Cited by 145Bipolar Disorder and TreatmentSchizophrenia research and treatmentTreatment of Major Depression

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Neuropathological and neuromorphometric abnormalities in bipolar disorder: View from the medial prefrontal cortical network

Savitz, Jonathan B., Price, Joseph L., Drevets, Wayne C.·2014·Neuroscience & Biobehavioral Reviews

DOI 10.1016/j.neubiorev.2014.02.008

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Abstract

The question of whether BD is primarily a developmental disorder or a progressive, neurodegenerative disorder remains unresolved. Here, we review the morphometric postmortem and neuroimaging literature relevant to the neuropathology of bipolar disorder (BD). We focus on the medial prefrontal cortex (mPFC) network, a key system in the regulation of emotional, behavioral, endocrine, and innate immunological responses to stress. We draw four main conclusions: the mPFC is characterized by (1) a decrease in volume, (2) reductions in neuronal size, and/or changes in neuronal density, (3) reductions in glial cell density, and (4) changes in gene expression. These data suggest the presence of dendritic atrophy of neurons and the loss of oligodendroglial cells in BD, although some data additionally suggest a reduction in the cell counts of specific subpopulations of GABAergic interneurons. Based on the weight of the postmortem and neuroimaging literature discussed herein, we favor a complex hypothesis that BD primarily constitutes a developmental disorder, but that additional, progressive, histopathological processes also are associated with recurrent or chronic illness. Conceivably BD may be best conceptualized as a progressive neurodevelopmental disorder.

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Authors: Savitz, J. B., Price, J. L., & Drevets, W. C.
Affiliations: Laureate Institute for Brain Research (US)
Washington University in St. Louis (US)
Corresponding author: Savitz, Jonathan B.
ORCID: Savitz, Jonathan B.
Drevets, Wayne C.
Venue: Neuroscience & Biobehavioral Reviews
Publisher: Elsevier BV
Published: 2014-05
Volume: 42
Pages: 132-147
ISSN: 0149-7634 (ISSN-L)
DOI: 10.1016/j.neubiorev.2014.02.008
OpenAlex: W1968616230
Cited by: 145
References: 211
Citations by year: 2026: 5 · 2025: 9 · 2024: 4 · 2023: 3 · 2022: 9 · 2021: 29 · 2020: 11 · 2019: 9 · 2018: 8 · 2017: 13 · 2016: 18 · 2015: 21 · 2014: 6
FWCI: 2.66
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Neuroscience & Biobehavioral Reviews (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
Keywords: bipolar disorder, medial prefrontal cortex, neuropathology, neurodevelopmental disorders, neurodegeneration, neuron size, glial cell density, dendritic atrophy, GABAergic interneurons, gene expression, stress response, chronic disease
MeSH terms: Animals, Bipolar Disorder, Humans, Neural Pathways, Neuroglia, Neurons, Prefrontal Cortex

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Neuropathological and neuromorphometric abnormalities in bipolar disorder: View from the medial prefrontal cortical network

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