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Towards further understanding of the co-morbidity between attention deficit hyperactivity disorder and bipolar disorder: a MRI study of brain volumes

Published online by Cambridge University Press:  15 October 2007

J. Biederman ,
N. Makris ,
E. M. Valera ,
M. C. Monuteaux ,
J. M. Goldstein ,
S. Buka ,
D. L. Boriel ,
S. Bandyopadhyay ,
D. N. Kennedy  and
V. S. Caviness
...Show all authors
J. Biederman*
Affiliation:
Clinical and Research Program in Pediatric Psychopharmacology, Psychiatry Department, Massachusetts General Hospital, Boston, MA, USA
N. Makris
Affiliation:
Clinical and Research Program in Pediatric Psychopharmacology, Psychiatry Department, Massachusetts General Hospital, Boston, MA, USA
E. M. Valera
Affiliation:
Clinical and Research Program in Pediatric Psychopharmacology, Psychiatry Department, Massachusetts General Hospital, Boston, MA, USA
M. C. Monuteaux
Affiliation:
Clinical and Research Program in Pediatric Psychopharmacology, Psychiatry Department, Massachusetts General Hospital, Boston, MA, USA
J. M. Goldstein
Affiliation:
Clinical and Research Program in Pediatric Psychopharmacology, Psychiatry Department, Massachusetts General Hospital, Boston, MA, USA
S. Buka
Affiliation:
Clinical and Research Program in Pediatric Psychopharmacology, Psychiatry Department, Massachusetts General Hospital, Boston, MA, USA
D. L. Boriel
Affiliation:
Clinical and Research Program in Pediatric Psychopharmacology, Psychiatry Department, Massachusetts General Hospital, Boston, MA, USA
S. Bandyopadhyay
Affiliation:
Clinical and Research Program in Pediatric Psychopharmacology, Psychiatry Department, Massachusetts General Hospital, Boston, MA, USA
D. N. Kennedy
Affiliation:
Clinical and Research Program in Pediatric Psychopharmacology, Psychiatry Department, Massachusetts General Hospital, Boston, MA, USA
V. S. Caviness
Affiliation:
Clinical and Research Program in Pediatric Psychopharmacology, Psychiatry Department, Massachusetts General Hospital, Boston, MA, USA
G. Bush
Affiliation:
Clinical and Research Program in Pediatric Psychopharmacology, Psychiatry Department, Massachusetts General Hospital, Boston, MA, USA
M. Aleardi
Affiliation:
Clinical and Research Program in Pediatric Psychopharmacology, Psychiatry Department, Massachusetts General Hospital, Boston, MA, USA
P. Hammerness
Affiliation:
Clinical and Research Program in Pediatric Psychopharmacology, Psychiatry Department, Massachusetts General Hospital, Boston, MA, USA
S. V. Faraone
Affiliation:
Clinical and Research Program in Pediatric Psychopharmacology, Psychiatry Department, Massachusetts General Hospital, Boston, MA, USA
L. J. Seidman
Affiliation:
Clinical and Research Program in Pediatric Psychopharmacology, Psychiatry Department, Massachusetts General Hospital, Boston, MA, USA
*
*Address for correspondence: J. Biederman, M.D., Clinical and Research Program in Pediatric Psychopharmacology, Massachusetts General Hospital, Fruit Street, Warren 7, Boston, MA 02114, USA. (Email: jbiederman@partners.org)
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Abstract

Background

Although attention deficit hyperactivity disorder (ADHD) and bipolar disorder (BPD) co-occur frequently and represent a particularly morbid clinical form of both disorders, neuroimaging research addressing this co-morbidity is scarce. Our aim was to evaluate the morphometric magnetic resonance imaging (MRI) underpinnings of the co-morbidity of ADHD with BPD, testing the hypothesis that subjects with this co-morbidity would have neuroanatomical correlates of both disorders.

Method

Morphometric MRI findings were compared between 31 adults with ADHD and BPD and with those of 18 with BPD, 26 with ADHD, and 23 healthy controls. The volumes (cm3) of our regions of interest (ROIs) were estimated as a function of ADHD status, BPD status, age, sex, and omnibus brain volume using linear regression models.

Results

When BPD was associated with a significantly smaller orbital prefrontal cortex and larger right thalamus, this pattern was found in co-morbid subjects with ADHD plus BPD. Likewise, when ADHD was associated with significantly less neocortical gray matter, less overall frontal lobe and superior prefrontal cortex volumes, a smaller right anterior cingulate cortex and less cerebellar gray matter, so did co-morbid ADHD plus BPD subjects.

Conclusions

Our results support the hypothesis that ADHD and BPD independently contribute to volumetric alterations of selective and distinct brain structures. In the co-morbid state of ADHD plus BPD, the profile of brain volumetric abnormalities consists of structures that are altered in both disorders individually. Attention to co-morbidity is necessary to help clarify the heterogeneous neuroanatomy of both BPD and ADHD.

Keywords

ADHDbipolar disorderco-morbidityMRI
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 7 , July 2008 , pp. 1045 - 1056
Copyright
Copyright © 2007 Cambridge University Press

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