Normal pituitary volumes in children and adolescents with bipolar disorder: A magnetic resonance imaging study

The volume of the pituitary gland in adults with bipolar disorder has previously been reported to be smaller than that of healthy controls. Such abnormalities would be consistent with the HPA dysfunction reported in this illness. We conducted a study of children and adolescents with bipolar disorder to determine whether size abnormalities in the pituitary gland are already present early in illness course. Magnetic resonance imaging (MRI) morphometric analysis of the pituitary gland was carried out in 16 DSM‐IV children and adolescents with bipolar disorder (mean age±sd=15.5±3.4 years) and 21 healthy controls (mean age±sd=16.9±3.8 years). Subjects underwent a 1.5 T MRI, with 3‐D Spoiled Gradient Recalled (SPGR) acquisition. There was no statistically significant difference between pituitary gland volumes of bipolar patients compared to healthy controls (ANCOVA, age, gender, and ICV as covariates; F=1.77, df=1,32, P=.19). There was a statistically significant direct relationship between age and pituitary gland volume in both groups (r=.59, df=17, P=.007 for healthy controls; r=.61, df=12, P=.008 for bipolar patients). No evidence of size abnormalities in the pituitary gland was found in child and adolescent bipolar patients, contrary to reports involving adult bipolar patients. This suggests that anatomical abnormalities in this structure may develop later in illness course as a result of continued HPA dysfunction. Depression and Anxiety 20:182–186, 2004. © 2005 Wiley‐Liss, Inc.

[1]  J. Soares,et al.  Contributions from brain imaging to the elucidation of pathophysiology of bipolar disorder. , 2003, The international journal of neuropsychopharmacology.

[2]  M. Bauer,et al.  Lithium Augmentation Increases the ACTH and Cortisol Response in the Combined DEX/CRH Test in Unipolar Major Depression , 2002, Neuropsychopharmacology.

[3]  A. Yamaura,et al.  Morphological changes on MR imaging of the normal pituitary gland related to age and sex: main emphasis on pubescent females , 2002, Journal of Clinical Neuroscience.

[4]  D. Kupfer,et al.  Decreased pituitary volume in patients with bipolar disorder , 2001, Biological Psychiatry.

[5]  S. Southwick,et al.  Decreased benzodiazepine receptor binding in prefrontal cortex in combat-related posttraumatic stress disorder. , 2000, The American journal of psychiatry.

[6]  B. Gómez-Anson MRI of the Brain. Normal Anatomy and Normal Variants , 2000, Journal of neurology, neurosurgery, and psychiatry.

[7]  L. Staib,et al.  Hippocampal volume reduction in major depression. , 2000, The American journal of psychiatry.

[8]  Koichi Takano,et al.  Normal development of the pituitary gland: assessment with three-dimensional MR volumetry. , 1999, AJNR. American journal of neuroradiology.

[9]  N. Ryan,et al.  Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data. , 1997, Journal of the American Academy of Child and Adolescent Psychiatry.

[10]  A. Rush,et al.  Dexamethasone response, thyrotropin-releasing hormone stimulation, rapid eye movement latency, and subtypes of depression , 1997, Biological Psychiatry.

[11]  A. Elster,et al.  Magnetization transfer imaging of the pituitary: further insights into the nature of the posterior "bright spot". , 1997, Journal of computer assisted tomography.

[12]  J. Soares,et al.  The anatomy of mood disorders—review of structural neuroimaging studies , 1997, Biological Psychiatry.

[13]  Matcheri S. Keshavan,et al.  An objective method for edge detection in MRI morphometry , 1994, European Psychiatry.

[14]  K. Krishnan,et al.  Pituitary size in depression. , 1991, The Journal of clinical endocrinology and metabolism.

[15]  K. Krishnan,et al.  In vivo assessment of pituitary gland volume with magnetic resonance imaging: the effect of age. , 1990, The Journal of clinical endocrinology and metabolism.

[16]  A. Elster,et al.  Pituitary gland: MR imaging of physiologic hypertrophy in adolescence. , 1990, Radiology.

[17]  D. Blackwood,et al.  Disturbed Endocrine Function in the Psychoses , 1989, British Journal of Psychiatry.

[18]  T. H. Newton,et al.  Histochemical characterization and functional significance of the hyperintense signal on MR images of the posterior pituitary. , 1988, AJR. American journal of roentgenology.

[19]  P. Linkowski,et al.  24-hour profiles of adrenocorticotropin, cortisol, and growth hormone in major depressive illness: effect of antidepressant treatment. , 1987, The Journal of clinical endocrinology and metabolism.

[20]  J. F. Lopez,et al.  The HPA axis response to insulin hypoglycemia in depression , 1987, Biological Psychiatry.