Structural correlates of trait impulsivity in patients with bipolar disorder and healthy controls: a surface-based morphometry study

Jan 13, 2017Psychological medicine

Brain surface differences linked to impulsive personality in people with bipolar disorder and healthy individuals

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Abstract

Patients with bipolar disorder exhibited significantly higher impulsivity scores compared to healthy controls.

Trait impulsivity was assessed using the Barratt Impulsiveness Scale in both patients with bipolar disorder and healthy controls.
Higher impulsivity scores in healthy individuals were linked to a thinner cortex in specific frontal brain areas.
In contrast, patients with bipolar disorder showed thicker cortical structures in the right insula associated with higher impulsivity scores.
Overall, patients with bipolar disorder had a thinner cortex in the identified regions compared to healthy controls.
The impact of psychotropic medications on the brain structure and impulsivity findings in bipolar disorder may limit interpretations.

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BACKGROUND: Patients with bipolar disorder (BD) frequently exhibit impulsive behaviors independent of their mood state, and trait impulsivity is increasingly recognized as a crucial BD biomarker. This study aimed to investigate structural correlates of trait impulsivity measured using the Barratt Impulsiveness Scale (BIS) in healthy controls (HCs) and patients with BD.

METHOD: We recruited 59 patients diagnosed with BD I or BD II (35.3 ± 8.5 years) and 56 age- and sex-matched HCs (33.9 ± 7.4 years). Participants underwent structural magnetic resonance imaging and clinical evaluations, and their BIS scores were evaluated. An automated surface-based method (FreeSurfer) was used to measure cortical thickness and generate thickness maps for each participant. Brain-wise regression analysis of the association between cortical thickness and BIS scores was performed separately for BD and HC groups by using a general linear model.

RESULTS: Patients with BD obtained significantly higher BIS scores than HCs. In HCs, higher BIS scores were associated with a thinner cortex in the left inferior, middle and medial frontal cortices. By contrast, in BD patients, higher BIS scores were associated with a thicker cortex in the right insula. Patients with BD showed a thinner cortex than HCs in all these four structures.

CONCLUSIONS: The findings indicate that the left prefrontal cortex plays a cardinal role in trait impulsivity of healthy individuals. Patients with BD have a different structural correlate of trait impulsivity in the right insula. However, the use of various psychotropics in patients with BD may limit our interpretation of BD findings.

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Structural correlates of trait impulsivity in patients with bipolar disorder and healthy controls: a surface-based morphometry study

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