Molecular psychiatry · 2026

Psychotropic medications and their interactions with subcortical brain volume in bipolar disorder: An ENIGMA mega-analysis.

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King Sinead, O'Connor John, Corley Emma, Tronchin Giulia, Fontana Elisa, Nabulsi Leila, Kang Melody J Y, Radua Joaquim, Hallahan Brian, Abé Christoph, Alda Martin, Alnæs Dag, Alonso-Lana Silvia, Amoretti Silvia, Bauer Jochen, Benedetti Francesco, Berger Klaus, Berk Michael, Bøen Erlend, Böhnlein Joscha, Boye Birgitte, Bravi Beatrice, Canales-Rodríguez Erick J, Dannlowski Udo, Demro Caroline, Di Giorgio Annabella, Diaz-Zuluaga Ana M, Elvsåshagen Torbjørn, Favre Pauline, Erwin-Grabner Tracy, Forte María Florencia, Fullerton Janice M, Furlong Lisa S, Rossell Susan L, Glahn David C, Goldstein Benjamin I, Gotlib Ian H, Goya-Maldonado Roberto, Green Melissa J, Grotegerd Dominik, Gruber Oliver, Haarman Bartholomeus C M, Hahn Tim, Hajek Tomas, Hater Leonie, Hermesdorf Marco, Houenou Josselin, Howells Fleur M, Karantonis James A, Kennedy Kody G, Kircher Tilo, Klahn Anna Luisa, Konowski Maximilian, Krämer Bernd, Lahud Elijah, Kuplicki Rayus, Landén Mikael, López-Jaramillo Carlos, MacIntosh Bradley J, Meinert Hannah, Meinert Susanne, Melloni Elisa M T, Mitchell Philip B, Mwangi Benson, Nenadić Igor, Overs Bronwyn J, Parker Nadine, Pearlson Godfrey, Pomarol-Clotet Edith, Prisciandaro James J, Quidé Yann, Roberts Gloria, Rodrigue Amanda, Rodríguez-Cano Elena, Rauer Lisa, Sacchet Matthew D, Salvador Raymond, Sambataro Fabio, Satterthwaite Theodore D, Savitz Jonathan, Scheffler Freda, Schürmeyer Navid, Shen Chen, Sim Kang, Soares Jair C, Solanes Aleix, Soeiro-de-Souza Márcio Gerhardt, Sponheim Scott R, Stein Dan J, Stein Frederike, Temmingh Henk S, Teutenberg Lea, Thomopoulos Sophia I, Urosevic Snezana, Van Rheenen Tamsyn E, Vieta Eduard, Westlye Lars T, Wolf Daniel H, Wu Mon-Ju, Yatham Lakshmi N, Zunta-Soares Giovana B, Cannon Dara M, Thompson Paul M, Andreassen Ole A, Ching Christopher R K, McDonald Colm, ENIGMA Bipolar Disorder Working Group

Аннотация

MRI studies in bipolar disorder (BD) have yielded inconsistent findings, partly due to the varied use of psychotropic medications. This study utilised a mega-analysis approach, accounting for concurrent medication status (syndrome-based and Neuroscience-based Nomenclature (NbN) classifications), in order to assess the association of medication status with subcortical brain volumes in BD. Data from 2,664 BD patients and 4,065 controls (CN) were pooled from 34 research groups as part of the ENIGMA Bipolar Disorder Working Group. Standardized ENIGMA protocols were used to measure subcortical brain volumes. Linear-mixed-effects regression evaluated the association between psychotropic medications and subcortical volumes, and moderation analyses explored interactions. Medication-free patients (n = 410) showed mild ventricular enlargement (d = 0.07) and increased putamen volume (d = 0.06) compared to CN. Patients taking psychotropic medications exhibited smaller subcortical volumes (d = -0.06 to -0.11) and larger ventricles (d = 0.11 to 0.19). Use of antiepileptic and antipsychotic medications was associated with smaller hippocampal and thalamic volumes (d = -0.07 to -0.14), while NbN classification indicated that the categories of 'valproate' and 'dopamine and other monoamine receptor antagonists' are key variables when considering volume differences between BD and CN. Concurrent lithium use weakened the negative association between antiepileptic use and hippocampal volume (β = 0.19, q = 0.038) in patients. Medication status is associated with altered subcortical brain volumes in BD. The NbN classification provides a useful framework for future studies, emphasizing the need for comprehensive longitudinal research to further unravel complex clinical-pharmacological-neurobiological interactions in BD.

Предметные рубрики MeSH

Humans Bipolar Disorder Magnetic Resonance Imaging Brain Psychotropic Drugs Female Male Adult Middle Aged Organ Size Antipsychotic Agents Hippocampus Anticonvulsants Thalamus

Psychotropic medications and their interactions with subcortical brain volume in bipolar disorder: An ENIGMA mega-analysis.

Ошибки и ограничения

Аннотация

Предметные рубрики MeSH