wiener Neustadt, Wiener Neustadt, Austria.
⁵⁷ Department of Psychology & Counselling, Newman University, Birmingham, UK.
⁵⁸ Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands.
⁵⁹ Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
⁶⁰ School of Psychiatry and Black Dog Institute, University of New South Wales, Sydney, NSW, Australia.
⁶¹ Department of Clinical Radiology, University of Münster, Münster, Germany.
⁶² Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
⁶³ School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia.
⁶⁴ Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland.
⁶⁵ Faculty of Community Medicine, The University of Tulsa, Tulsa, OK, USA.
⁶⁶ Department of Radiology, University of São Paulo, São Paulo, Brazil.
⁶⁷ LIM44-Laboratory of Magnetic Resonance in Neuroradiology, University of São Paulo, São Paulo, Brazil.
⁶⁸ Department of Psychiatry, Dalhousie University, Halifax, NS, Canada.
⁶⁹ Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden.
⁷⁰ Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the Gothenburg University, Goteborg, Sweden.
⁷¹ Department of Psychology, University of Exeter, Exeter, UK.
⁷² Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA.
⁷³ School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.
⁷⁴ National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA.
⁷⁵ National Institute of Mental Health, Klecany, Czech Republic.
⁷⁶ Division of Clinical Neuroscience, Department of Research and Education, Oslo University Hospital, Oslo, Norway.
⁷⁷ Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
⁷⁸ Janssen Research & Development, Titusville, NJ, USA.
⁷⁹ MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK.

PMID: 28461699
PMCID: PMC5668195
DOI: 10.1038/mp.2017.73

Abstract

Despite decades of research, the pathophysiology of bipolar disorder (BD) is still not well understood. Structural brain differences have been associated with BD, but results from neuroimaging studies have been inconsistent. To address this, we performed the largest study to date of cortical gray matter thickness and surface area measures from brain magnetic resonance imaging scans of 6503 individuals including 1837 unrelated adults with BD and 2582 unrelated healthy controls for group differences while also examining the effects of commonly prescribed medications, age of illness onset, history of psychosis, mood state, age and sex differences on cortical regions. In BD, cortical gray matter was thinner in frontal, temporal and parietal regions of both brain hemispheres. BD had the strongest effects on left pars opercularis (Cohen's d=-0.293; P=1.71 × 10^-21), left fusiform gyrus (d=-0.288; P=8.25 × 10^-21) and left rostral middle frontal cortex (d=-0.276; P=2.99 × 10^-19). Longer duration of illness (after accounting for age at the time of scanning) was associated with reduced cortical thickness in frontal, medial parietal and occipital regions. We found that several commonly prescribed medications, including lithium, antiepileptic and antipsychotic treatment showed significant associations with cortical thickness and surface area, even after accounting for patients who received multiple medications. We found evidence of reduced cortical surface area associated with a history of psychosis but no associations with mood state at the time of scanning. Our analysis revealed previously undetected associations and provides an extensive analysis of potential confounding variables in neuroimaging studies of BD.

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Conflict of interest statement

AMM has received funding from Lilly, Janssen and Pfizer. It is unconnected with the current work. TvE has a contract with Otsuka Pharmaceutical Inc. The contract is not related to this work. UFM participated in the speaker’s bureau for Lundbeck Norway and was a consultant for Takeda Pharmaceuticals. ACB has received salaries from P1vital Ltd, which is unrelated to this work. PGR trained personnel for Janssen Pharmaceuticals. It is unconnected with the current work. DPH and WCD are employed by Janssen Research and Development, LLC. MB has received grant/research support from Deutsche Forschungsgemeinschaft (DFG), Bundesministeriums für Bildung und Forschung (BMBF), American Foundation of Suicide Prevention. MB is/has been a consultant for AstraZeneca, Bristol Myers Squibb, Ferrer Internacional, Janssen, Lilly, Lundbeck, Merz, Neuraxpharm, Novartis, Otsuka, Servier, Takeda, and has received speaker honoraria from AstraZeneca, GlaxoSmithKline, Lilly, Lundbeck, Otsuka and Pfizer, which is all unrelated to this work. OAA has received speaker’s honorarium from Lundbeck, Otsuka and Lilly. The remaining authors declare no conflicts of interest. All authors have contributed to and approved the contents of this manuscript.

Figures

**Figure 1**
Cortical thinning in adult patients with bipolar disorder compared with healthy controls. Cohen’s d effect sizes are plotted for each region of interest on the cortical surface of a template image. Only significant regions are shown; non-significant regions are colored in gray.

**Figure 2**
Cortical thinning in adult patients with bipolar disorder associated with duration of illness. Pearson’s correlation r effect sizes are plotted for each region of interest on the cortical surface of a template image. Only significant regions are shown; non-significant regions are colored in gray.

**Figure 3**
Cortical thickening in adult patients with bipolar disorder associated with lithium treatment. Cohen’s d effect sizes are plotted for each region of interest on the cortical surface of a template image. Only significant regions are shown; non-significant regions are colored in gray.

**Figure 4**
Cortical thinning in adult patients with bipolar disorder associated with antiepileptic treatment. Cohen’s d effect sizes are plotted for each region of interest on the cortical surface of a template image. Only significant regions are shown; non-significant regions are colored in gray.

See this image and copyright information in PMC

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Cortical abnormalities in bipolar disorder: an MRI analysis of 6503 individuals from the ENIGMA Bipolar Disorder Working Group

Affiliations

Cortical abnormalities in bipolar disorder: an MRI analysis of 6503 individuals from the ENIGMA Bipolar Disorder Working Group

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

Miscellaneous