***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND The Heschl gyrus and planum temporale have crucial roles in auditory perception and language processing . Our previous investigation using magnetic resonance imaging ( MRI ) indicated smaller gray matter volumes bilaterally in the Heschl gyrus and in left planum temporale in patients with first-episode schizophrenia but not in patients with first-episode affective psychosis . We sought to determine whether there are progressive decreases in anatomically defined MRI gray matter volumes of the Heschl gyrus and planum temporale in patients with first-episode schizophrenia and also in patients with first-episode affective psychosis . METHODS At a private psychiatric hospital , we conducted a prospect i ve high spatial resolution MRI study that included initial scans of 28 patients at their first hospitalization ( 13 with schizophrenia and 15 with affective psychosis , 13 of whom had a manic psychosis ) and 22 healthy control subjects . Follow-up scans occurred , on average , 1.5 years after the initial scan . RESULTS Patients with first-episode schizophrenia showed significant decreases in gray matter volume over time in the left Heschl gyrus ( 6.9 % ) and left planum temporale ( 7.2 % ) compared with patients with first-episode affective psychosis or control subjects . CONCLUSIONS These findings demonstrate a left-biased progressive volume reduction in the Heschl gyrus and planum temporale gray matter in patients with first-episode schizophrenia in contrast to patients with first-episode affective psychosis and control subjects . Schizophrenia but not affective psychosis seems to be characterized by a postonset progression of neocortical gray matter volume loss in the left superior temporal gyrus and thus may not be developmentally fixed BACKGROUND Functional and morphologic abnormalities of the cingulate cortex have been reported in mood disorder patients . To examine the involvement of anatomic abnormalities of the cingulate in bipolar disorder , we measured the volumes of this structure in untreated and lithium-treated bipolar patients and healthy control subjects , using magnetic resonance imaging ( MRI ) . METHODS The volumes of gray matter at the right and left anterior and posterior cingulate cortices were measured in 11 bipolar patients not taking any psychotropic medications ( aged 38 + /- 11 years , 5 women ) , 16 bipolar patients treated with lithium monotherapy ( aged 33 + /- 11 years , 7 women ) , and 39 healthy control subjects ( aged 37 + /- 10 years , 14 women ) .  Volumetric measurements were made with T1-weighted coronal MRI images , with 1.5-mm-thick slices , at 1.5 T , and were done blindly . RESULTS Using analysis of covariance with age and intracranial volume as covariates , we found that untreated bipolar patients had decreased left anterior cingulate volumes compared with healthy control subjects [ 2.4 + /-.3 cm3 and 2.9 + /-.6 cm3 , respectively ; F(1,58 ) = 6.4 , p = .042 ] and compared with lithium-treated patients [ 3.3 + /-.5 cm3 ; F(1,58 ) = 11.7 , p = .003 ] . The cingulate volumes in lithium-treated patients were not significantly different from those of healthy control subjects . CONCLUSIONS Our findings indicate that anatomic abnormalities in left anterior cingulate are present in bipolar patients . Furthermore , our results suggest that lithium treatment might influence cingulate volumes in bipolar patients , which could possibly reflect postulated neuroprotective effects of lithium BACKGROUND Decreased cau date volumes have been noted in unipolar depressed subjects , especially in the elderly and those with cognitive impairment . No differences have been noted in initial studies of multi-aged bipolar subjects ; however , this region has not been examined in older bipolar subjects . METHODS We examined the cau date nuclei volumes of 36 older bipolar subjects ( mean age 58 ) and 35 older controls ( mean age 62 ) using logistic regression analyses to control for age and gender differences . Differences between late- and early-onset ( age-of-onset before age 45 ) bipolar subjects were also examined , as well as the effect of length of illness . RESULTS The right cau date was noted to be smaller in older bipolar subjects compared with older controls when controlled for sex and age ( p = 0.0448 ) . No differences were noted in overall brain volume nor lateral ventricular volume between the bipolar and control subjects . Late-onset bipolar subjects had a decrease in brain volume ( p = 0.035 ) compared with early-onset bipolar subjects . Late-onset bipolar subjects had a decrease in the right ( p = 0.044 ) and total ( p = 0.04 ) cau date size compared with older controls . CONCLUSIONS Right cau date volume is decreased in older bipolar subjects compared to controls . Bipolar subjects with late-onset illness have significantly decreased right and total cau date volumes compared to controls . This is affected by neither the length of illness nor the age of onset . Late-onset bipolar subjects have decreased total brain volume compared with early-onset bipolar subjects This study examined possible differences in total gray and white matter brain content in bipolar patients and healthy individuals , and their relationship with age . 