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A Critical Review on Structural Neuroimaging Studies in BD: a Transdiagnostic Perspective from Psychosis to Fronto-Temporal Dementia

  • Bipolar Disorder (J Soares and M Sanches, Section Editors)
  • Published:
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Abstract

Recent Findings

In the last decades, many neuroimaging studies have investigated the brain structural deficits associated with the pathophysiology of Bipolar Disorder (BD). Notably, the available literature identified the presence of selective brain structural abnormalities, in terms of both gray matter (GM) and white matter, known to be involved in emotion regulation and processing. Nonetheless, the complex and heterogeneous nature of BD has not yet allowed the identification of a clear biological signature of this disorder.

Purpose of Review

In this context, this review aims to a) briefly summarize the evidence from structural Magnetic Resonance Imaging (MRI) studies on BD in order to provide a clearer picture of the neural circuits involved in this disabling mental illness, and b) describe some critical clinical issues that need to be taken into account when studying BD, especially the history of psychosis and the link between BD and behavioral variant fronto-temporal dementia (bvFTD).

Summary

Evidence from structural MRI studies on BD suggests ventricular, prefrontal and temporal abnormalities but remain largely inconsistent, possibly reflecting the disorder complexity. Moreover, the reviewed evidence showed that psychotic BD might represent a subtype of the disorder with specific and enhanced alterations of GM morphology. Finally, from the available MRI evidence exploring the relationship between BD and bvFTD emerged the need of a differential identification of biological markers to enable the early and accurate detection of the two disorders, ultimately guaranteeing a better prognosis and the employment of more targeted and effective treatments.

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Acknowledgements

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Funding Source

Paolo Brambilla was partially supported by grants from the Italian Ministry of Health (RF-2016-02364582). Grant support of Eleonora Maggioni was provided by the Fondazione Cariplo (grant n° 2016–0908).

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Authors and Affiliations

  1. Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

    Giuseppe Delvecchio, Letizia Squarcina & Paolo Brambilla

  2. Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, via F. Sforza 35, 20122, Milan, Italy

    Eleonora Maggioni & Paolo Brambilla

  3. Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Neurodegenerative Disease Unit,, Milan, Italy

    Andrea Arighi, Daniela Galimberti & Elio Scarpini

  4. Department of Biomedical, Surgical and Dental Sciences, Dino Ferrari Center, University of Milan, Milan, Italy

    Daniela Galimberti & Elio Scarpini

  5. Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy

    Marcella Bellani

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  1. Giuseppe Delvecchio
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  2. Eleonora Maggioni
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Delvecchio, G., Maggioni, E., Squarcina, L. et al. A Critical Review on Structural Neuroimaging Studies in BD: a Transdiagnostic Perspective from Psychosis to Fronto-Temporal Dementia. Curr Behav Neurosci Rep 7, 86–95 (2020). https://doi.org/10.1007/s40473-020-00204-7

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