Orbitofrontal cortex gray matter volumes in bipolar disorder patients: A region-of-interest MRI study

Fabiano G. Nery, Hua Hsuan Chen, John P. Hatch, Mark A. Nicoletti, Paolo Brambilla, Roberto B. Sassi, Alan G. Mallinger, Matcheri S. Keshavan, Jair C. Soares

Research output: Contribution to journalArticlepeer-review

37 Scopus citations


Objectives: Functional and postmortem studies suggest that the orbitofrontal cortex (OFC) is involved in the pathophysiology of bipolar disorder (BD). This anatomical magnetic resonance imaging (MRI) study examined whether BD patients have smaller OFC gray matter volumes compared to healthy comparison subjects (HC). Methods: Twenty-eight BD patients were compared to 28 age- and gender-matched HC. Subjects underwent a 1.5T MRI with 3D spoiled gradient recalled acquisition. Total OFC and medial and lateral subdivisions were manually traced by a blinded examiner. Images were segmented and gray matter volumes were calculated using an automated method. Results: Analysis of covariance, with intracranial volume as covariate, showed that BD patients and HC did not differ in gray matter volumes of total OFC or its subdivisions. However, total OFC gray matter volume was significantly smaller in depressed patients (n=10) compared to euthymic patients (n=18). Moreover, total OFC gray matter volumes were inversely correlated with depressive symptom intensity, as assessed by the Hamilton Depression Rating Scale. OFC gray matter volumes were not related to lithium treatment, age at disease onset, number of episodes, or family history of mood disorders. Conclusion: Our results suggest that abnormal OFC gray matter volumes are not a pervasive characteristic of BD, but may be associated with specific clinical features of the disorder.

Original languageEnglish (US)
Pages (from-to)145-153
Number of pages9
JournalBipolar disorders
Issue number2
StatePublished - 2009


  • Bipolar disorder
  • Magnetic resonance imaging
  • Neuronal plasticity
  • Prefrontal cortex
  • Region-of-interest
  • Stress

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry


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