Brain computed tomography in geriatric manic disorder

Bipolar disorder in older adults: a critical review

“…Several studies have reported results of structural neuroimaging in late life bipolar disorder. Two studies found evidence for increased ventricle brain ratio (VBR) in bipolar disorder compared with age‐matched adults without psychiatric disorders via computed tomography (38, 125). Broadhead & Jacoby (38) found no differences between early and late‐onset groups in VBR.…”

Volumetric brain imaging studies in the elderly with mood disorders

“…In bipolar subjects, CT scans measuring the VBR also have been inconsistent (positive findings [21][22][23][24]; negative findings [25][26][27]. Among MRI studies, most findings were negative [28][29][30][31] (positive [32]), although comparisons of bipolar subjects with schizophrenia subjects tended to be positive [33][34][35] (negative [31]).…”

“…Among MRI studies, most findings were negative [28][29][30][31] (positive [32]), although comparisons of bipolar subjects with schizophrenia subjects tended to be positive [33][34][35] (negative [31]). When elderly bipolar subjects were specifically evaluated, Young et al [27] found that VBR did not differ between subjects and healthy control subjects, but bipolar subjects had greater cortical sulcal widening that correlated with age of onset and age of first manic episode. Tanaka et al [36] suggested that although cortical atrophy in their elderly bipolar subjects was similar with normal control subjects, atrophy may occur at an earlier age in subjects with bipolar illness.…”

The significance of manic syndromes in old age

“…3 Cognitive impairment is most common in the areas of memory and executive functions. 15,16,43,44 Neuroimaging research CT scanning, 45 SPECT 46 and MRI technologies have demonstrated that cerebral organic disorders are most frequently associated with bipolarity in mixed-age, as well as elderly, samples. Elderly manic patients have been found to have increased cortical sulcal widening on CT scanning.…”

“…Elderly manic patients have been found to have increased cortical sulcal widening on CT scanning. 45 An increase in subcortical hyperintensities found in bipolar patients is associated with hypertension, atherosclerotic heart disease and diabetes. 22 This tends to confirm the validity of a vascular subtype for mania or at the very least points to a significant cerebrovascular contribution to bipolarity in old age.…”