{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T00:52:37Z","timestamp":1784335957148,"version":"3.55.0"},"reference-count":37,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2016,10,19]],"date-time":"2016-10-19T00:00:00Z","timestamp":1476835200000},"content-version":"vor","delay-in-days":48,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100008207","name":"AstraZeneca Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008207","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2016,9]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Bipolar I disorder (<jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content>\u2010I) is associated with gray matter volume (<jats:styled-content style=\"fixed-case\">GMV<\/jats:styled-content>) alterations in neural regions important for emotional regulation. Reductions found in patients with multiple episodes are not seen at illness onset, suggesting that changes occur with illness progression, although no prospective studies to date have examined this. In the present study, we assessed <jats:styled-content style=\"fixed-case\">GMV<\/jats:styled-content> at baseline and one year following a first manic episode, examining the impact of episode recurrence on the trajectory of change.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 41 recently remitted first manic episode patients with <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content>\u2010I and 25 healthy subjects (<jats:styled-content style=\"fixed-case\">HS<\/jats:styled-content>) underwent 3T magnetic resonance imaging at baseline and one year later. Using voxel\u2010based morphometry, we compared <jats:styled-content style=\"fixed-case\">GMV<\/jats:styled-content> change between <jats:styled-content style=\"fixed-case\">HS<\/jats:styled-content>, patients who experienced a recurrence of a mood episode (<jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content><jats:sub>recurr<\/jats:sub>), and patients in sustained remission (<jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content><jats:sub>well<\/jats:sub>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">GMV<\/jats:styled-content> change from baseline to one year did not differ significantly between <jats:styled-content style=\"fixed-case\">HS<\/jats:styled-content> and the full <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content>\u2010I group or <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content><jats:sub>well<\/jats:sub> and <jats:styled-content style=\"fixed-case\">HS<\/jats:styled-content>. However, the <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content><jats:sub>recurr<\/jats:sub> group had greater <jats:styled-content style=\"fixed-case\">GMV<\/jats:styled-content> loss than <jats:styled-content style=\"fixed-case\">HS<\/jats:styled-content> in left frontal and bilateral temporal regions, and <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content><jats:sub>well<\/jats:sub> patients involving bilateral frontal, temporal and left parietal regions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">GMV<\/jats:styled-content> change early in the course of <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content>\u2010I is associated with clinical outcome, such that neuroprogression found in patients who experience a recurrence of a mood episode is not seen in those with sustained remission. These findings have important implications for the treatment of <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content>\u2010I as they suggest that prevention of recurrence might minimize neuroprogression of the disease, possibly requiring a multipronged early intervention approach to achieve this goal.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bdi.12437","type":"journal-article","created":{"date-parts":[[2016,10,19]],"date-time":"2016-10-19T11:15:19Z","timestamp":1476875719000},"page":"511-519","source":"Crossref","is-referenced-by-count":61,"title":["Neuroprogression and episode recurrence in bipolar I disorder: A study of gray matter volume changes in first\u2010episode mania and association with clinical outcome"],"prefix":"10.1111","volume":"18","author":[{"given":"Jan\u2010Marie","family":"Kozicky","sequence":"first","affiliation":[{"name":"Department of Psychiatry University of British Columbia  Vancouver BC 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