Neuroprogressive effects of lifetime illness duration in older adults with bipolar disorder

Ariel G. Gildengers, Kuo Hsuan Chung, Shou Hung Huang, Amy Begley, Howard J. Aizenstein, Shang Ying Tsai

Research output: Contribution to journalArticlepeer-review

48 Citations (Scopus)


OBJECTIVE: The aim of the present study was to examine the long-term effects of bipolar disorder (BD) on brain structure (gray matter volumes).

METHODS: Fifty-four adults with BD [mean (standard deviation) age = 64.4 (5.4) years] underwent brain MR imaging along with comprehensive clinical assessment. Total gray matter, hippocampal, and amygdala volumes were extracted using methods developed through the Geriatric Neuroimaging Laboratory at the University of Pittsburgh (Pittsburgh, PA, USA).

RESULTS: Lower total gray matter volumes were related to longer duration of BD, even when controlling for current age and cerebrovascular accident (CVA) risk/burden. Additionally, longer exposure to antipsychotic medication was related to lower gray matter volumes. Lower hippocampal volumes were related to total years of antipsychotic agent exposure and CVA risk/burden scores. Older age was related to lower total gray matter, hippocampal, and amgydala volumes.

CONCLUSIONS: Our study of older adults with BD supports the understanding that BD is a neuroprogressive disorder with a longer duration of illness and more antipsychotic agent exposure related to lower gray matter volume.

Original languageEnglish
Pages (from-to)617-623
Number of pages7
JournalBipolar Disorders
Issue number6
Publication statusPublished - Sept 1 2014


  • amygdala
  • bipolar disorder
  • brain
  • hippocampus
  • lithium
  • neuroimaging
  • neuroprogression

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry


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