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

Published online by Cambridge University Press:  12 September 2022

Guanmao Chen
Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
Junjing Wang
Department of Applied Psychology, Guangdong University of Foreign Studies, Guangzhou, 510006, China
Jiaying Gong
Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China Department of Radiology, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
Zhangzhang Qi
Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
Siying Fu
Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
Guixian Tang
Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
Pan Chen
Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
Li Huang
Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
Ying Wang*
Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
Author for correspondence: Ying Wang, E-mail:



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.


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.


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.


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.

Review Article
Copyright © The Author(s), 2022. Published by Cambridge University Press

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Guanmao Chen, Junjing Wang and Jiaying Gong contributed equally to this work.


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