The functional neuroanatomy of bipolar disorder: a review of neuroimaging findings
Abstract
The authors review existing structural and functional neuroimaging studies of patients with bipolar disorder and discuss how these investigations enhance our understanding of the neurophysiology of this illness. Findings from structural magnetic resonance imaging (MRI) studies suggest that some abnormalities, such as those in prefrontal cortical areas (SGPFC), striatum and amygdala exist early in the course of illness and, therefore, potentially, predate illness onset. In contrast, other abnormalities, such as those found in the cerebellar vermis, lateral ventricles and other prefrontal regions (eg, left inferior), appear to develop with repeated affective episodes, and may represent the effects of illness progression and associated factors. Magnetic resonance spectroscopy investigations have revealed abnormalities of membrane and second messenger metabolism, as well as bioenergetics, in striatum and prefrontal cortex. Functional imaging studies report activation differences between bipolar and healthy controls in these same anterior limibic regions. Together, these studies support a model of bipolar disorder that involves dysfunction within subcortical (striatal-thalamic)-prefrontal networks and the associated limbic modulating regions (amygdala, midline cerebellum). These studies suggest that, in bipolar disorder, there may be diminished prefrontal modulation of subcortical and medial temporal structures within the anterior limbic network (eg, amygdala, anterior striatum and thalamus) that results in dysregulation of mood. Future prospective and longitudinal studies focusing on these specific relationships are necessary to clarify the functional neuroanatomy of bipolar disorder.
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Evidence for abnormalities in reward-related neural network function in mania is scarce.
“Although functional MRI studies have identified prefrontal dysfunction in bipolar disorder and manic psychosis, evidence for abnormalities in reward-related neural network function in mania is scarce [271-275].”
From Reward circuitry dysfunction in psychiatric and neurodevelopmental disorders and genetic syndromes: animal models and clinical findings (2012) · cites this paper as [274]
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- Authors
- Strakowski, S. M., DelBello, M. P., & Adler, C. M.
- Affiliations
- University of Cincinnati (US)
- Corresponding author
- Strakowski, S M
- Venue
- Molecular Psychiatry
- Published
- 2004-08-31
- Volume
- 10
- Issue
- 1
- Pages
- 105-116
- ISSN
- 1359-4184 (ISSN-L)
- 1476-5578
- OpenAlex
- W1995907546
- Cited by
- 818
- References
- 87
- Citations by year
- 2026: 11 · 2025: 22 · 2024: 15 · 2023: 21 · 2022: 22 · 2021: 44 · 2020: 33 · 2019: 31 · 2018: 41 · 2017: 32 · 2016: 36 · 2015: 34 · 2014: 45 · 2013: 48 · 2012: 64
- FWCI
- 4.29
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Molecular Psychiatry (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
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- bipolar disorder, functional neuroanatomy, structural MRI, magnetic resonance spectroscopy, prefrontal cortex, striatum, amygdala, cerebellar vermis, mood dysregulation, affective episodes
- MeSH terms
- Bipolar Disorder, Brain, Brain Mapping, Cerebellum, Humans, Magnetic Resonance Imaging, Temporal Lobe, Prefrontal Cortex
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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