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Studies of the cortical sulcation in bipolar disorder have yielded mixed results, probably due to high variability in clinical phenotype. We investigated whole\u2010brain cortical sulcation in a large sample of selected patients with high neurodevelopmental load.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 263 patients with bipolar disorder I and 320 controls were included in a multicentric magnetic resonance imaging (<jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>) study. All subjects underwent high\u2010resolution T1\u2010weighted brain <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>. Images were processed with an automatized pipeline to extract the global sulcal index (g\u2010<jats:styled-content style=\"fixed-case\">SI<\/jats:styled-content>) and the local sulcal indices (l\u2010<jats:styled-content style=\"fixed-case\">SI<\/jats:styled-content>s) from 12 a priori determined brain regions covering the whole brain. We compared l\u2010<jats:styled-content style=\"fixed-case\">SI<\/jats:styled-content> and g\u2010<jats:styled-content style=\"fixed-case\">SI<\/jats:styled-content> between patients with and without early\u2010onset bipolar disorder and between patients with and without a positive history of psychosis, adjusting for age, gender and handedness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients with early\u2010onset bipolar disorder had a higher l\u2010<jats:styled-content style=\"fixed-case\">SI<\/jats:styled-content> in the right prefrontal dorsolateral region. Patients with psychotic bipolar disorder had a decreased l\u2010<jats:styled-content style=\"fixed-case\">SI<\/jats:styled-content> in the left superior parietal cortex. No group differences in g\u2010<jats:styled-content style=\"fixed-case\">SI<\/jats:styled-content> or l\u2010<jats:styled-content style=\"fixed-case\">SI<\/jats:styled-content> were found between healthy subjects and the whole patient cohort. We could replicate the early\u2010onset finding in an independent cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our work suggests that bipolar disorder is not associated with generalized abnormalities of sulcation, but rather with localized changes of cortical folding restricted to patients with a heavy neurodevelopmental loading. These findings support the hypothesis that bipolar disorder is heterogeneous but may be disentangled using <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>, and suggest the need for investigations into neurodevelopmental deviations in the disorder.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bdi.12664","type":"journal-article","created":{"date-parts":[[2018,7,7]],"date-time":"2018-07-07T07:18:41Z","timestamp":1530947921000},"page":"721-732","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Neurodevelopmental subtypes of bipolar disorder are related to cortical folding patterns: An international multicenter study"],"prefix":"10.1111","volume":"20","author":[{"given":"Samuel","family":"Sarrazin","sequence":"first","affiliation":[{"name":"APHP, DHU PePSY P\u00f4le de psychiatrie et d'addictologie des H\u00f4pitaux Universitaires Henri Mondor  Cr\u00e9teil France"},{"name":"INSERM U955 Team 15 \u201cTranslationnal Psychiatry\u201d  IMRB Cr\u00e9teil France"},{"name":"Fondation FondaMental  Cr\u00e9teil France"},{"name":"Lab. 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