Functional imaging of bipolar illness

doi:10.1017/CBO9780511782091.008

7 - Functional imaging of bipolar illness

from Section II - Mood Disorders

Published online by Cambridge University Press: 10 January 2011

William M. Marchand and

Deborah A. Yurgelun-Todd

Edited by

Martha E. Shenton and

Bruce I. Turetsky

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William M. Marchand: Affiliation:
Department of Psychiatry University of Utah School of Medicine Salt Lake City, UT, USA
Deborah A. Yurgelun-Todd: Affiliation:
Department of Psychiatry Salt Lake City VA Healthcare System and Department of PsychiatryUniversity of Utah School of Medicine Salt Lake City, UT, USA
Martha E. Shenton: Affiliation:
VA Boston Healthcare System and Brigham and Women's Hospital, Harvard Medical School
Bruce I. Turetsky: Affiliation:
University of Pennsylvania

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Summary

Introduction

Bipolar disorder (BD) is a complex neuropsychiatric disorder characterized by cognitive, emotional and motor symptoms. Multiple neuroimaging modalities have been applied to patients with bipolar disorder; nevertheless, the underlying neurobiology remains poorly understood. Data acquired with increasingly sophisticated functional neuroimaging techniques in combination with advances in neuroscience have the potential to enhance our understanding of the neuropathy of this illness. Further, these studies may provide a means of assessing those brain functional abnormalities associated with a specific phase of illness and those consistent across mood states, thus differentiating brain changes which are trait markers from those functional changes related to mood state. Moreover, functional neuroimaging is being incorporated into the development of biomarkers that may aid in clinical diagnosis and treatment selection.

The number of functional imaging studies reported in the literature has increased dramatically in recent years. Comparison of these studies is complicated by several factors. These include the fact that patient groups have been studied with significant differences in clinical variables, such as comorbidity, duration of illness and current treatment. Also, many different activation paradigms have been used for functional magnetic resonance imaging (fMRI) studies and some metabolism and blood flow studies have been conducted at rest. Nonetheless, a review of functional imaging studies may provide insights into the neurobiology of this disorder.

Since bipolar illness is a disorder characterized by dysregulation of affect as well as changes in cognitive function, it is likely that the underlying neuropathology involves the neural systems involved in the production and regulation of affect.

Keywords

basal ganglia dysfunction bipolar disorder brain regions ventral emotional control systems supplementary motor area dysfunction primary motor cortex dysfunction dorsal emotional control systems functional imaging studies

Type: Chapter
Information: Understanding Neuropsychiatric Disorders
Insights from Neuroimaging
, pp. 109 - 124

DOI: https://doi.org/10.1017/CBO9780511782091.008 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2010

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References

Adler, C M, Delbello, M P, Mills, N P, Schmithorst, V, Holland, S and Strakowski, S M. 2005. Comorbid ADHD is associated with altered patterns of neuronal activation in adolescents with bipolar disorder performing a simple attention task. Bipolar Disord 7, 577–88.Google Scholar

Adler, C M, Holland, S K, Schmithorst, V, Tuchfarber, M J and Strakowski, S M. 2004. Changes in neuronal activation in patients with bipolar disorder during performance of a working memory task. Bipolar Disord 6, 540–9.Google Scholar

Altshuler, L L, Bookheimer, S Y, Townsend, J, et al. 2005. Blunted activation in orbitofrontal cortex during mania: A functional magnetic resonance imaging study. Biol Psychiatry 58, 763–9.Google Scholar

Altshuler, L, Bookheimer, S, Townsend, J, et al. 2008. Regional brain changes in bipolar I depression: A functional magnetic resonance imaging study. Bipolar Disord 10, 708–17.Google Scholar

Baxter, L R, Schwartz, J M, Phelps, M E, et al. 1989. Reduction of prefrontal cortex glucose metabolism common to three types of depression. Arch Gen Psychiatry 46, 243–50.Google Scholar

Benabarre, A, Vieta, E, Martin, F, et al. 2004. Clinical value of 99mTc-HMPAO SPECT in depressed bipolar I patients. Psychiatry Res 132, 285–9.Google Scholar