22 DSM-IV bipolar patients and 22 healthy controls underwent a 1.5-tesla Spoiled Gradient Recalled Acquisition ( SPGR ) MRI . Evaluators blind to patients ’ identities measured total brain , gray and white matter volumes using a semi-automated software . No differences were found for total brain volume , gray matter or white matter volumes between bipolar patients and healthy controls ( MANCOVA , age as covariate , p > 0.05 ) . Age was inversely correlated with total gray matter volume in patients ( r = –0.576 , p = 0.005 ) , but not in controls ( r = –0.193 , p = 0.388 ) . Our findings suggest that any existing gray matter deficits in bipolar disorder are likely to be localized to specific brain regions , rather than generalized . The inverse correlation between age and brain gray matter volumes in bipolar patients , not present in healthy controls , in this sample of mostly middle-aged adults , could possibly indicate more pronounced age-related gray matter decline in bipolar patients , and may be of potential relevance for the pathophysiology of the disorder Echoplanar functional magnetic resonance imaging ( fMRI ) was used in normal human subjects to investigate the role of the amygdala in conditioned fear acquisition and extinction . A simple discrimination procedure was employed in which activation to a visual cue predicting shock ( CS+ ) was compared with activation to another cue presented alone ( CS- ) . CS+ and CS- trial types were intermixed in a pseudor and om order . Functional images were acquired with an asymmetric spin echo pulse sequence from three coronal slices centered on the amygdala . Activation of the amygdala/periamygdaloid cortex was observed during conditioned fear acquisition and extinction . The extent of activation during acquisition was significantly correlated with autonomic indices of conditioning in individual subjects . Consistent with a recent electrophysiological recording study in the rat ( Quirk et al. , 1997 ) , the profile of the amygdala response was temporally grade d , although this dynamic was only statistically reliable during extinction . These results provide further evidence for the conservation of amygdala function across species and implicate an amygdalar contribution to both acquisition and extinction processes during associative emotional learning tasks BACKGROUND Structural brain abnormalities of the medial temporal lobe have been found in people with bipolar disorder ( BPD ) . It is not known whether these abnormalities progress over the course of the illness or how they relate to neuropsychologic functioning . We sought to address these uncertainties in a prospect i ve cohort study of people with bipolar I disorder . METHODS Twenty patients with bipolar I disorder and 21 control subjects were recruited from the community . Participants were group matched for age , sex , and premorbid IQ . Longitudinal change in gray matter density was assessed using magnetic resonance imaging and evaluated using the technique of tensor-based morphometry with SPM2 software . Changes in gray and white matter density were estimated and compared with changes in cognitive function and clinical outcome . RESULTS Patients with BPD showed a larger decline in hippocampal , fusiform , and cerebellar gray matter density over 4 years than control subjects . No significant changes in white matter density were found . Reductions in temporal lobe gray matter correlated with decline in intellectual function and with the number of intervening mood episodes over the follow-up period . CONCLUSIONS Patients with BPD lose hippocampal , fusiform and cerebellar gray matter at an accelerated rate compared with healthy control subjects . This tissue loss is associated with deterioration in cognitive function and illness course Since qualitative CT studies have suggested decreased cerebellar size in patients with bipolar disorder , we performed a quantitative analysis of the cerebellum in patients with bipolar disorder to determine whether high-resolution , thin slice magnetic resonance imaging ( MRI ) morphometry would reveal similar results . Bipolar patients hospitalized for a first manic episode ( n = 16 ) , bipolar patients with prior manic episodes hospitalized for a manic episode ( n = 14 ) , and normal volunteers ( n = 15 ) matched