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Previous studies in animals and humans have suggested that lithium has a neuroprotective effect, might prevent the development of dementia, and could increase gray matter volume in bipolar patients. This elegant study using magnetic resonance imaging (MRI) is the first to measure gray matter volume in mood-stabilizer–naive bipolar patients.
The 22 patients (19 depressed; 3 euthymic) underwent MRI, initially when medication-free and again after being randomized to lithium or valproate for 16 weeks (1–3 additional scans). A group of 14 healthy controls underwent MRI twice. In a mixed-model regression analysis of 93 scans, only lithium-treated patients had specific gray matter increases (estimated at 2.56%), which peaked at 10 to 12 weeks and p…