Benabarre, A, Vieta, E, Martinez-Aran, A, et al. 2005. Neuropsychological disturbances and cerebral blood flow in bipolar disorder. Aust N Z J Psychiatry 39, 227–34.Google Scholar

Benedetti, F, Bernasconi, A, Blasi, V, et al. 2007. Neural and genetic correlates of antidepressant response to sleep deprivation: A functional magnetic resonance imaging study of moral valence decision in bipolar depression. Arch Gen Psychiatry 64, 179–87.Google Scholar

Berns, G S, Martin, M and Proper, S M. 2002. Limbic hyperreactivity in bipolar II disorder. Am J Psychiatry 159, 304–06.Google Scholar

Blumberg, H P, Leung, H C, Skudlarski, P, et al. 2003a. A functional magnetic resonance imaging study of bipolar disorder: State- and trait-related dysfunction in ventral prefrontal cortices. Arch Gen Psychiatry 60, 601–09.Google Scholar

Blumberg, H P, Martin, A, Kaufman, J, et al. 2003b. Frontostriatal abnormalities in adolescents with bipolar disorder: Preliminary observations from functional MRI. Am J Psychiatry 160, 1345–7.Google Scholar

Blumberg, H P, Stern, E, Martinez, D, et al. 2000. Increased anterior cingulate and caudate activity in bipolar mania. Biol Psychiatry 48, 1045–52.Google Scholar

Blumberg, H P, Stern, E, Ricketts, S, et al. 1999. Rostral and orbital prefrontal cortex dysfunction in the manic state of bipolar disorder. Am J Psychiatry 156, 1986–8.Google Scholar

Caligiuri, M P, Brown, G G, Meloy, M J, et al. 2003. An fMRI study of affective state and medication on cortical and subcortical brain regions during motor performance in bipolar disorder. Psychiatry Res 123, 171–82.Google Scholar

Caligiuri, M P, Brown, G G, Meloy, M J, et al. 2004. A functional magnetic resonance imaging study of cortical asymmetry in bipolar disorder. Bipolar Disord 6, 183–96.Google Scholar

Caligiuri, M P, Brown, G G, Meloy, M J, et al. 2006. Striatopallidal regulation of affect in bipolar disorder. J Affect Disord 91, 235–42.Google Scholar

Chang, K, Adleman, N E, Dienes, K, Simeonova, D I, Menon, V and Reiss, A. 2004. Anomalous prefrontal–subcortical activation in familial pediatric bipolar disorder: A functional magnetic resonance imaging investigation. Arch Gen Psychiatry 61, 781–92.Google Scholar

Chang, K D, Wagner, C, Garrett, A, Howe, M and Reiss, A. 2008. A preliminary functional magnetic resonance imaging study of prefrontal–amygdalar activation changes in adolescents with bipolar depression treated with lamotrigine. Bipolar Disord 10, 426–31.Google Scholar

Chen, C H, Lennox, B, Jacob, R, et al. 2006. Explicit and implicit facial affect recognition in manic and depressed States of bipolar disorder: A functional magnetic resonance imaging study. Biol Psychiatry 59, 31–9.Google Scholar

Culha, A F, Osman, O, Dogangun, Y, et al. 2008. Changes in regional cerebral blood flow demonstrated by 99mTc-HMPAO SPECT in euthymic bipolar patients. Eur Arch Psychiatry Clin Neurosci 258, 144–51.Google Scholar

Curtis, V A, Dixon, T A, Morris, R G, et al. 2001. Differential frontal activation in schizophrenia and bipolar illness during verbal fluency. J Affect Disord 66, 111–21.Google Scholar

Davidson, R J. 1998. Anterior electrophysiological asymmetries, emotion, and depression: Conceptual and methodological conundrums. Psychophysiology 35, 607–14.Google Scholar

Dickstein, D P, Rich, B A, Roberson-Nay, R, et al. 2007. Neural activation during encoding of emotional faces in pediatric bipolar disorder. Bipolar Disord 9, 679–92.Google Scholar

Drapier, D, Surguladze, S, Marshall, N, et al. 2008. Genetic liability for bipolar disorder is characterized by excess frontal activation in response to a working memory task. Biol Psychiatry 64, 513–20.Google Scholar

