Neural correlates of delusion in bipolar depression

Daniele Radaelli, Sara Poletti, Irene Gorni, Clara Locatelli, Enrico Smeraldi, Cristina Colombo, Francesco Benedetti

Research output: Contribution to journalArticlepeer-review


Approximately one-half of all patients affected by bipolar disorder present psychotic features at least in one occasion. This factor worsens the personal and social burden of the disease. Several studies find an altered brain activity in mesolimbic and prefrontal regions in relation to aberrant attribution of salience to stimuli in delusional patients. The aim of the present study is to investigate gray matter (GM) structural correlates of the past history of delusions in a sample of bipolar patients. The sample includes 34 delusional and 39 non-delusional bipolar patients. Brain-imaging volumetric sequences were acquired on a 3.0. T scanner. Voxel based morphometry (VBM) was performed comparing delusional and non-delusional patients. VBM analysis found significant (p=0.001) differences in prefrontal areas and in the insula where delusional patients show lower GM volume compared to non-delusional patients. The main finding of the present study is a reduction of gray matter volume in the dorsolateral prefrontal cortex and in the insula of delusional patients. This result supports the hypothesis of abnormalities in salience and executive-control networks of delusional patients, which could be associated with an aberrant assignment of salience to the elements of one's own experience that is linked to delusion and psychotic symptoms.

Original languageEnglish
Pages (from-to)1-5
Number of pages5
JournalPsychiatry Research - Neuroimaging
Issue number1
Publication statusPublished - Jan 30 2014


  • Bipolar disorder
  • Delusion
  • Salience
  • Voxel based morphometry

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Radiology Nuclear Medicine and imaging
  • Neuroscience (miscellaneous)


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