for age , sex , race , and education were recruited and  anatomic brain scans  were acquired using a Picker 1.5 Tesla MRI scanner . Right and left cerebellar hemisphere volumes and vermal areas V1 ( lobules I-V ) , V2 ( lobules VI-VII ) , and V3 ( lobules VIII-X ) were measured . ANCOVA comparing each ROI , adjusting for race , sex , age , total cerebral volume , and substance abuse duration , revealed a significant group effect for vermal V3 area . Specifically , V3 area was significantly smaller in multiple-episode patients than in first-episode patients or healthy volunteers . Number of previous episodes of depression may contribute to this finding . These results suggest that cerebellar vermal atrophy may be a later neurodegenerative event in patients with bipolar disorder who have had multiple affective episodes . The confounding effects of medications are considered OBJECTIVE Ventriculomegaly has been reported in bipolar disorder , although whether it occurs at illness onset or progresses during the course of the disorder is unknown . In addition , it is unknown whether ventriculomegaly in bipolar disorder reflects acquired volume loss or underdevelopment of periventricular structures . METHOD Magnetic resonance imaging was used to measure the volumes of the lateral and third ventricles and periventricular structures ( cau date , putamen , thalamus , hippocampus ) . Patients with DSM-IV bipolar disorder , 18 who were having a first episode and 17 with multiple episodes , were compared with 32 healthy subjects . RESULTS The lateral ventricles were significantly larger in the patients with multiple-episode bipolar disorder than in the first-episode patients or the healthy subjects , even after periventricular and total cerebral volumes were taken into account . Having larger lateral ventricles was associated with a higher number of prior manic episodes . The multiple-episode patients had a smaller total cerebral volume than the healthy subjects but not the first-episode patients . The putamen was significantly larger in the first-episode patients ( and nearly so in the multiple-episode patients ) than in the healthy subjects , although there was no difference between patient groups . CONCLUSIONS Lateral ventriculomegaly was greater in bipolar disorder patients who had had repeated manic episodes , but it does not appear to be secondary to small critical periventricular structures . A larger than normal striatum , which has been reported in previous studies , was observed in first-episode patients . These results support the importance of prospect ively study ing neuroanatomic changes in bipolar disorder BACKGROUND Ventricular enlargement and temporal lobe volume deficits have been demonstrated in patients with affective disorder as well as those with schizophrenia . This study compares quantitative measures of temporal lobe , hemispheric , and ventricular volumes in a group of patients with chronic schizophrenia and bipolar disorder and seeks to determine if the groups can be differentiated on the basis of measured brain abnormalities . METHODS A series of coronal magnetic resonance imaging sections were acquired and analyzed for each of 22 patients with chronic schizophrenia , 14 patients with bipolar disorder , and 15 community volunteers . Eleven regions of interest for each brain were defined , which included temporal lobe , superior temporal gyrus , hemisphere , lateral ventricle , third ventricle , and temporal horn measures . Tissue measures were obtained by tracing , and cerebrospinal fluid measures were obtained by fluid-tissue thresholding using specialized computer software . RESULTS Both patient groups had significantly larger temporal horn volumes in comparison with the control group both before and after correction for intracranial volume . The two patient groups did not differ from each other or controls on any other tissue or fluid measure . CONCLUSIONS This study confirms the findings of increased temporal horn volume in patients with schizophrenia and suggests that this structural abnormality does not differentiate the structural neuropathology of schizophrenia from that of bipolar disorder 
    Output:
    
RESULTS Participants with bipolar disorder are characterised by whole brain and prefrontal lobe volume reductions , and also by increases in the volume of the globus pallidus and lateral ventricles .
In comparison with schizophrenia , bipolar disorder is associated with smaller lateral ventricular volume and enlarged amygdala volume .
There appear to be robust changes in brain volume in bipolar disorder compared with healthy volunteers , although most changes do not seem to be diagnostically specific .
Age and duration of illness appear to be key issues in determining the magnitude of observed effect sizes