Decreased cortical gyrification in patients with bipolar disorder

Kwan Woo Choi, Kyu Man Han, Aram Kim, Wooyoung Kang, Youbin Kang, Woo Suk Tae, Byung Joo Ham

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)


Background 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). Methods 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. Results 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. Conclusions 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 languageEnglish
Pages (from-to)2232-2244
Number of pages13
JournalPsychological Medicine
Issue number12
Publication statusPublished - 2022 Sept 16

Bibliographical note

Publisher Copyright:
Copyright © The Author(s) 2020. Published by Cambridge University Press.


  • Bipolar disorder
  • brain magnetic resonance imaging
  • cortical folding
  • endophenotype
  • local gyrification index

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health


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