Drevets, W C, Price, J L, Bardgett, M E, Reich, T, Todd, R D and Raichle, M E. 2002. Glucose metabolism in the amygdala in depression: Relationship to diagnostic subtype and plasma cortisol levels. Pharmacol Biochem Behav 71, 431–47.Google Scholar

Dunn, R T, Kimbrell, T A, Ketter, T A, et al. 2002. Principal components of the Beck Depression Inventory and regional cerebral metabolism in unipolar and bipolar depression. Biol Psychiatry 51, 387–99.Google Scholar

Dye, S M, Spence, S A, Bench, C J, et al. 1999. No evidence for left superior temporal dysfunction in asymptomatic schizophrenia and bipolar disorder. PET study of verbal fluency. Br J Psychiatry 175, 367–74.Google Scholar

Elliott, R, Ogilvie, A, Rubinsztein, J S, Calderon, G, Dolan, R J and Sahakian, B J. 2004. Abnormal ventral frontal response during performance of an affective go/no go task in patients with mania. Biol Psychiatry 55, 1163–70.Google Scholar

Foland, L C, Altshuler, L L, Bookheimer, S Y, Eisenberger, N, Townsend, J and Thompson, P M. 2008. Evidence for deficient modulation of amygdala response by prefrontal cortex in bipolar mania. Psychiatry Res 162, 27–37.Google Scholar

Frangou, S. 2005. The Maudsley Bipolar Disorder Project. Epilepsia 46 (Suppl 4), 19–25.Google Scholar

Frangou, S, Kington, J, Raymont, V and Shergill, S S. 2008. Examining ventral and dorsal prefrontal function in bipolar disorder: A functional magnetic resonance imaging study. Eur Psychiatry 23, 300–08.Google Scholar

Goel, V and Dolan, R J. 2003. Reciprocal neural response within lateral and ventral medial prefrontal cortex during hot and cold reasoning. Neuroimage 20, 2314–21.Google Scholar

Goodwin, G M, Cavanagh, J T, Glabus, M F, Kehoe, R F, O'Carroll, R E and Ebmeier, K P. 1997. Uptake of 99mTc-exametazime shown by single photon emission computed tomography before and after lithium withdrawal in bipolar patients: Associations with mania. Br J Psychiatry 170, 426–30.Google Scholar

Gruber, S A, Rogowska, J and Yurgelun-Todd, D A. 2004. Decreased activation of the anterior cingulate in bipolar patients: An fMRI study. J Affect Disord 82, 191–201.Google Scholar

Gyulai, L, Alavi, A, Broich, K, Reilley, J, Ball, W B and Whybrow, P C. 1997. I-123 iofetamine single-photon computed emission tomography in rapid cycling bipolar disorder: A clinical study. Biol Psychiatry 41, 152–61.Google Scholar

Haldane, M, Jogia, J, Cobb, A, Kozuch, E, Kumari, V and Frangou, S. 2008. Changes in brain activation during working memory and facial recognition tasks in patients with bipolar disorder with Lamotrigine monotherapy. Eur Neuropsychopharmacol 18, 48–54.Google Scholar

Hariri, A R, Mattay, V S, Tessitore, A, Fera, F and Weinberger, D R. 2003. Neocortical modulation of the amygdala response to fearful stimuli. Biol Psychiatry 53, 494–501.Google Scholar

Ito, H, Kawashima, R, Awata, S, et al. 1996. Hypoperfusion in the limbic system and prefrontal cortex in depression: SPECT with anatomic standardization technique. J Nucl Med 37, 410–4.Google Scholar

Jogia, J, Haldane, M., Cobb, A., Kumari, V. and Frangou, S. 2008. Pilot investigation of the changes in cortical activation during facial affect recognition with lamotrigine monotherapy in bipolar disorder. Br J Psychiatry 192, 197–201.Google Scholar

Ketter, T A, Kimbrell, T A, George, M S, et al. 2001. Effects of mood and subtype on cerebral glucose metabolism in treatment-resistant bipolar disorder. Biol Psychiatry 49, 97–109.Google Scholar

Killgore, W D, Gruber, S A and Yurgelun-Todd, D A. 2008. Abnormal corticostriatal activity during fear perception in bipolar disorder. Neuroreport 19, 1523–7.Google Scholar

