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. 2021 Feb 16:12:614010.
doi: 10.3389/fpsyt.2021.614010. eCollection 2021.

A 7 Tesla Amygdalar-Hippocampal Shape Analysis of Lithium Response in Bipolar Disorder

Thomas L Athey  1   2   3 , Can Ceritoglu  1 , Daniel J Tward  1   2   3 , Kwame S Kutten  1 , J Raymond DePaulo  4 , Kara Glazer  5 , Fernando S Goes  4 , John R Kelsoe  6   7 , Francis Mondimore  4 , Caroline M Nievergelt  7 , Kelly Rootes-Murdy  8 , Peter P Zandi  4   9 , J Tilak Ratnanather  1   2   3 , Pamela B Mahon  4   10   11
Affiliations

A 7 Tesla Amygdalar-Hippocampal Shape Analysis of Lithium Response in Bipolar Disorder

Thomas L Athey et al. Front Psychiatry. .

Abstract

Research to discover clinically useful predictors of lithium response in patients with bipolar disorder has largely found them to be elusive. We demonstrate here that detailed neuroimaging may have the potential to fill this important gap in mood disorder therapeutics. Lithium treatment and bipolar disorder have both been shown to affect anatomy of the hippocampi and amygdalae but there is no consensus on the nature of their effects. We aimed to investigate structural surface anatomy changes in amygdala and hippocampus correlated with treatment response in bipolar disorder. Patients with bipolar disorder (N = 14) underwent lithium treatment, were classified by response status at acute and long-term time points, and scanned with 7 Tesla structural MRI. Large Deformation Diffeomorphic Metric Mapping was applied to detect local differences in hippocampal and amygdalar anatomy between lithium responders and non-responders. Anatomy was also compared to 21 healthy comparison participants. A patch of the ventral surface of the left hippocampus was found to be significantly atrophied in non-responders as compared to responders at the acute time point and was associated at a trend-level with long-term response status. We did not detect an association between response status and surface anatomy of the right hippocampus or amygdala. To the best of our knowledge, this is the first shape analysis of hippocampus and amygdala in bipolar disorder using 7 Tesla MRI. These results can inform future work investigating possible neuroimaging predictors of lithium response in bipolar disorder.

Keywords: 7T MRI; amygdala; bipolar disorder; hippocampus; lithium; shape analysis.

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Conflict of interest statement

JRD reports that he is Chairperson of the Board of Directors of the National Network of Depression Centers and receives reimbursement for official travel (amounting to less than $1500 annually). He has been an unpaid consultant for Myriad Neuroscience (formerly Assurex Health, Inc.) on behalf of the NNDC for meetings in 2017 and 2019. The NNDC was compensated for his effort. JRD owns stock in CVS-Health (275 shares valued today at just over $20,000). The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Amygdalar and hippocampal surface discretization from spectral clustering. After clustering, left and right amygdala are divided into 4 patches each and left and right hippocampus into 9 patches each.
Figure 2
Figure 2
Non-responders were found to have 15% atrophy in a surface patch on the ventral side of the left hippocampus (in red), when compared to responders.
See this image and copyright information in PMC

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