Evidence for reduced dentate gyrus and fimbria volume in bipolar II disorder

Objectives: Dentate gyrus (DG)-dependent inhibition of the stress response might play an important role in mood disorders. During stress, hippocampal projections traversing the fimbria, a white matter bundle on the hippocampal surface, inhibit the hypothalamicpituitaryadrenal (HPA) axis. The aim of the present study was to measure the volumes of the DGcornu ammonis 4 (DGCA4) and fimbria in patients with bipolar II disorder (BD-II) and healthy controls using a recently developed magnetic resonance imaging (MRI)-based technique. Methods: Thirty-seven individuals with a DSM-IV diagnosis of BD-II and 42 healthy controls underwent 3-Tesla MRI. Hippocampal subfield volumes were estimated using a novel segmentation algorithm implemented in FreeSurfer. Results: In patients with BD-II there was a significant reduction in the volume of the left [analysis of covariance (ANCOVA), F=7.84, p=0.006] and total (left+right) (F=4.01, p=0.047) DGCA4 and left (F=4.38, p=0.040) and total (F=4.15, p=0.045) fimbria compared to healthy controls. Explorative analyses indicated a smaller left CA23 volume in subjects with BD-II compared to healthy controls, and a reduced left fimbria volume in unmedicated patients compared to medicated patients and controls. Conclusions: Our results provide evidence for the involvement of the DG and fimbria in BD-II. Longitudinal studies of the DG and fimbria with assessments of the HPA axis in BD-II are warranted.