TY - JOUR
T1 - Neuropathological and neuromorphometric abnormalities in bipolar disorder
T2 - View from the medial prefrontal cortical network
AU - Savitz, Jonathan B.
AU - Price, Joseph L.
AU - Drevets, Wayne C.
N1 - Funding Information:
JS and WCD received support from The William K. Warren Foundation. The foundation played no role in the writing of the manuscript.
PY - 2014/5
Y1 - 2014/5
N2 - 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.
AB - 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.
KW - Bipolar disorder
KW - Depression
KW - Developmental
KW - Gene expression
KW - Magnetic resonance imaging
KW - Medial prefrontal cortex
KW - Neuron
KW - Neuropathology
KW - Oligodendrocyte
KW - Postmortem
UR - http://www.scopus.com/inward/record.url?scp=84896029352&partnerID=8YFLogxK
U2 - 10.1016/j.neubiorev.2014.02.008
DO - 10.1016/j.neubiorev.2014.02.008
M3 - Review article
C2 - 24603026
AN - SCOPUS:84896029352
VL - 42
SP - 132
EP - 147
JO - Neuroscience and Biobehavioral Reviews
JF - Neuroscience and Biobehavioral Reviews
SN - 0149-7634
ER -