Lagopoulos, J, Ivanovski, B and Malhi, G S. 2007. An event-related functional MRI study of working memory in euthymic bipolar disorder. J Psychiatry Neurosci 32, 174–84.Google Scholar

Lagopoulos, J and Malhi, G S. 2007. A functional magnetic resonance imaging study of emotional Stroop in euthymic bipolar disorder. Neuroreport 18, 1583–7.Google Scholar

Lawrence, N S, Williams, A M, Surguladze, S, et al. 2004. Subcortical and ventral prefrontal cortical neural responses to facial expressions distinguish patients with bipolar disorder and major depression. Biol Psychiatry 55, 578–87.Google Scholar

Lennox, B R, Jacob, R, Calder, A J, Lupson, V and Bullmore, E T. 2004. Behavioural and neurocognitive responses to sad facial affect are attenuated in patients with mania. Psychol Med 34, 795–802.Google Scholar

Levesque, J, Eugene, F, Joanette, Y, et al. 2003. Neural circuitry underlying voluntary suppression of sadness. Biol Psychiatry 53, 502–10.Google Scholar

Liotti, M, Mayberg, H S, Brannan, S K, Mcginnis, S, Jerabek, P and Fox, P T. 2000. Differential limbic–cortical correlates of sadness and anxiety in healthy subjects: implications for affective disorders. Biol Psychiatry 48, 30–42.Google Scholar

Malhi, G S, Lagopoulos, J, Owen, A M, Ivanovski, B, Shnier, R and Sachdev, P. 2007a. Reduced activation to implicit affect induction in euthymic bipolar patients: an fMRI study. J Affect Disord 97, 109–22.Google Scholar

Malhi, G S, Lagopoulos, J, Sachdev, P S, Ivanovski, B and Shnier, R. 2005. An emotional Stroop functional MRI study of euthymic bipolar disorder. Bipolar Disord 7 (Suppl 5), 58–69.Google Scholar

Malhi, G S, Lagopoulos, J, Sachdev, P S, Ivanovski, B, Shnier, R and Ketter, T. 2007b. Is a lack of disgust something to fear? A functional magnetic resonance imaging facial emotion recognition study in euthymic bipolar disorder patients. Bipolar Disord 9, 345–57.Google Scholar

Malhi, G S, Lagopoulos, J, Sachdev, P, Mitchell, P B, Ivanovski, B and Parker, G B. 2004a. Cognitive generation of affect in hypomania: An fMRI study. Bipolar Disord 6, 271–85.Google Scholar

Malhi, G S, Lagopoulos, J, Ward, P B, et al. 2004b. Cognitive generation of affect in bipolar depression: An fMRI study. Eur J Neurosci 19, 741–54.Google Scholar

Marchand, W R, Lee, J N, Thatcher, G W, et al. 2007a. A functional MRI study of a paced motor activation task to evaluate frontal–subcortical circuit function in bipolar depression. Psychiatry Res 155, 221–30.Google Scholar

Marchand, W R, Lee, J N, Thatcher, J, Thatcher, G W, Jensen, C and Starr, J. 2007b. A preliminary longitudinal fMRI study of frontal–subcortical circuits in bipolar disorder using a paced motor activation paradigm. J Affect Disord 103, 237–41.Google Scholar

Matsuo, K, Kouno, T, Hatch, J P, et al. 2007. A near-infrared spectroscopy study of prefrontal cortex activation during a verbal fluency task and carbon dioxide inhalation in individuals with bipolar disorder. Bipolar Disord 9, 876–83.Google Scholar

Mayberg, H S. 1997. Limbic–cortical dysregulation: A proposed model of depression. J Neuropsychiatry Clin Neurosci 9, 471–81.Google Scholar

Mcintosh, A M, Whalley, H C, Mckirdy, J, et al. 2008. Prefrontal function and activation in bipolar disorder and schizophrenia. Am J Psychiatry 165, 378–84.Google Scholar

Migliorelli, R, Starkstein, SE, Teson, A, et al. 1993. SPECT findings in patients with primary mania. J Neuropsychiatry Clin Neurosci 5, 379–83.Google Scholar

