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Yet, it is unclear whether these individuals at risk and those diagnosed with BD share similar gray matter brain alterations.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291724001193_sec_a2\"><jats:title>Methods:<\/jats:title><jats:p>In 410 male and female participants aged 17\u201335 years, we compared gray matter volume (3T MRI) between individuals at risk for BD (as assessed using the EPI<jats:italic>bipolar<\/jats:italic> scale; <jats:italic>n<\/jats:italic> = 208), patients with a DSM-IV-TR diagnosis of BD (<jats:italic>n<\/jats:italic> = 87), and healthy controls (<jats:italic>n<\/jats:italic> = 115) using voxel-based morphometry in SPM12\/CAT12. We applied conjunction analyses to identify similarities in gray matter volume alterations in individuals at risk and BD patients, relative to healthy controls. We also performed exploratory whole-brain analyses to identify differences in gray matter volume among groups. ComBat was used to harmonize imaging data from seven sites.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291724001193_sec_a3\" sec-type=\"results\"><jats:title>Results:<\/jats:title><jats:p>Both individuals at risk and BD patients showed larger volumes in the right putamen than healthy controls. Furthermore, individuals at risk had smaller volumes in the right inferior occipital gyrus, and BD patients had larger volumes in the left precuneus, compared to healthy controls. These findings were independent of course of illness (number of lifetime manic and depressive episodes, number of hospitalizations), comorbid diagnoses (major depressive disorder, attention-deficit hyperactivity disorder, anxiety disorder, eating disorder), familial risk, current disease severity (global functioning, remission status), and current medication intake.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291724001193_sec_a4\" sec-type=\"conclusions\"><jats:title>Conclusions:<\/jats:title><jats:p>Our findings indicate that alterations in the right putamen might constitute a vulnerability marker for BD.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0033291724001193","type":"journal-article","created":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T10:34:58Z","timestamp":1716806098000},"page":"3071-3081","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":8,"title":["Larger putamen in individuals at risk and with manifest bipolar 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