Psychology

Middle temporal gyrus

Temporal cortex

Fusiform gyrus

White matter

Voxel-based morphometry

Voxel

Neuroscience

Prefrontal cortex

Medial frontal gyrus

Superior frontal gyrus

Gyrus

Insula

Magnetic resonance imaging

Functional magnetic resonance imaging

Precuneus

Cognition

Superior temporal gyrus

Radiology

Middle frontal gyrus

Resting state fMRI

Limbic lobe

Inferior frontal gyrus

Neuroimaging

Medicine

Psychological Medicine

Background Numerous studies of resting-state functional imaging and voxel-based morphometry (VBM) have revealed differences in specific brain regions of patients with bipolar disorder (BD), but the results have been inconsistent. Methods A whole-brain voxel-wise meta-analysis was conducted on resting-state functional imaging and VBM studies that compared differences between patients with BD and healthy controls using Seed-based d Mapping with Permutation of Subject Images software. Results A systematic literature search identified 51 functional imaging studies (1842 BD and 2190 controls) and 83 VBM studies (2790 BD and 3690 controls). Overall, patients with BD displayed increased resting-state functional activity in the left middle frontal gyrus, right inferior frontal gyrus (IFG) extending to the right insula, right superior frontal gyrus and bilateral striatum, as well as decreased resting-state functional activity in the left middle temporal gyrus extending to the left superior temporal gyrus and post-central gyrus, left cerebellum, and bilateral precuneus. The meta-analysis of VBM showed that patients with BD displayed decreased VBM in the right IFG extending to the right insula, temporal pole and superior temporal gyrus, left superior temporal gyrus extending to the left insula, temporal pole, and IFG, anterior cingulate cortex, left superior frontal gyrus (medial prefrontal cortex), left thalamus, and right fusiform gyrus. Conclusions The multimodal meta-analyses suggested that BD showed similar patterns of aberrant brain activity and structure in the insula extending to the temporal cortex, fronto-striatal-thalamic, and default-mode network regions, which provide useful insights for understanding the underlying pathophysiology of BD.

Functional and structural brain differences in bipolar disorder: a multimodal meta-analysis of neuroimaging studies