Mitchell, R L, Elliott, R, Barry, M, Cruttenden, A and Woodruff, P W. 2004. Neural response to emotional prosody in schizophrenia and in bipolar affective disorder. Br J Psychiatry 184, 223–30.Google Scholar

Monks, P J, Thompson, J M, Bullmore, E T, et al. 2004. A functional MRI study of working memory task in euthymic bipolar disorder: Evidence for task-specific dysfunction. Bipolar Disord 6, 550–64.Google Scholar

Nelson, E E, Vinton, D T, Berghorst, L, et al. 2007. Brain systems underlying response flexibility in healthy and bipolar adolescents: An event-related fMRI study. Bipolar Disord 9, 810–9.Google Scholar

Nestler, E J, Barrot, M, Dileone, R J, Eisch, A J, Gold, S J and Monteggia, L M. 2002. Neurobiology of depression. Neuron 34, 13–25.Google Scholar

O'Connell, R A, Heertum, R L, Luck, D, et al. 1995. Single-photon emission computed tomography of the brain in acute mania and schizophrenia. J Neuroimaging 5, 101–04.Google Scholar

Pavuluri, M N, O'Connor, M M, Harral, E M and Sweeney, J A. 2008. An fMRI study of the interface between affective and cognitive neural circuitry in pediatric bipolar disorder. Psychiatry Res 162, 244–55.Google Scholar

Phillips, M L, Drevets, W C, Rauch, S L and Lane, R. 2003. Neurobiology of emotion perception I: The neural basis of normal emotion perception. Biol Psychiatry 54, 504–14.Google Scholar

Rich, B A, Fromm, S J, Berghorst, L H, et al. 2008. Neural connectivity in children with bipolar disorder: Impairment in the face emotion processing circuit. J Child Psychol Psychiatry 49, 88–96.Google Scholar

Ridderinkhof, K R, Ullsperger, M, Crone, E A and Nieuwenhuis, S. 2004. The role of the medial frontal cortex in cognitive control. Science 306, 443–7.Google Scholar

Roth, R M, Koven, N S, Randolph, J J, et al. 2006. Functional magnetic resonance imaging of executive control in bipolar disorder. Neuroreport 17, 1085–9.Google Scholar

Rubin, E, Sackeim, H A, Prohovnik, I, Moeller, J R, Schnur, D B and Mukherjee, S. 1995. Regional cerebral blood flow in mood disorders: IV. Comparison of mania and depression. Psychiatry Res 61, 1–10.Google Scholar

Salamone, J D. 2007. Functions of mesolimbic dopamine: Changing concepts and shifting paradigms. Psychopharmacology (Berl) 191, 389.Google Scholar

Silverstone, P H, Bell, E C, Willson, M C, Dave, S and Wilman, A H. 2005. Lithium alters brain activation in bipolar disorder in a task- and state-dependent manner: An fMRI study. Ann Gen Psychiatry 4, 14.Google Scholar

Stern, C E, Owen, A M, Tracey, I, Look, R B, Rosen, B R and Petrides, M. 2000. Activity in ventrolateral and mid-dorsolateral prefrontal cortex during nonspatial visual working memory processing: Evidence from functional magnetic resonance imaging. Neuroimage 11, 392–9.Google Scholar

Strakowski, S M, Adler, C M, Holland, S K, Mills, N and Delbello, M P. 2004. A preliminary FMRI study of sustained attention in euthymic, unmedicated bipolar disorder. Neuropsychopharmacology 29, 1734–40.Google Scholar

Strakowski, S M, Adler, C M, Holland, S K, Mills, N P, Delbello, M P and Eliassen, J C. 2005. Abnormal FMRI brain activation in euthymic bipolar disorder patients during a counting Stroop interference task. Am J Psychiatry 162, 1697–705.Google Scholar

Yurgelun-Todd, D A, Gruber, S A, Kanayama, G, Killgore, W D, Baird, A A and Young, A D. 2000. fMRI during affect discrimination in bipolar affective disorder. Bipolar Disord 2, 237–48.Google Scholar

Yurgelun-Todd, D A, and Ross, A J. 2006. Functional magnetic resonance imaging studies in bipolar disorder [review]. CNS Spectr 11, 287–97.Google Scholar

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7 - Functional imaging of bipolar illness

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