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Decreased cortical gyrification in patients with bipolar disorder

Published online by Cambridge University Press:  16 November 2020

Kwan Woo Choi
Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
Kyu-Man Han
Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
Aram Kim
Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
Wooyoung Kang
Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
Youbin Kang
Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
Woo-Suk Tae
Brain Convergence Research Center, Korea University Anam Hospital, Seoul, Republic of Korea
Byung-Joo Ham*
Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea Brain Convergence Research Center, Korea University Anam Hospital, Seoul, Republic of Korea
Author for correspondence: Byung-Joo Ham, E-mail:



An aberrant neural connectivity has been known to be associated with bipolar disorder (BD). Local gyrification may reflect the early neural development of cortical connectivity and has been studied as a possible endophenotype of psychiatric disorders. This study aimed to investigate differences in the local gyrification index (LGI) in each cortical region between patients with BD and healthy controls (HCs).


LGI values, as measured using FreeSurfer software, were compared between 61 patients with BD and 183 HCs. The values were also compared between patients with BD type I and type II as a sub-group analysis. Furthermore, we evaluated whether there was a correlation between LGI values and illness duration or depressive symptom severity in patients with BD.


Patients with BD showed significant hypogyria in various cortical regions, including the left inferior frontal gyrus (pars opercularis), precentral gyrus, postcentral gyrus, superior temporal cortex, insula, right entorhinal cortex, and both transverse temporal cortices, compared to HCs after the Bonferroni correction (p < 0.05/66, 0.000758). LGI was not associated with clinical factors such as illness duration, depressive symptom severity, and lithium treatment. No significant differences in cortical gyrification according to the BD subtype were found.


BD appears to be characterized by a significant regionally localized hypogyria, in various cortical areas. This abnormality may be a structural and developmental endophenotype marking the risk for BD, and it might help to clarify the etiology of BD.

Original Article
Copyright © The Author(s) 2020. Published by Cambridge University Press

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These authors contributed equally to this article as co-first authors.


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