PURPOSE: The Maudsley Bipolar Disorder Project was set up in order to investigate the cognitive and structural/functional brain characteristics of Bipolar Disorder I (BDI). METHODS: Participating patients with BDI (n = 43) were recruited from a secondary care setting, while in remission. They were matched to healthy controls for age, gender, race and years of education. Each participant underwent extensive clinical review, cognitive assessment, and Magnetic Resonance Imaging (MRI) in order to obtain brain structural and functional data. RESULTS: When compared to controls, patients demonstrated subtle widespread impairment with executive function being more markedly reduced. Patients also displayed volume decrements in the ventral prefrontal cortex (VPFC) bilaterally and in the dorsal PFC (DPFC) on the left. The volume of the amygdala was bilaterally enlarged. Functional MRI of patients showed subtle abnormalities in their DPFC, with marked decrements in activity in both the DPFC and VPFC during tasks that rely on these regions functionally interacting. CONCLUSIONS: The results suggest that trait deficits in executive function occur in BDI, along with altered structure and function of the PFC.
Pathophysiology; imaging; cognition; bipolar disorder
