Elevated Left and Reduced Right Orbitomedial Prefrontal Fractional Anisotropy in Adults With Bipolar Disorder Revealed by Tract-Based Spatial Statistics

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Abstract
Bipolar disorder (BD) remains 1 of the 10 most debilitating illnesses worldwide.1 Neuroimaging investigations have aimed to identify functional and structural neural circuitry abnormalities that may reflect pathogenetic processes of the disorder,2 particularly neural abnormalities implicated in mood dysregulation, a key symptom of BD. Although few, these studies2-4 provide some evidence for functional abnormalities in neural systems that may be associated with the following key symptoms: (1) abnormally increased activity in a subcortical limbic-centered system underlying emotion processing and (2) abnormally decreased activity in a system that includes ventral and dorsal prefrontal cortices underlying cognitive control processes. These findings require replication, but they provide a basic framework to guide examination of brain structure in subjects with BD.