Cingulate abnormalities in bipolar disorder relate to gender and outcome: a voxel-based morphometry study

  • Giuseppe Delvecchio
  • Valentina Ciappolino
  • Cinzia Perlini
  • Marco Barillari
  • Mirella Ruggeri
  • A. Carlo Altamura
  • Marcella Bellani
  • Paolo BrambillaEmail author
Original Paper


Structural magnetic resonance imaging (MRI) studies reported gray matter (GM) loss in bipolar disorder (BD) in cingulate cortices, key regions subserving emotional regulation and cognitive functions in humans. The aim of this study was to further explore cingulate GM volumes in a sizeable group of BD patients with respect to healthy controls, particularly investigating the impact of gender and clinical variables. 39 BD patients (mean Age = 48.6 ± 9.7, 15 males and 24 females) and 39 demographically matched healthy subjects (mean Age = 47.9 ± 9.1, 15 males and 24 females) underwent a 1.5T MRI scan. GM volumes within the cingulate cortex were manually detected, including anterior and posterior regions. BD patients had decreased left anterior cingulate volumes compared with healthy controls (F = 6.7, p = 0.01). Additionally, a significant gender effect was observed, with male patients showing reduced left anterior cingulate cortex (ACC) volumes compared to healthy controls (F = 5.1, p = 0.03). Furthermore, a significant inverse correlation between right ACC volumes and number of hospitalizations were found in the whole group of BD patients (r = − 0.51, p = 0.04) and in male BD patients (r = − 0.88, p = 0.04). Finally, no statistically significant correlations were observed in female BD patients. Our findings further confirm the putative role of the ACC in the pathophysiology of BD. Interestingly, this study also suggested the presence of gender-specific GM volume reductions in ACC in BD, which may also be associated to poor outcome.


Mood disorders Outcome Gray matter Illness severity Hospitalizations 



This study was partially supported by grants from the Italian Ministry of Health to PB and GD (RF-2011-02352308) and to MB (GR-2010-2319022). We thank Gianluca Rambaldelli for managing the dataset.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Giuseppe Delvecchio
    • 1
  • Valentina Ciappolino
    • 2
  • Cinzia Perlini
    • 3
    • 4
  • Marco Barillari
    • 5
  • Mirella Ruggeri
    • 4
    • 6
  • A. Carlo Altamura
    • 2
  • Marcella Bellani
    • 4
    • 6
  • Paolo Brambilla
    • 2
    • 7
    Email author
  1. 1.IRCCS “E. Medea” Scientific InstituteSan Vito al TagliamentoItaly
  2. 2.Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoUniversity of MilanMilanItaly
  3. 3.Section of Clinical Psychology, Department of Neurosciences, Biomedicine and Movement SciencesUniversity of VeronaVeronaItaly
  4. 4.Interuniversity Centre for Behavioural NeurosciencesAOUI VeronaVeronaItaly
  5. 5.Section of Radiology, Department of Neurological and Movement SciencesUniversity Hospital of VeronaVeronaItaly
  6. 6.Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement SciencesUniversity of VeronaVeronaItaly
  7. 7.Department of Psychiatry and Behavioural NeurosciencesUniversity of Texas at HoustonHoustonUSA

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